Cochlear impairment and autoimmune ear disorder in a patient with breast cancer

  • Alessandra Fioretti Tinnitus Center, European Hospital, Rome, Italy. http://orcid.org/0000-0002-6443-7805
  • Vittoria Di Rubbo Department of Applied Clinical Sciences and Biotechnology, L’Aquila University, L’Aquila, Italy.
  • Giorgia Peri Audin Clinic, Rome, Italy.
  • Elisa Vitti Department of Applied Clinical Sciences and Biotechnology, L’Aquila University, L’Aquila, Italy.
  • Sara Cisternino Department of Applied Clinical Sciences and Biotechnology, L’Aquila University, L’Aquila, Italy.
  • Theodoros Varakliotis | theo_va@hotmail.com Department of Applied Clinical Sciences and Biotechnology, L’Aquila University, L’Aquila, Italy. http://orcid.org/0000-0002-3656-7688
  • Alberto Eibenstein Tinnitus Center, European Hospital, Rome; Department of Applied Clinical Sciences and Biotechnology, L’Aquila University, L’Aquila, Italy. http://orcid.org/0000-0001-8845-0505

Abstract

The purpose of this study was to consider the possible role of autoimmune diseases and paraneoplastic syndrome in the genesis of tinnitus. The incidence of autoimmune inner ear disease (AIED) is rare, accounting for <1% of all cases of hearing impairment and dizziness. In presence of auditory and vestibular deficit in oncological patients, a paraneoplastic syndrome with cochleovestibulopathy should be considered. We described a 50-year-old Caucasian woman came to our attention with complaints of severe disabling bilateral tinnitus (Tinnitus Handicap Inventory, THI: 96), ear fullness and headache. The onset of tinnitus was associated to the last breast implant and prolonged antibiotic therapy. Serological autoimmunity tests were positive and a diagnosis of mixed connective tissue disease with notes of fibromyalgia was made. Pure tone audiometry testing revealed bilateral fluctuating mild hearing loss on high frequencies. The tinnitus was successfully treated with bilateral wideband sound generators (listening 8-9 hours for day) regulated at the mixing point. At 12 months follow up THI has shrunk considerably (THI: 4) and the patient has continued treatment only with the sound pillow. In conclusion significant progress is needed to better understand the role of autoantibodies in the pathogenesis and diagnosis of paraneoplastic cochleovestibulopathy. To our knowledge, our study is the first in which hearing loss and tinnitus is considered as a manifestation of a paraneoplastic syndrome.

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Published
2017-03-13
Section
Case Reports
Keywords:
Tinnitus, autoimmune ear disorder, paraneoplastic syndrome, breast cancer.
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How to Cite
Fioretti, A., Di Rubbo, V., Peri, G., Vitti, E., Cisternino, S., Varakliotis, T., & Eibenstein, A. (2017). Cochlear impairment and autoimmune ear disorder in a patient with breast cancer. Audiology Research, 7(1). https://doi.org/10.4081/audiores.2017.165

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