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

Abstract

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).

Cochlear implantation in patients with autoimmune inner ear disease including cogan syndrome: A comparison with age‐ and sex‐matched controls

“…This finding was not replicated in the Cogan group. In 2002, Freeman et al10 reported the feature of macrocytosis in 10 long‐term codeine users who underwent cochlear implantation following sudden or rapidly progressive SNHL. Although the authors identified codeine use as the cause of deafness, a proportion of the study population presented very similarly to our group of AIED patients with bilateral SNHL occurring over a period of weeks or months.…”

Oxymorphone Insufflation Associated with Acute Sensorineural Hearing Loss: Case Files of the University of Massachusetts Medical Toxicology Fellowship

“…In a cochlear culture model study, ototoxicity of hydrocodone/acetaminophen coformulation was in fact secondary to high levels of acetaminophen causing damage to inner and outer hair cells [42]. However, isolated acetaminophen toxicity is well described, and we were unable to find any reports of clinically demonstrated acetaminophen-related hearing loss [42][43][44]. Two reviews have demonstrated successful treatment of irreversible OAHL attributed to codeine and hydrocodone with cochlear implantation [43,44].…”

“…However, isolated acetaminophen toxicity is well described, and we were unable to find any reports of clinically demonstrated acetaminophen-related hearing loss [42][43][44]. Two reviews have demonstrated successful treatment of irreversible OAHL attributed to codeine and hydrocodone with cochlear implantation [43,44]. The efficacy of cochlear implantation suggests that the mechanism of OAHL is likely to heavily involve the cochlea [44].…”

Hearing Loss in the 21st Century and the Legacy of Beethoven

“…Colin Binns, MBBS, PhD 1 and Wah Yun Low, PhD 2,3 causes suggested include Paget's disease, Cogan's syndrome, hypovitaminosis A due to pancreatitis, drug addiction, or alcoholism. [7][8][9][10] Beethoven also suffered from renal stones, cardiac arrhythmias, and he finally died from cirrhosis. As a child, he had smallpox, which marred his appearance for life, far different from the numerous statues in Europe and the miniatures, which grace the pianos of many young music students.…”