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Scientific Oral Presentation

Otology/Neurotology

Vestibulocochlear Adverse Effects of Immune Checkpoint Inhibitors

Tuesday, October 20, 2026
9:39 AM - 9:45 AM PT
Location: West Exhibit Hall A, Learning Zone 1

    Presenting Author(s)

  • MP

    Marcelina Puc, MS

    Medical Student
    Frist College of Medicine
    Nashville, Tennessee, United States

    • Co-Author(s)

  • MA

    Mariya Ahmed, n/a

    Medical Student
    University of Maryland School of Medicine, Maryland, United States

  • JN

    Javier K. Nishikawa, MD

    Resident Physician
    Department of Otolaryngology- Head and Neck Surgery, University of Maryland Medical System
    Baltimore, MD, United States

  • Christopher Z. Wen, MD

    Resident PGY 5
    University of Maryland Medical Center
    Baltimore, MD, United States

    • Senior Author(s)

  • Adam C. Kaufman, MD, PhD

    Assistant Professor
    University of Maryland Medical System
    Baltimore, Maryland, United States

Disclosure(s):
Christopher Z. Wen, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Adam C. Kaufman, MD, PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Immune checkpoint inhibitors (ICI) have transformed oncology, and immune related adverse events span many organ systems, yet vestibulocochlear effects remain poorly defined beyond case reports and small series. We therefore used a national multi system EHR to estimate short term rates of tinnitus, sensorineural hearing loss (SNHL), and acute vestibular events after ICI initiation, and to compare them with supportive infusion controls to inform counseling and surveillance.

Methods: Using Epic Cosmos encounters from 2014 to 2025, we identified adults with cancer receiving an ICI (anti CTLA-4, anti PD-1, anti PD-L1). Controls were adults with cancer receiving outpatient normal saline or lactated Ringer’s infusions. Outcomes within 90 days were tinnitus (H93.11–H93.19), SNHL (H90.3–H90.8, H90.A2-A3), and acute vestibular events (H81.2, H83.0). Between group differences used unadjusted odds ratios from 2×2 tables with chi square given rare events.

Results: A total of 8,758 patients receiving ICI compared to 28,735 patients in the control group were evaluated. Tinnitus rates did not differ (ICI 0.51%, control 0.65%). Acute vestibular events were rare in both groups (fewer than 10 events per arm). There were decreased odds of SNHL (p=0.04; OR 0.76 [0.58,0.98]) in the ICI group (0.8%) compared to the control group (1.1%).

Conclusions: In this national EHR cohort, ICIs were not linked to increased 90 day tinnitus, SNHL, or acute vestibular events. Findings support routine surveillance only, and motivate follow up with further well-defined audiology anchored endpoints.