Audiovestibular Dysfunction in Patients with Hashimoto’s Disease: A Systematic Review

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...

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Published inInternational journal of molecular sciences Vol. 26; no. 10; p. 4703
Main Authors Chen, Jiann-Jy, Hsu, Chih-Wei, Chen, Tien-Yu, Liang, Chih-Sung, Chen, Yen-Wen, Zeng, Bing-Yan, Tseng, Ping-Tao
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 14.05.2025
MDPI
Subjects
Antibodies
Autoantibodies
Autoimmunity
Care and treatment
Development and progression
Disease
Diseases
Evidence-based medicine
Hashimoto Disease - complications
Hashimoto Disease - physiopathology
Hearing loss
Humans
Hypothyroidism
Leukocytes
Meta-analysis
Pathophysiology
Review
Systematic review
Taiwan
Thyroid gland
Thyroid hormones
Vertigo
Vestibular Diseases - etiology
Taiwan
sensorineural hearing loss
treatment
cochleopathy
Hashimoto’s disease
vestibular dysfunction
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Summary: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.
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These authors contributed equally to this work.
These authors also contributed equally to this work.
ISSN:1422-0067
1661-6596
1422-0067
DOI:10.3390/ijms26104703