Changes in auditory ossicles in rheumatoid arthritis: scanning electron microscopic study

Abstract

The aim of this study was to define the existence of surface changes on auditory ossicles caused by rheumatoid arthritis. The study comprised of nine pairs of auditory ossicles (mallei and incudes) from autopsy of patients with rheumatoid arthritis, and five pairs of ossicles from persons without RA, taken during autopsies. The specimens were studied with JEOL JSM 5300 type scanning electron microscope. Surface changes of auditory ossicles were defined, affected areas were calculated, and expressed in percentage of total surface. Changes in auditory ossicles in patients with rheumatoid arthritis are significantly higher than in control ossicles, both on ossicular surface and articulations. Increased lysis of incudes, especially in the region of long propagation, corresponds to vascular damage. Articular degeneration is also present, indicating specific rheumatoid alteration. Both changes are statistically more intense in cases with longer duration of disease. In conclusion, rheumatoid arthritis reduces vascularity of auditory ossicles and causes degeneration of articular surfaces.

Hearing Loss in Rheumatoid Arhritis

“…Scanning electron microscopic study of auditory ossicles from patients with RA confirmed significantly higher incidence of surface and articular changes. Longer duration of disease caused more intense ossicular alterations [15]. Hearing was worse in older patients, with longer duration of disease, with active disease, and RA nodules.…”

Idiopathic Inflammatory Arthritis in the Auditory Canal in a Patient With Hearing Impairment: A Case Report and Literature Review

“…Although hearing impairment occurs frequently in patients with autoimmune disease, the pathogenesis of hearing impairment remains controversial [ 13 , 15 ]. Bone defects in the middle ear were observed in murine models of RA and destruction of the incudostapedial and incudomalleolar joints can result in impaired conduction [ 18 , 34 ]. However, it does not necessarily lead to a hearing impairment [ 6 , 17 , 23 ].…”

“…Sensorineural hearing loss was the most common hearing impairment, occurring in up to 80% of cases, following by conductive hearing loss [ 13 , 15 ]. While conductive hearing loss can be caused by arthritis of the incudostapedial and incudomalleolar joints, sensorineural hearing loss can be associated with inflammation of the inner ear, as well as vasculitis, neuritis, or deposition of immune complex, which result in cochlear damage [ 15 - 18 ]. The risk factors for hearing impairment in RA include old age, male, long disease duration, and anti-citrullinated peptide antibody (ACPA) positivity [ 13 - 15 ].…”

“…Hearing impairment has been reported in patients with autoimmune diseases including rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA), systemic lupus erythematosus (SLE), and vasculitis [1][2][3][4][5][6][7][8][9][10]. Among autoimmune diseases, previous studies have described the association between hearing impairment and RA [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. While hearing impairment has been reported to occur in up to 60% of patients with RA, its pathogenesis is not clear [11].…”

Hipoacusia neurosensorial subclínica en pacientes femeninas con artritis reumatoide

“…Aunque algunos autores hacen énfasis en la naturaleza neurosensorial de la hipoacusia, otros consideran el oído medio como el blanco primario de la enfermedad 19,20 .…”