PLASMAPHERESIS IN AUTOIMMUNE INNER-EAR DISEASE - LONG-TERM FOLLOW-UP

Objective: This study aimed to evaluate the outcome of longterm hearin g benefits of plasmapheresis (PMP) in presumed autoimmune inner ear di sease (AIED). Study Design: The study was a case series, with retrospe ctive chart review written questionnaire, telephone interview, and fol low-up examination. Setting: It was performed in a private practice ot ology and neurotology referral center. Patients: Sixteen patients (5 m ales, 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: Plasma pheresis at one or more times during the active phase of disease. Main Outcome Measure: Stability of hearing, defined according to the Ameri can Academy of Otolaryngology-Head and Neck Surgery recommended criter ia for reporting hearing results in Meniere's disease, was used as the main outcome measure. Results: Eight (50%) of 16 patients had improve d or stable hearing in I or both ears. Eleven (39.3%) of 28 ears with measurable hearing pre-PMP were improved or stable. Only 25% of patien ts required continued use of immunosuppressive drugs. Conclusion: Plas mapheresis 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 tre atment of AIED.