Subjective audiological tests and transient evoked otoacoustic emissions in patients with rheumatoid arthritis: analysis of the factors affecting hearing levels

Abstract

We investigated hearing functions in patients with rheumatoid arthritis (RA) using audiological tests and transient evoked otoacoustic emissions (TEOAEs). The study group consisted of 20 adult patients with RA (7 males, 13 females); 20 adult healthy subjects without RA (7 males, 13 females) were recruited as controls. All patients were evaluated by pure tone audiometry, high frequency audiometry, tympanometry and TEOAEs. There were no statistical differences between the study and control groups with respect to the pure tone and high frequency audiometries. TEOAE results of 1.0-2.0 kHz % and of 1.5 and 3.0 kHz amplitude values were significantly lower, and ipsilateral stapes reflex threshold value at 1.0 kHz was significantly higher in the study group when compared to respective values in the control group. In elderly patients and those with longer disease duration, RA nodules and higher methotrexate cumulative doses, hearing thresholds increased and TEOAE values decreased. In active stage of the disease, hearing thresholds diminished and in higher Brinkman Index values, TEOAE values decreased. Compliance values decreased in patients with higher Ritchie Articular Index, C-reactive protein, erythrocyte sedimentation rate and platelet counts, and longer disease duration. Sensorineural hearing loss is generally observed in patients with RA, and this condition may be detected by TEOAEs in an early period of the disease. Inflammation during the active stage of the disease and the subsequent fibrosis may cause conductive hearing loss of varying degrees. In those patients detected as having initiation of TEOAE decrease, vasodilator treatment and antioxidant drugs may be useful in protecting the inner ear.

Audiological Findings in Autoimmune Hepatitis: Hearing Loss at High Frequencies

“…Hearing impairment may be due to several different etiologies for each of these disorders. It may be due to vasculitis, ossicular involvement, neuritis or ototoxicity of the drugs used for the treatment of rheumatologic diseases (18). Thus, hearing loss may be seen in conductive, sensorineural or in mixed pattern in secondary AIED (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(19)(20).…”

“…Thus, hearing loss may be seen in conductive, sensorineural or in mixed pattern in secondary AIED (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(19)(20). Özcan et al suggested middle ear involvement for the reason of hearing loss in RA (18). Whereas, Kastanioudakis and colleagues have shown SNHL in RA.…”

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

“…[15], timpanometri ile değerlendirdikleri 68 RA'lı hastada , %56 oranında esneklik kaybı olduğu-nu bildirmişlerdir. Literatürde RA'lı hastalarda kontrollere göre anlamlı işitme kaybı olmadığını belirten çalışmalar [16,17] olmakla birlikte %60'ın üzerinde işitme kaybı olduğunu bildiren çalışmalar da mevcuttur [5]. Çeşitli çalışmalarda işitme kaybının 0 -%17,4 arasında iletim tipi işitme kaybı [10,13,15] olduğu, 0 -%48 arasında ise SN tipte işitme kaybı [13,18] olduğu rapor edilmiştir.…”

Hearing Loss in Rheumatoid Arhritis

“…However, substantial efficacy of etanercept has not been confirmed for improvement of hearing in patients with immune mediated cochlovestibular disorders [23]. Vasodilatators and antioxidants were also proposed for treatment of hearing loss in RA [13]. Successful use of adalimumab was verified for RA with sensorineural hearing loss [24].…”

“…Acoustic reflexes were with normal thresholds, but with occasional prolonged latency. Besides increased hearing threshold, patients with RA have higher air-bone gaps, and increased wave I latency on ABRs [12,13].…”