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Cochlear Implantation in a Patient with Granulomatosis with Polyangiitis
Noam Bartov1, Tzofit Dahan2, Doron Halperin1
1Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel.
The Israel Medical Association Journal : IMAJ
|December 27, 2022
Summary
Cochlear implants (CI) can restore hearing in patients with Granulomatosis with polyangiitis (GPA)-related hearing loss (HL). Medical management of GPA inflammation before CI surgery is crucial for successful outcomes.
Area of Science:
- Otolaryngology
- Rheumatology
- Audiology
Background:
- Granulomatosis with polyangiitis (GPA) can cause hearing loss (HL) through otologic manifestations.
- Cochlear implants (CI) offer a solution for profound HL unresponsive to hearing aids.
- Current guidelines for CI in GPA patients are lacking.
Observation:
- A case report details a 71-year-old female with GPA and bilateral profound HL undergoing CI.
- Pre-operative management included audiological assessments and medical treatment (prednisone, methotrexate) for inflammation.
- CI surgery proceeded without complications.
Findings:
- The patient achieved a speech reception threshold of 25 dBHL.
- Post-operative monosyllabic word discrimination score was 75%.
- Medical control of GPA inflammation is effective, negating the need for subtotal petrosectomy.
Implications:
- GPA-related hearing loss is treatable with cochlear implantation.
- Successful CI outcomes are achievable with appropriate medical management of GPA.
- This approach provides a viable option for deaf patients with GPA.
