Autoimmune inner ear disease: A systematic review of management

Autor:	Rex S Haberman, Nathaniel K. Breslin, Eric S. Sobel, Varun V. Varadarajan
Rok vydání:	2020
Předmět:	medicine.medical_specialty Anakinra business.industry Autoimmune inner ear disease Azathioprine General Medicine Review medicine.disease Infliximab Golimumab Etanercept autoimmune inner ear disease Internal medicine medicine Adalimumab Rituximab Otology Neurotology and Neuroscience business medicine.drug
Zdroj:	Laryngoscope Investigative Otolaryngology
ISSN:	2378-8038
Popis:	Objectives The study systematically reviewed the existing literature on the management of autoimmune inner ear disease (AIED). Study Design Systematic review. Methods We performed a literature search of Embase, NCBI, Cochrane, and Web of Science databases from April 1990 to April 2020. Inclusion criteria included studies that were retrospective or prospective in nature evaluating the treatment of AIED with audiometric data measuring hearing outcomes during treatment. Hearing improvement was the primary study outcome and improvement in vestibular symptoms was the secondary study outcome. Results Sixteen of 412 candidate articles were included in our study. Systemic steroid treatment is most commonly described. Alternative treatment modalities included intratympanic steroid treatment, methotrexate, cyclophosphamide, azathioprine, infliximab, etanercept, adalimumab, golimumab, methylprednisolone, rituximab, and anakinra. Conclusion Systemic corticosteroids are the first line treatment of AIED. Intratympanic steroids are a potential adjuvant or alternative treatment for patients who cannot tolerate or become refractory to steroid treatment. Steroid nonresponders may benefit from biologic therapy. Alternative treatment modalities including nonsteroidal immunosuppressants and biologics have been studied in small cohorts of patients with varying results. Prospective studies investigating the efficacy of biologic and nonsteroidal therapy are warranted. Level of Evidence 2. Autoimmune inner ear disease is an uncommon inner ear disorder characterized by progressive and often fluctuating sensorineural hearing loss. Currently, there are no consensus treatment recommendations for management of AIED. In this systematic review, we review published treatment paradigms, and create a novel treatment protocol based on existing evidence.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::507ac58aba371ccc86dc7d78a2582a13 https://pubmed.ncbi.nlm.nih.gov/33364414 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.