European Archives of Oto-Rhino-Laryngology

, Volume 266, Issue 11, pp 1719–1726 | Cite as

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

  • Oğuzhan Dikici
  • Nuray Bayar MulukEmail author
  • Aliye Kapukiran Tosun
  • Ihsan Ünlüsoy


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.


Rheumatoid arthritis (RA) Hearing levels Pure tone audiometry High frequency audiometry Transient evoked otoacoustic emissions (TEOAEs) 



The authors declare that there was no sponsor for this research and that there is no financial relationship to disclose.

Conflict of interest statement

The authors also have no conflicts of interest to declare.


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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Oğuzhan Dikici
    • 1
  • Nuray Bayar Muluk
    • 1
    • 2
    Email author
  • Aliye Kapukiran Tosun
    • 3
  • Ihsan Ünlüsoy
    • 3
  1. 1.ENT Department, Faculty of MedicineKırıkkale UniversityKırıkkaleTurkey
  2. 2.Çankaya/AnkaraTurkey
  3. 3.Department of Physical Medicine and Rehabilitation, Faculty of MedicineKırıkkale UniversityKırıkkaleTurkey

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