Subjective audiological tests and transient evoked otoacoustic emissions in patients with rheumatoid arthritis: analysis of the factors affecting hearing levels
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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.
KeywordsRheumatoid 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.
- 2.Rigual NR (1987) Otolaryngologic manifestations of rheumatoid arthritis. Ear Nose Throat J 66:18–22Google Scholar
- 16.Lipsky PE (1987) Rheumatoid arthritis. In: Braunwald E, Isselbacher KJ, Petersdorf RG, Wılson JD, Martin JB, Fauci AS (eds) Harrison’s principles of internal medicine 2, vol 2, 11th edn. McGraw-Hill, New York, pp 1423–1428Google Scholar
- 17.Green DS (1983) Pure tone air conduction testing. In: Katz J (ed) Handbook of clinical audiology, 2nd edn. Waverly Press, Baltimore, pp 98–108Google Scholar
- 19.52nd WMA General Assembly (2000) World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 284:3043–3049. doi: 10.1001/jama.284.23.3043
- 32.Lantz J, Petrak M, Prigge L (2004) High-frequency immittance with infants. Using the 1000-Hz probe for immittance measurements in infants. Hear J 57(10). http://www.msrwest.com/Resources/1K_Probe_Tone.pdf (Accessed 15 Jan 2009)
- 35.Sutton G, Baldwin M, Brooks D, et al (2002) Tympanometry in neonates and infants under 4 months: a recommended test protocol. The Newborn Hearing Screening Programme, UK. http://www.nhsp.info
- 36.Zhuravskii SG, Aleksandrova LA, Sirot VS et al (2004) Natural antioxidant l-carnosine inhibits LPO intensification in structures of the auditory analyzer under conditions of chronic exposure to aminoglycoside antibiotics. Bull Exp Biol Med 138(10):361–364. doi: 10.1007/s10517-004-0012-5 PubMedCrossRefGoogle Scholar