(852) Immune-Mediated Disease Burden Affects Audiovestibular Symptoms in Ménière's Disease

Introduction: Ménière's Disease (MD) is an inner ear disease with proposed immune-mediated mechanisms that may correlate with disease severity. This study evaluates immune comorbidities in MD and associations with audiovestibular symptoms.

Methods: Patients with MD were identified from the Nationwide Inpatient Sample (2012-2022). Immune-mediated conditions, hearing loss (HL), tinnitus, and vestibular symptoms were identified using ICD 9/10 codes. Immune burden was defined as 0, 1, or ≥2 immune conditions. Multivariable logistic regression assessed the association between immune burden and outcomes.

Results: 174,745 MD cases (mean age 69.8 years; 66.5% female; 88.2% White) were identified, of which 34,785 (19.9%) had at least one immune condition. These patients were younger, more often female, and Medicaid insured (all p< 0.001). The most prevalent conditions included asthma (10.9%), rheumatoid arthritis (3.2%), allergic rhinitis (2.2%), inflammatory bowel disease (1.4%), systemic lupus erythematosus (1.0%), and psoriasis (0.9%).

21,075 patients (12.1%) had documented HL. Increasing immune condition burden was independently associated with higher odds of HL (aOR per condition 1.07, 95% CI 1.03–1.11; p < 0.001), with the strongest association among patients with ≥2 immune conditions (aOR 1.21; 95% CI 1.07–1.36; p = 0.002). Particularly, psoriasis (aOR 1.53), asthma (aOR 1.06), and allergic rhinitis (aOR 1.47; all p< 0.05) were associated with increased odds of hearing loss.

Tinnitus was identified in 2,630 patients (1.5%), and vestibular symptoms in 6,960 patients (4.0%). Immune comorbidities were not associated with increased odds of tinnitus or vestibular symptoms.

Conclusions: Immune comorbidities are prevalent among patients with MD and identify increased hearing loss. These findings support the consideration of immune-mediated comorbidities in MD evaluation.