l-Thyroxine does not prevent immunemediated sensorineural hearing loss in autoimmune thyroid diseases

Area of Science:

• Otolaryngology
• Immunology
• Endocrinology

Background:

• Autoimmune thyroid disease (AITD) is linked to various autoimmune conditions.
• Hearing loss can occur in hypothyroidism, but immune-mediated inner ear disease (IMIED) in AITD patients is less understood.
• Levothyroxine is standard treatment for hypothyroidism, but may not address immune-mediated hearing loss.

Purpose of the Study:

• To investigate immune-mediated inner ear disease (IMIED) hearing loss in patients with autoimmune thyroid disease (AITD).
• To explore the immunopathology linking the inner ear and thyroid gland.
• To assess the efficacy of corticosteroid treatment for IMIED in AITD patients.

Main Methods:

• Selected 220 patients with sensorineural hearing loss (SNHL) not due to aging.
• Performed audiometry to calculate pure tone average before and after corticosteroid treatment.
• Identified patients with autoimmune hearing loss and diagnosed AITD (Hashimoto's disease).

Main Results:

• 84 patients had autoimmune SNHL; 15 were diagnosed with AITD.
• Sudden sensorineural hearing loss was the most common presentation.
• Nine patients experienced hearing recovery >10dB after corticosteroid treatment.

Conclusions:

• IMIED can occur in AITD patients despite levothyroxine treatment.
• Corticosteroids may be effective in achieving hearing recovery for IMIED in AITD.
• Shared antigen targets between the inner ear and thyroid gland likely contribute to IMIED in AITD.