The association of codeine, macrocytosis and bilateral sudden or rapidly progressive profound sensorineural deafness.

Abstract:

CONCLUSIONS:Codeine shows a similar association with profound deafness to other opiates. Good cochlear implant outcomes suggest a sensory disorder. Although macrocytosis could be due to confounding factors, the lack of other consistent findings may signify a vascular pathology. OBJECTIVES:To describe a series of patients identified as codeine users after referral for cochlear implantation. PATIENTS AND METHODS:This was a retrospective case series review. Patients were identified by the senior audiologist. Information regarding mode of onset of deafness, past medical history, drug and alcohol history, investigations and audiological outcomes following cochlear implantation was collected from hospital records and patient questionnaires. RESULTS:Ten patients were included in the study. All patients had taken codeine phosphate and paracetamol in combination for several years, usually at greater than recommended daily dose. All patients presented with sudden or rapidly progressive bilateral deafness. All patients had a significant macrocytosis at the time of deafness (mean cell volume (MCV): mean 115 fL; range 105-132 fL). No other investigation was consistently abnormal. Four patients had a history of alcoholism. Seven patients had abnormal liver function tests. Patients usually performed well with cochlear implants (CUNY sentence scores without lip reading >90% in 9 of 10 patients).

journal_name

Acta Otolaryngol

journal_title

Acta oto-laryngologica

authors

Freeman SR,Bray ME,Amos CS,Gibson WP

doi

10.1080/00016480802579082

subject

Has Abstract

pub_date

2009-10-01 00:00:00

pages

1061-6

issue

10

eissn

0001-6489

issn

1651-2251

pii

907278663

journal_volume

129

pub_type

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