Pak Kaitlynne Y, Cutri Raffaello M, Nadeem Wasiq, Kothari Dhruv, Wong Yu-Tung, Wu Arthur W, Miller Mia E
Cedars-Sinai Medical Center, Division of Otolaryngology-Head and Neck Surgery, Los Angeles, CA.
Otol Neurotol. 2025 Jan 1;46(1):19-22. doi: 10.1097/MAO.0000000000004373.
GLP-1 receptor agonists (GLP-1 RAs) have gained traction in the management of obesity. There is limited literature on the implications of GLP-1 RAs in the field of otolaryngology.
We explore the association between GLP-1 RAs with eustachian tube dysfunction (ETD) and patulous ETD (PETD) by review of cases, literature, and the FDA adverse event database (FAERS). We also performed a systematic review using the PRISMA guidelines.
We present autophony and aural fullness following GLP-1 agonist use. In both cases, nasal endoscopy confirmed significant loss of tissue bulk of the anterior and posterior ET cushions. The total number of adverse events (AEs) with GLP-1 RAs was 97,237. The proportion of otologic AEs was 958 (0.99%): 515 hypoacusis, 203 vertigo, 97 deafness, 93 tinnitus, 22 ear pain, 21 motion sickness, 5 hyperacusis, 2 ear fullness, and 0 autophony. The largest number of potential ETD-related AEs occurred with dulaglutide (417). The greatest proportion of potential ETD-related AEs occurred with exenatide (1.52%) followed by semaglutide (1.17%) and liraglutide (1.16%). The systematic review using PRISMA guidelines yielded 1,490 initial articles, of which 937 were screened and 10 met the inclusion criteria. The top 3 identified otologic side effects included nasopharyngitis, sinusitis, unspecified dizziness.
Ear complaints due to GLP-1 RAs have been reported previously. However, this is the first report of PETD associated with GLP-1 RAs. While literature on GLP-1 RAs and PETD is currently limited, the mechanism is well established as reports of PETD after rapid weight loss, especially in bariatric surgery, are well known. Given the rising use of GLP-1 RAs for weight loss, clinicians should be vigilant in screening for otolaryngologic side effects, especially PET, in this population.
Otolaryngologists should be aware and monitor for possible otolaryngologic side effects, particularly PETD, with GLP-1 RA use.
胰高血糖素样肽-1受体激动剂（GLP-1 RAs）在肥胖症管理中受到关注。关于GLP-1 RAs在耳鼻喉科领域影响的文献有限。
我们通过病例回顾、文献及美国食品药品监督管理局不良事件数据库（FAERS），探讨GLP-1 RAs与咽鼓管功能障碍（ETD）及开放性咽鼓管功能障碍（PETD）之间的关联。我们还使用PRISMA指南进行了系统评价。
我们报告了使用GLP-1激动剂后出现的自听过响和耳闷胀感。在这两例病例中，鼻内镜检查均证实咽鼓管前后襞组织量显著减少。GLP-1 RAs的不良事件总数为97,237例。耳科不良事件的比例为958例（0.99%）：515例听力减退、203例眩晕、97例耳聋、93例耳鸣、22例耳痛、21例晕动病、5例听觉过敏、2例耳闷胀感，无自听过响病例。与潜在ETD相关的不良事件数量最多的是度拉糖肽（417例）。与潜在ETD相关的不良事件比例最高的是艾塞那肽（1.52%），其次是司美格鲁肽（1.17%）和利拉鲁肽（1.16%）。使用PRISMA指南进行的系统评价共获得1490篇初始文章，其中937篇经过筛选，10篇符合纳入标准。确定的前3种耳科副作用包括鼻咽炎、鼻窦炎、未明确的头晕。
此前已有关于GLP-1 RAs引起耳部不适的报道。然而，这是首次关于GLP-1 RAs与PETD相关的报道。虽然目前关于GLP-1 RAs与PETD的文献有限，但机制已明确，因为快速减重后出现PETD的报道很常见，尤其是在减肥手术中。鉴于GLP-1 RAs用于减肥的情况日益增多，临床医生应警惕对该人群进行耳鼻喉科副作用筛查，尤其是PET。
耳鼻喉科医生应意识到并监测使用GLP-1 RA时可能出现的耳鼻喉科副作用，特别是PETD。
