Hypoacusia in a Patient Treated by Isotretinoin

Rosende, Laura; Verea-Hernando, M. M.; Andrés, A. de; Piñeyro-Molina, F.; Barja, Juan; Castro-Castro, S.; Fonseca, Eduardo

doi:10.1155/2011/789143

Cited by 7 publications

(4 citation statements)

References 7 publications

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“…According to the Naranjo possibility scale, toxicity was probable. [11] In another study of 12 patients who used acitretin for hidradenitis suppurativa, one patient described tinnitus, which disappeared after discontinuation of therapy. Repeated treatment with acitretin caused tinnitus to recur and the therapy had to be terminated.…”

Section: Discussionmentioning

confidence: 99%

Hearing loss in patients using isotretinoin: is it a side effect or due to hyperlipidemia?

Boztepe¹

2013

J Med Updates

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ÖzetAmaç: Bu çal›flman›n amac›, izoretinoin tedavisinin iflitme fonksiyonlar› üzerine etkisini prospektif olarak araflt›rmak ve efl zamanl› trigliserit düzeyleriyle iliflkisini göstermektir.Yöntem: Bu çal›flmaya aknelerinin 0.5 mg/kg izoretinoinle tedavisi için fiubat 2011 -Haziran 2011 tarihleri aras›nda dermatoloji klini¤i-mize kabul edilen toplam 47 hasta dahil edilmifltir. ‹lac› tolere edebilme derecelerine göre hastalar›n hepsinde günlük 0.5 mg/kg izoretinoin dozuyla tedaviye bafllanm›flt›r. Yafl, cinsiyet, ilk 6 ayda izoretinoin dozu, tedavi öncesi ve sonras› ayl›k AST, ALT, trigliserit ve total kolesterol de¤erleri kaydedilmifltir. Çal›flma grubunda 33 kad›n ve 14 erkek kat›l›mc› vard›. Bulgular: ‹zoretinoinle tedaviye bafllamadan önce odyometrik de¤er-lendirmeler yap›lm›flt›r. PTA1 ve PTA2 de¤erleri s›ras›yla 11.96 ve 12.59 idi. Bu de¤erler tedavi sonras› testlerin sonuçlar› ile karfl›laflt›-r›lm›fl, tedavi sonras› PTA1 ve PTA2 sonuçlar›n›n ayn› oldu¤u saptanm›flt›r. ‹lac›n kullan›m› tedaviden 1 ay sonra iflitmeyi etkilememiflti. Üç ay sonra PTA1 ve PTA2 de¤erleri s›ras›yla 12.16 ve 13.85 idi. Bu de¤erler tedavi öncesi de¤erlerle karfl›laflt›r›lm›fl, hem PTA1, hem de PTA2 düzeylerinin azald›¤› saptanm›flt›r. Ancak 3. ayda eflik de¤er-deki azalma istatistiksel aç›dan anlaml› de¤ildi (p<0.05). Alt›nc› aydan sonra PTA1 ve PTA2 de¤erleri s›ras›yla 12.25 ve 12.96 idi. Tedavi öncesi de¤erlerle karfl›laflt›r›ld›¤›nda bu azalma anlaml›yd› (p<0.05).Sonuç: ‹zoretrinoinle tedavi total kolesterol ve trigliserit düzeylerini yükseltmiflti. ‹zoretinoin 6. ayda saf ton ortalama iflitme fonksiyonlar›n› azaltm›fl olup bu etki trigliseritler ve total kolesterol düzeylerin-deki art›fllarla iliflkiliydi.Anahtar sözcükler: Akne vulgaris, ilaç tedavisi, yan etkiler, iflitme kayb›, hiperlipidemi. AbstractObjective: To prospectively investigate the effect of isotretinoin therapy on the functions of hearing and to show the relationship between concurrent triglyceride levels. Methods:A total of 47 patients who were admitted to our dermatology clinic between February 2011 and June 2011 for the treatment of acne using 0.5 mg/kg isotretinoin were included in this study. All the patients were started on 0.5 mg/kg/day isotretinoin depending on their tolerance of the drug. Details such as age, sex, dose of isotretinoin for the first 6 months, monthly pretreatment and posttreatment, and ALT, AST, triglyceride and total cholesterol values were recorded. There were 33 females and 14 males in the study group.Results: Audiometric evaluations made prior to treatment with isotretinoin, levels of PTA1 and PTA2 were 11.96 and 12.59, respectively, these were compared with the results of tests carried out after the treatment and pre-and posttreatment values of PTA1 and PTA2 were found to be the same, 1 month after the treatment, drug use did not effect hearing. PTA 1 value after 3 months was 12.16 and PTA 2 value was 13.85. These values are compared to pretreatment values and PTA2 PTA1 both were decreased. However, in the third month the threshold...

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Section: Discussionmentioning

confidence: 99%

Hearing loss in patients using isotretinoin: is it a side effect or due to hyperlipidemia?

