Evaluation of the endothelial cell antibodies in serum and perilymphatic fluid of cochlear implanted children with sensorineural hearing loss.

INTRODUCTION: Serum Anti endothelial Cell Antibodies (AECAs) play a prominent role in idiopathic Sensorineural Hearing Loss (SNHL) in that they induce vascular damage (immune mediated). The of the current study is To compare AECAs in serum and perilymphatic fluid of idiopathic SNHL children (<15y) undergoing cochlear implant surgery. METHODS: This was a cross sectional study performed in the cochlear implant ward in Rasoul Akram hospital, Tehran, Iran (2008 -2010) on 99 SNHL children undergoing cochlear implant surgery. The data collected from47 idiopathic and 52 non-idiopathic SNHL cases. AECAs were measured by indirect immuno fluorescence assay and compared in sera and perilymphatic fluids between the two groups. P-value < 0.05 was considered significant. RESULTS: Idiopathic SNHL was diagnosed in 47.5% of cases. Positive AECA results in serum and perilymphatic fluid were 10% and 12%, respectively. Although AECA results in perilymphatic fluids were different between idiopathic and non-Idiopathic SNHL patients (PV < 0.05), AECAs in serum showed no significant difference between the two (PV = 0.1). No significant difference was detected between the mean age of idiopathic and non-idiopathic SNHL patients with positive AECAs in serum and perilymphatic fluids (PV = 0.2; PV = 0.2). DISCUSSION: Idiopathic SNHL was diagnosed in 47.5% of studied cases. Idiopathic SNHL has a poor out come in children. In cases with idiopathic SNHL, finding AECAs in perilymphatic fluids are more valuable than in the serum. We suggest that serum and perilymphatic fluids testing for AECAs would be helpful in management of idiopathic SNHL cases. Specific immunosuppressive treatments for selected cases suffering from Idiopathic SNHL (only in those older than 5) might be successful in disease management. However, this theory should first be validated by randomized clinical trials.

Infection in childhood sensory hearing loss.

OBJECTIVE: To evaluate the possible role of infectious agents on the occurrence of idiopathic sensorineural hearing loss (SNHL) in children. METHODS: This case control study was carried out at Rasul Hospital in Tehran, Iran from 2002-2003. We compared specific serum antibodies (IgG, IgM) measured by enzyme linked immunosorbent assay in 95 sensory hearing loss cases and 63 controls. RESULTS: Acute infections (IgM) detected in cases included: cytomegalovirus (CMV) 34.6%, toxoplasma 11.5%, mumps 8.7%, rubella 5.3%, and herpes simplex 5.3%. Previous infections (IgG) detected in cases included CMV 72%, herpes 6.6%, toxoplasma 26%, mumps 23.3%, and rubella 17.2%. Acute CMV and toxoplasma infections were more frequent in cases. Previous CMV, toxoplasma, rubella, and herpes infections were higher in controls. There was no significant difference for acute mumps, rubella, and herpes infections between cases and controls. CONCLUSION: These data are compatible with infectious agents having a significant role in the studied idiopathic SNHL cases, but association does not prove causation. We recommend specific drugs for confirmed active infections (CMV, toxoplasma, herpes) in idiopathic SNHL infants diagnosed before their first birthday. Mumps and rubella induced SNHL are preventable with routine vaccination.