Hearing Outcomes During Induction Therapy in ANCA-Associated Vasculitis: Applicability of Sudden Sensorineural Hearing Loss Criteria.

Objectives: ANCA-associated vasculitis (AAV) is a relapsing-remitting systemic disease in which auditory involvement is increasingly recognized as a determinant of quality of life. The objective of this study was to evaluate hearing outcomes during induction therapy in AAV and to assess the applicability of sudden sensorineural hearing loss (SSNHL) criteria for monitoring treatment response. Methods: A prospective study included 27 patients with AAV hospitalized at the Department of Internal Medicine, Nephrology and Dialysis, Military Institute of Medicine-National Research Institute. Audiologic assessment included pure-tone audiometry (including high-frequency audiometry), immittance audiometry, otoacoustic emissions, and auditory brainstem response (ABR). Examinations were performed at baseline (induction phase) and after remission. Hearing outcomes were evaluated using SSNHL criteria defined by the Ministry of Health and Welfare of Japan. Associations between hearing loss and organ involvement were also analyzed. Results: Improvement to normal hearing in pure-tone audiometry was observed in three ears, while deterioration from normal hearing occurred in four ears. No statistically significant differences were found in overall otoacoustic emission responses between baseline and follow-up. A statistically significant association was identified between hearing loss and peripheral nervous system involvement (50.0% vs. 11.1%, p = 0.057). No significant correlations were observed between hearing outcomes and other clinical parameters. Conclusions: SSNHL-based hearing outcome criteria may represent a practical tool for assessing auditory dysfunction and monitoring treatment response in AAV. High-frequency audiometry and structured outcome measures may improve detection of subtle cochlear changes. Further studies with larger cohorts are required to validate these findings and clarify the relationship between systemic disease activity and hearing impairment.