[T-lymphocyte subpopulation and HLA-DR antigens in hearing loss of vestibular neuropathy, Ménière's diseases and Bell's palsy].

In patients with various otoneurological diseases like hearing loss, neuronitis vestibularis, Ménière's disease and Bell's palsy, analyses concerning the immunoregulation and immunogenetics were done. For analysing the immunoregulation the T-helper (CD4) T-suppressor (CD8) ratio was determined. In contrast to patients with hearing loss caused by otobasal fractures and a healty control group, this ratio was elevated in 50% of the patients suffering from hearing loss. The elevation of the CD4/CD8 ratio was mainly caused by a reduction of CD8 positive cytotoxic-suppressor T-lymphocytes. The CD4/CD8 ratio may be of prognostic value, since an elevated ratio was found more often in patients with relapse of hearing loss, fluctuations, persistence of tinnitus or vestibular symptoms. An elevated ratio could also be detected in 48% of the patients with neuronitis vestibularis, in 50% of the patients with Ménière's disease and in 39% of the patients with Bell's palsy. A normal value was found in paralysis of the facial nerve of known origin like a state after trauma or after herpes zoster oticus paralysis. Immunogenetics was tested by HLA-DR typing. In patients with hearing loss HLA-DR4 antigen was distinctly increased, the relative risk was 2.8. The presence of the HLA-DR4 antigen proved to be an unfavourable sign, since in 44% of the patients presenting these antigens we found no improvement of the hearing. In patients with neuronitis vestibularis we found a relative risk of 3.12 and in patients with Ménière's disease a relative risk of 3.64, both for HLA-DR4.(ABSTRACT TRUNCATED AT 250 WORDS)