Bilateral cochlear implantation after immunotherapy-related profound hearing loss: A case report.
Cochlear Implants Int
; 24(5): 268-272, 2023 09.
Article
em En
| MEDLINE
| ID: mdl-36988037
ABSTRACT
OBJECTIVES:
Immune-checkpoint inhibitors (ICI) are being utilized with increasing frequency and may be linked to neurologic and audiovestibular toxicities. This report aimed to describe a case of ICI-induced sensorineural hearing loss ultimately requiring bilateral cochlear implantation.METHODS:
A 42-year-old female with stage IV metastatic melanoma of the perianal skin was treated with ipilimumab (blocker of cytotoxic T-lymphocyte associated protein 4 [CTLA-4]) and nivolumab (anti-programmed cell death protein 1 [PD1]). After 21 weeks of therapy, she developed sudden vertigo and bilateral hearing loss. A full workup including MRI and lumbar puncture ruled out intracranial parenchymal metastases, leptomeningeal metastases, stroke and intracranial infection. ICI-associated aseptic meningoencephalitis was therefore diagnosed. The patient received systemic steroids as well as intratympanic steroids, which temporarily improved hearing, but eventually developed permanent, bilateral profound sensorineural hearing loss.RESULTS:
The patient received bilateral cochlear implants and has demonstrated good performance one year after implantation.DISCUSSION:
ICI are being increasingly used to treat a variety of advanced malignancies. This is the first report of bilateral cochlear implants in the context of profound hearing loss after an immunotherapy induced meningoencephalitis.CONCLUSION:
ICI carries the risk of potential ototoxicity, including profound SNHL as depicted in our case. Cochlear implantation proved to be beneficial and may be considered in patients with ICI-related hearing loss.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Implante Coclear
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Inibidores de Checkpoint Imunológico
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Perda Auditiva Neurossensorial
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Imunoterapia
Limite:
Adult
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Female
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Humans
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article