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Plasmapheresis in autoimmune inner ear disease: long-term follow-up
1Otologic Center, Inc., Kansas City, Missouri 64111, USA.
Objective:
This study aimed to evaluate the outcome of long-term hearing benefits of plasmapheresis (PMP) in presumed autoimmune inner ear disease (AIED).
Study Design:
The study was a case series, with retrospective chart review, written questionnaire, telephone interview, and follow-up examination.
Setting:
It was performed in a private practice otology and neurotology referral center.
Patients:
Sixteen patients (5 males, 11 females) whose symptoms were compatible with the diagnosis of AIED, who underwent PMP, and who had 2-year or later objective follow-up. Age ranged from 8-62 years, with a mean of 40.9 years. Follow-up ranged from 2-12 years, with a mean of 6.7 years.
Intervention:
Plasmapheresis at one or more times during the active phase of disease.
Main Outcome Measure:
Stability of hearing, defined according to the American Academy of Otolaryngology-Head and Neck Surgery recommended criteria for reporting hearing results in Meniere's disease, was used as the main outcome measure.
Results:
Eight (50%) of 16 patients had improved or stable hearing in 1 or both ears. Eleven (39.3%) of 28 ears with measurable hearing pre-PMP were improved or stable. Only 25% of patients required continued use of immunosuppressive drugs.
Conclusion:
Plasmapheresis may be beneficial as an adjunctive therapy for maintaining hearing in some patients with AIED. Cost and reimbursement factors are major obstacles in the use of this therapy. The overall success rate and individual patient results warrant further study of PMP in the treatment of AIED.
