Department of Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
Otolaryngology, Johns Hopkins Hospital, Baltimore, Maryland, USA.
J Immunother Cancer. 2020 Dec;8(2). doi: 10.1136/jitc-2020-001675.
Immune checkpoint inhibitors (ICIs) are associated with a range of organ-specific toxicities known as immune-related adverse events (irAEs). Immune-mediated ototoxicity from ICIs is poorly described. Herein, we describe the clinical presentation, diagnostic evaluation and management of six ICI-treated patients who developed immune-mediated ototoxicity, identified by a multidisciplinary immune-related toxicity team. This is the largest case series to date and identifies bilateral high-frequency hearing loss and tinnitus as the most common reported symptoms and can be associated with abnormal speech reception thresholds and word recognition ability on audiogram in select patients. We propose multidisciplinary evaluation of patients with suspected otologic irAEs including referral to otolaryngology, audiometry evaluation±magnetic resonance imaging for evaluation of suspected immune-mediated ototoxicity.
免疫检查点抑制剂（ICIs）与一系列已知的免疫相关不良反应（irAEs）有关，这些不良反应涉及特定器官。ICI 引起的免疫介导性耳毒性描述甚少。在此，我们描述了 6 名接受 ICI 治疗后发生免疫介导性耳毒性患者的临床表现、诊断评估和管理，这些患者是由多学科免疫相关毒性小组确定的。这是迄今为止最大的病例系列，确定双侧高频听力损失和耳鸣是最常见的报告症状，并且在某些患者中可能与听觉测试中的异常语音接受阈值和单词识别能力有关。我们建议对疑似耳 irAEs 的患者进行多学科评估，包括转介耳鼻喉科、听力评估+/-磁共振成像，以评估疑似免疫介导性耳毒性。
