Hearing thresholds in patients affected by rheumatoid arthritis

Abstract

Hearing thresholds in patients affected by rheumatoid arthritis The aim of the study was to evaluate hearing thresholds in 38 patients with rheumatoid arthritis, divided according to disease activity into active (group A, n = 20) and non‐active (group B, n = 18) patients. Pure tone audiometry, tympanometry and complete rheumatological assessment were performed. All patients presented poorer auditory thresholds compared with controls. Patients of group A had both air and bone conduction thresholds poorer than group B (although not statistically significant), and most patients of both groups presented an air–bone (a–b) gap. No significant difference in middle ear pressure was noticed between patients and controls. No correlation between hearing impairment and duration of the disease or patients' age was found. The high prevalence of hearing loss in autoimmune diseases supports the importance of audiometric evaluation in such patients. The auditory recovery through middle ear surgery before cranial nerve involvement could be considered in selected patients. Further investigations are needed for a better knowledge of the middle and inner ear involvement in patients with rheumatoid arthritis.

Relationship Between Disease Activity and Hearing Loss in Rheumatoid Arthritis Patients A Case Control Study

“…The DAS disease activity score was higher in cases of RA with hypoacusia. Those results are consistent with some literature data [4,9,16,17,21]. Takatsu et al detected statistical significant correlations between the degree of hearing loss and the plasma concentrations of interleukin 6 and metalloproteinase [10].…”

Flexibility within the middle ears of vertebrates

“…128 A histological study of rheumatoid arthritis has also suggested malleo-incudal and incudo-stapedial joint involvement, 129 and the expected increase in stiffness of the middle ear has been documented. [130][131][132][133] In contrast, other studies have found a decrease in stiffness, 134,135 but this could relate to changes in other parts of the ear, such as the tympanic membrane 134 or the joint capsules and ligaments. 133 Small conductive and sensorineural hearing losses have been reported in a proportion of patients with rheumatoid arthritis.…”

“…133 Small conductive and sensorineural hearing losses have been reported in a proportion of patients with rheumatoid arthritis. 132,[136][137][138] It has been suggested that the sensorineural hearing impairment may be due to an increase in compressive force on the labyrinth, 131 perhaps due to a relative inability to buffer static pressure changes. However, alternative hypotheses include the effects of systemic neuritis, vasculitis or salicylate toxicity.…”

Evaluation of Hearing Functions with Audiological Tests in Patients with Rheumatoid Arthritis

“…[19] otoimmun hastalığı olan kişilerde iç kulağın durumunu incelemişler ve RA'lı hastalarda bilateral progresif sensorinöral işitme kaybı olduğunu tespit etmişlerdir. İşitme kayıpları genellikle SN tipte işitme kaybı olarak bildirilse de, birçok çalışmada SN ve iletim tipi işitme kaybının sıklıkla birlikte olduğu vurgulanmaktadır [4,9,10,15,20]. Literatüre benzer şekilde bu ça-lışmada da, RA'lı hasta grubumuzda iletim tipi işitme kaybının anlamlı olarak daha fazla olduğu, kemik yolu iletiminin ise özellikle yüksek frekanslarda ve kısmen etkilendiği ve sonuçta hem iletim tipi hem de SN tip işitme kayıpları olduğu görüldü.…”

“…[23] hastalığın aktif döneminde, yüksek frekanslarda işitme kaybının fazla olduğunu göstermiştir. Bu yayınlara rağmen birçok çalışmada ise, herhangi bir korelasyon olmadığı bildirilmiştir [20][21][22][23][24][25]. Bizim çalışmamızda da; hastaların RF pozitifliği, şiş eklem sayısı, sedimantasyon ve CRP değerleri ile işitme kaybı arasında herhangi bir ilişki saptanmamıştır.…”