Meta-analysis links facial palsy and ANCA negativity to poor hearing in OMAAV patients
This systematic review and meta-analysis examines hearing outcomes in patients with otitis media associated with ANCA-associated vasculitis. The analysis pooled data from four studies, comprising one retrospective cohort study and three case-control studies. The setting for these studies was not reported. The primary outcome measured was hearing status.
The analysis identified significant associations between specific clinical features and poor hearing prognosis. Facial palsy showed an odds ratio of 1.51 with a 95% CI of 1.07-2.15 and a p-value of .02. Hypertrophic pachymeningitis was associated with an odds ratio of 1.73 (95% CI 1.18-2.53; p = .005). ANCA negativity demonstrated an odds ratio of 1.75 (95% CI 1.11-2.77; p = .02).
In contrast, the period from onset to diagnosis was not significantly associated with poor hearing outcomes. The effect size was reported as SEM ± SD 2.54 with a 95% CI of -1.56 to 6.64 and a p-value of .22. Absolute numbers for these outcomes were not reported. Safety data, adverse events, and tolerability were not reported in the included studies.
The authors note that these findings provide diagnosis and treatment guidance in protecting patients' hearing. However, the study design limits causal inference. The certainty of the evidence was not reported. These results highlight specific clinical markers that may warrant closer monitoring for hearing impairment in this population.
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