Ear Involvement in Inflammatory Bowel Disease: A Review of the Literature

Abstract

Inflammatory bowel disease (IBD) is a multisystemic disease. The ear is a rare but recognized site of extraintestinal manifestations of IBD. In external ear, the more common manifestations of IBD are pyoderma gangrenosum, metastatic Crohn’s disease and relapsing polychondritis and the treatment includes corticosteroids and anti-TNF agents. Sensorineural hearing loss (SNHL) is the most common ear disease in IBD and especially in patients with ulcerative colitis. In most cases of IBD patients with SNHL, the hearing loss is attributable to autoimmune inner ear disease (AIED). Diagnosis of AIED is based on clinical presentation, the demonstration of a progressive sensorineural hearing loss in periodic audiological tests, a response to immunosuppressive drugs and exclusion of other causes of SNHL. The only diagnostic test that is available for clinical use is the Otoblot test (Western blot for antibodies against 68 kD protein-inner ear antigens). Initial therapy is usually steroids, with a step up to anti-TNF-a therapy and cochlear implantations with failure of treatment. Furthermore, Cogan’s syndrome, a chronic disease characterized by deafness, vertigo keratitis and aortitis, has been associated with IBD and mainly with Crohn’s disease.

Safety of P28GST, a Protein Derived from a Schistosome Helminth Parasite, in Patients with Crohn’s Disease: A Pilot Study (ACROHNEM)

“…However, in our patient, vestibular neuronitis was accompanied by a very moderate and transient increase in blood CRP at the time of the AE occurrence. It is interesting to notice that the ear is a rare but recognized site of extra-intestinal manifestations of IBD [17]. The etiology of vestibular neuronitis disease remains unclear.…”

Co-existence of relapsing polychondritis and Crohn disease treated successfully with infliximab

“…As both RP and IBD are immune-mediated diseases, they can theoretically appear together. Reportedly, RP has been introduced as one of the extra-intestinal manifestations (EIMs) of IBD, but compared to other EIMs, such as peripheral and axial arthropathies, erythema nodosum, and pyoderma gangrenosum, RP is an extremely rare EIM of IBD [ 8 , 9 ]. Furthermore, RP is easily overlooked by clinicians, owing to its non-specific and unusual manifestations [ 2 ].…”

A Study of Sensorineural Hearing Loss in Patients of Inflammatory Bowel Disease

“…Fousekis et al suggested initial corticosteroid therapy for SNHL, if that fails anti TNF agents and the last resort being cochlear implantation. 11 Kanzaki and O-uchi et al suggested that adequate treatment of Primary IBD causes improvement of SNHL. 9 The present study emphasises the importance of early identification of SNHL in patients of IBD through periodic testing of pure tone thresholds before severe hearing impairment occurs.…”

“…10 SNHL due to autoimmune disease is usually diagnosed based on clinical presentation. 11 Otoscopic examination, tympanometry and pure tone audiometry help in assessing the level of hearing loss. The response to treatment can also be monitored by serial audiometric testing at regular intervals.…”