Cochlear implant in immune mediated inner ear diseases: Impedance variations and clinical outcomes

Abstract

OBJECTIVE

Immune-mediated inner ear disease (IMIED) might cause severe/profound hearing loss and these patients are considered ideal candidates to cochlear implant (CI) surgery. The aim of the study was to evaluate impedance changes over time.

METHOD

The Study Group (SG) was composed of CI IMIED patients (31 ears) and a Control Group (CG) of CI patients with hearing loss not related to their immune system (31 ears). Audiological performance and impedance values were measured and compared amongst groups at 3, 6, 12 and 18 months following the fitting sessions.

RESULTS

Speech perception was significantly better for SG in word and sentence recognition in quiet. Impedance values were, on average, significantly higher for apical and middle electrode segments in SG compared to CG at the 3- month follow-up and were maintained over time. Additionally, a subset of SG patients (active patients) experienced significantly greater impedance fluctuation corresponding to clinical symptom reactivation.

CONCLUSION

IMIED patients achieve good audiological performance. However, the relapsing inflammation could change the inner ear environment, causing impedance fluctuations and, consequently, more frequent CI fittings. Additionally, impedance evaluation could be utilized as an early warning sign of IMIED recurrence and as an aid to therapeutic decision-making.

Keywords:

• Cochlear implant
• Impedances
• Autoimmune hearing loss
• Inner ear

Acknowledgements

The authors would also like to thank Dan McAuley for his assistance with the English language revision, and for comments that greatly improved the manuscript.

Disclaimer statements

Contributors None.

Funding None.

Conflicts of interest None.

Ethics approval None.

Additional information

Notes on contributors

Francesca Atturo

Francesca Atturo (MD, PhD) is an ENT specialist with PhD in Clinical and Experimental Neuroscience and Psychiatry at Sapienza University of Rome. Her research focuses on human inner ear anatomy and immune-mediated inner ear disease related to cochlear implantation.

Ginevra Portanova

Ginevra Portanova is an audiologist, PhD student in Clinical, Experimental Neuroscience and Psychiatry at Sapienza University of Rome. Her research is focused on the outcomes related to cochlear implantation. She is also interested in language development in deaf children.

Francesca Yoshie Russo

Francesca Yoshie Russo is an Assistant Professor of Otorhinolaryngology at Sapienza University of Rome, Italy, former ENT surgery fellow at Pitié-Salpetrière Hospital in Paris, France. Main field of expertise otology and audiology and central auditory pathways.

Daniele De Seta

Daniele De Seta is an Assistant Professor of Otorhinolaryngology at University of Cagliari, Italy, former researcher at INSERM unit UMRS 11-59, former surgery fellow at Pitié-Salpetrière Hospital in Paris, France.

Laura Mariani

Laura Mariani is a resident in Audiology and Phoniatrics at the Sapienza University of Rome. Her research focuses on cochlear implant outcomes and quality of life. She is also involved in research on speech and swallowing disorders in neurological diseases. She recently joined the PhD program in Clinical and Experimental Neuroscience and Psychiatry at Sapienza University of Rome.

Stephanie Borel

Stéphanie Borel is a Speech Therapist, Associate Professor in Rehabilitation Sciences at Sorbonne University of Paris, France. Her main research focus is on speech, voice and quality of life of hearing-impaired people.

Antonio Greco

Antonio Greco (MD) is a Full Professor of Otolaryngology. He is the Head of the Department of Sense Organs, Head of the Audiology Unit at the Sapienza University of Rome-Policlinico Umberto I. His bulk of research is focused on oncology and circulating tumor cells, in otology and immune-mediated diseases of the inner ear.

Isabelle Mosnier

Isabelle Mosnier is the Chief of the Unit of otology, hearing implants and functional explorations at Pitié-Salpetrière Hospital in Paris, France. Head of Rare Disease Center for Adult Genetic Deafness and Neurofibromatosis type 2 at Pitié-Salpetrière Hospital in Paris, France. Otologic surgeon, leading researcher in the cochlear implant field.

Patrizia Mancini

Patrizia Mancini (MD, PhD) is an Associate Professor in Otolaryngology and Medical Audiology, clinical coordinator of the Cochlear Implants Center at Sapienza University of Rome. She recently joined the Panel of Experts on Implantable Medical Devices of the European Community. Prof. Mancini has carried out extensive research in the field of otology, cochlear implants and hearing loss related to autoimmune diseases. Current projects are: “Communication and linguistic outcomes in children with cochlear implants.”, “Pitch and speech perception with cochlear implants”.