1. Take the Steroid Approach
As in any autoimmune disease where the body's immune system attacks certain tissues or organs, autoimmune inner ear disease (AIED) results when your immune system attacks the inner ear. Reasons for this are presently unknown, and this hearing loss mostly baffles doctors. Treatment is basically hit-or-miss. The most common form of treatment is the use of steroid drugs. About 60 percent of patients have significant improvement in hearing loss when administered these drugs over a four-week period. Success has been seen with the use of prednisone or dexamethasone. For patients with favorable results, a switch to a chemotherapy drug such as cyclophosphamide or methotrexate is the common course of treatment, as serious side effects from long-term use of steroids can arise. The result, unfortunately, is that steroid treatment does not always work for everyone; sometimes people who use these drugs see a vast improvement in their condition, while others do not. Doctors do not fully understand why this is so.
2. Injecting Your Way to Better Hearing
For those who cannot tolerate or who have had no favorable reaction to steroid drugs, these people might be given an anti-tumor necrosis factor (TNF) drug to treat AIED. These drugs have been used in other autoimmune diseases such as rheumatoid arthritis and Crohn's disease, with some amount of success. Anti-TNF drugs are immunosuppressants and also fight inflammation. Since it is thought that the pathology of AIED is much the same as other autoimmune diseases (the immune system attacking the body and causing inflammation, whether it's in the joints, digestive tract or inner ear), it is believed these drugs can have a strong positive influence on AIED. Injections of the anti-TNF agent etanercept (Enbrel) has shown promise in treating AIED, though another such injection-type agent, infliximab (Remicade) has had no such impact. Enbrel is given as an injection twice weekly. Lack of in-depth and long-term studies regarding the use of Enbrel as treatment for AIED has led to it not being used extensively despite the promise it shows.
3. Giving Your Inner Ear a Boost
In many cases, since anti-TNF treatment is not commonly prescribed and some people cannot take or have no reaction from steroid drugs, hearing aids or a cochlear implant may be the only choices when it comes to treating AIED. A cochlear implant involves placing a small device into the inner ear. This electronic device consists of a microphone, a speech processor, a transmitter and receiver and a group of electrodes. As AIED can change rapidly in some cases, hearing aids or an implant may not prove to be the answer over time. As is the case in many diseases, each person has a varying degree of AIED and treatment is according to each individual case.
