Chen Jiann-Jy, Hsu Chih-Wei, Chen Tien-Yu, Liang Chih-Sung, Chen Yen-Wen, Zeng Bing-Yan, Tseng Ping-Tao
Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung 811, Taiwan.
Department of Otorhinolaryngology, E-Da Cancer Hospital, I-Shou University, Kaohsiung 824, Taiwan.
Int J Mol Sci. 2025 May 14;26(10):4703. doi: 10.3390/ijms26104703.
Although the inner ear is considered an immune-privileged organ because of the blood-labyrinth barrier, accumulating evidence has revealed an unexpected relation between Hashimoto's disease and inner ear damage manifesting as audiovestibular dysfunction. Hashimoto's disease can simultaneously affect both the auditory and vestibular systems, either through direct autoantibody attacks or through metabolic dysfunction associated with hypothyroidism. Currently, there is no consensus regarding tests or treatments for audiovestibular dysfunction related to Hashimoto's disease. In this review, we summarize the currently available evidence regarding the characteristics, pathophysiology, diagnostic approaches, and treatment of audiovestibular dysfunction in patients with Hashimoto's disease. Furthermore, we propose a specific steroid-plus-thyroxine treatment protocol to manage audiovestibular dysfunction associated with Hashimoto's disease. This condition may respond to adequate treatment, potentially allowing reversibility if it is recognized and managed in a timely manner. Conversely, delayed diagnosis or failure to recognize the subtle presentation of audiovestibular dysfunction in patients with Hashimoto's disease may lead to progressive hearing loss, immobility, and reduced quality of life. Based on the updated evidence in our review and our modified treatment protocol, we aim to provide new insights and therapeutic directions for clinicians managing audiovestibular dysfunction in patients with Hashimoto's disease. Trial registration: PROSPERO CRD420250652982.
尽管由于血迷路屏障，内耳被认为是一个免疫豁免器官，但越来越多的证据揭示了桥本氏病与以内耳听觉和前庭功能障碍为表现的内耳损伤之间存在意想不到的关联。桥本氏病可通过直接的自身抗体攻击或与甲状腺功能减退相关的代谢功能障碍，同时影响听觉和前庭系统。目前，对于与桥本氏病相关的听觉和前庭功能障碍的检测或治疗尚无共识。在本综述中，我们总结了目前关于桥本氏病患者听觉和前庭功能障碍的特征、病理生理学、诊断方法及治疗的现有证据。此外，我们提出了一种特定的类固醇加甲状腺素治疗方案，以管理与桥本氏病相关的听觉和前庭功能障碍。这种情况可能对适当的治疗有反应，如果能及时识别并处理，可能具有可逆性。相反，桥本氏病患者听觉和前庭功能障碍的细微表现若诊断延迟或未被识别，可能会导致进行性听力损失、行动不便及生活质量下降。基于我们综述中的最新证据和修改后的治疗方案，我们旨在为管理桥本氏病患者听觉和前庭功能障碍的临床医生提供新的见解和治疗方向。试验注册：PROSPERO CRD420250652982 。
