Hearing loss in patients with scleroderma: associations with clinical manifestations and capillaroscopy

Abstract

Systemic sclerosis is a multi-systemic disease with widespread small-vessel vasculopathy and fibrosis. Involvement of the middle and inner ear and hearing loss has been reported as an uncommon manifestation of scleroderma in some studies. In this study, we evaluated hearing problems in scleroderma patients and determined its association with clinical manifestations and capillaroscopy. We evaluated 54 patients with scleroderma referred to Hafez Hospital clinic of scleroderma related to Shiraz University of Medical Science; they fulfilled the LeRoy and ACR/EULAR criteria for scleroderma. Control group consisted of 60 normal individuals. All clinical manifestations, nail fold capillaroscopy, pure tone audiometry, speech reception threshold, and speech audiometry were recorded during evaluation. Subjective hearing loss and objective hearing loss were seen in 10 and 36 patients of the case group (18.5%, 66.7%) and 6 and 10 of the control group (10%, 28.3%) (P values 0.03, < 0.001). Sensorineural hearing loss, abnormal pure tone audiometry, and abnormal speech reception threshold were more common in scleroderma patients compared to the control group (P values of < 0.001, < 0.001, and < 0.001). There was no correlation between objective hearing loss and type of scleroderma, duration of disease, skin score, interstitial lung disease, digital ulcer, gastrointestinal involvement, or nail fold capillaroscopy patterns (all P values > 0.05). In our study, subjective and objective hearing loss were higher in patients with scleroderma compared to the control group and also sensorineural hearing loss, abnormal pure tone audiometry, and abnormal speech reception threshold. There was no correlation between objective hearing loss and clinical manifestations or capillaroscopy findings.

Prevalence of retinal changes in patients with systemic sclerosis: the association between retinal vascular changes and nailfold capillaroscopic findings

“…A previous study by Shenavandeh et al [25] on the correlation of ear involvement and capillaroscopy of SSc patients also did not show any correlation between nailfoldcapillary changes and ear involvement, so it seems the pathogenic mechanisms in organs such as the ear and eye are different from nailfold capillaries in these patients.…”

“…The demographic data including disease duration (date of first Raynaud's and non-Raynaud's symptoms); serological (anti-Scl-70, anti-centromere and antinuclear antibody), clinical [diffuse cutaneous SSc (dsSSc), and limited cutaneous SSc (lcSSc)] subsets according to LeRoy et al [1]; and skin scoring according to the definition by LeRoy et al in the MRSS (Modified Rodnan Score) [18] classified into 5 groups -normal, mild (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14), moderate (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29), severe (30-39) and end stage (40+) -were gathered. Pulmonary involvement was assessed by high resolution CT scan (HRCT) at the first screening or after detecting low diffusing capacity of lung for carbon mono xide (DLCO) < 80% or low forced expiratory volume (FEV 1 ) < 75% in the pulmonary function test (PFT).…”

Human otopathology in scleroderma

“…4 From an otologic perspective, about 20%-40% of individuals with scleroderma develop hearing loss and related symptoms such as tinnitus and/or vertigo. [5][6][7] Sensorineural hearing loss predominates as was noted in a cohort study of 13 patients with scleroderma and hearing loss. 8 Whereas the association between scleroderma and hearing loss has been demonstrated, the mechanisms behind auditory dysfunction in scleroderma patients are not well understood.…”

Hearing Loss Secondary to Systemic Sclerosis Vasculopathy: Case Study with a Short Review

“…Shenavandeh and his study team reported 10 cases of subjective hearing loss and 36 cases of objective hearing loss in patients with SSc, as compared to the control group of 6 and 10 patients, respectively. 25 …”