Boztepe¹

2013

J Med Updates

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“…[13] us, it seems plausible that the retinoids may have unfavorable e ects on the adult ear in addition the known teratogenic e ects. Studies and case reports in the literature suggest that isotretinoin a ects hearing [3][4][5][6][7]9,[14][15][16][17]. Nikiforidis et al [5] investigated auditory brainstem responses in 33 patients with severe nodulocystic acne before and a er three weeks of treatment with isotretinoin.…”

Section: Discussionmentioning

confidence: 99%

“…us, it seems that the e ects of isotretinoin on hearing do not change much over time; however, there are some case reports that describe hearing loss that was reversible three weeks to two months a er withdrawal of isotretinoin. [14,15] It is possible that isotretinoin could immediately a ect hearing and then have an additional long-term cumulative e ect.…”

Section: Discussionmentioning

confidence: 99%

The effects of oral isotretinoin (13-Cis retinoic acid) on the inner ear: A prospective clinical study

Mehmet¹,

Akkurt²,

Gül³

et al. 2014

CIM

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e e ects of oral isotretinoin (13-Cis retinoic acid) on the inner ear: A prospective clinical study AbstractPurpose: e purpose of this study was to investigate the e ect of oral isotretinoin, a drug used in the treatment of acne vulgaris, on hearing function determined by serial audiology examinations.Methods: Forty patients with acne vulgaris were included in this study. Nine patients were excluded from the study because of inconsistent follow-up. e hearing of each participant was tested with pure tone audiometry and transient evoked autoacoustic emissions before and two and four weeks a er treatment with isotretinoin (0.3-0.6 mg/kg/day) in the remaining 31 patients (62 ears).Results: e di erences between the mean values of the pre-treatment and post-treatment pure tone hearing thresholds at 1000, 2000, 4000 and 6000 Hz frequencies were statistically signi cant (p<0.05), but there was no signi cant di erence between the pretreatment and post-treatment values at 250 and 500 Hz frequencies (p>0.05). e di erence between the pre-treatment and post-treatment signal-noise ratio values of the transient evoked autoacoustic emissions was not signi cantly di erent (p>0.05). Conclusion:Our results suggest that the use of isotretinoin may cause bilateral hearing threshold changes. Further animal and human studies are required to investigate and characterize isotretinoin-induced neurophysiological alterations in hearing.

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“…This same study also included patients who used acitretin (an oral retinoid for psoriasis) and topical salicylate (33). Whereas salicylate has known ototoxicity, acitretin has been associated with sudden-onset hypoacusis in only a few published cases (52)(53)(54). However, the other study examined a limited number of comorbidities, while excluding patients who used acitretin (44).…”

Section: Summary Of Key Findingsmentioning

confidence: 99%

Otologic Manifestations of Psoriasis: A Systematic Review and Meta-Analysis

et al. 2022

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Introduction: Psoriatic skin lesions are often seen in the auricle and external auditory canal, but middle ear and inner ear manifestations are not easily identified. Several studies have indicated hearing loss and vestibular dysfunction with psoriasis, but the extent of association has not been well defined. Methods: A systematic search of PubMed, CINAHL, Scopus, and Cochrane Library was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included studies described audiometric or vestibular assessment of psoriasis patients. Meta-analysis was represented with odds ratios (ORs) or mean difference (MD) with 95% confidence intervals. Results: A total of 13 studies with 589 psoriasis patients and 617 healthy controls were included. Age did not significantly differ between psoriasis patients (47.1 [12.4] yr) and healthy controls (45.4 [11.2] yr). Psoriasis area and severity index score was 9.9 (8.4), and body surface area scores was 7.9 (14.7). Pure-tone audiometry analysis showed higher mean hearing thresholds in psoriasis patients compared with healthy controls across all frequencies, with the greatest difference at 4000 Hz (MD,; p < 0.00001). Speech reception thresholds were worse with psoriasis (MD,; p < 0.0001). Abnormal stapedial reflex was more common in psoriasis (OR,; p = 0.004). Abnormal vestibular testing was more common in psoriasis for caloric testing (OR,; p < 0.0001). Two additional studies of 41,681 psoriasis patients and 80,273 healthy controls found that psoriasis patients were at higher risk for sudden sensorineural hearing loss (OR,; p < 0.0001). Conclusion:Our study shows that psoriasis is associated with hearing loss and vestibular dysfunction, but clinical significance remains undefined. The trends noted in our study require more investigation, and the pathophysiologic mechanisms need to be defined.

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Hypoacusia in a Patient Treated by Isotretinoin

Cited by 7 publications

References 7 publications

Hearing loss in patients using isotretinoin: is it a side effect or due to hyperlipidemia?

Hearing loss in patients using isotretinoin: is it a side effect or due to hyperlipidemia?

The effects of oral isotretinoin (13-Cis retinoic acid) on the inner ear: A prospective clinical study

Otologic Manifestations of Psoriasis: A Systematic Review and Meta-Analysis

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