Hearing difficulties are common in patients with rheumatoid arthritis
- 202 Downloads
Rheumatoid arthritis (RA) is well known to affect many different organ systems. Previous work suggests that this includes the auditory system and that measures of hearing may be related to indices of RA disease activity. The aims of this study were to determine whether hearing loss in young subjects with rheumatoid arthritis is greater than would be expected in the normal population and whether disease activity or duration correlate with hearing levels. About 55 patients (less than 50 years old) with RA were sampled from a secondary-care-level population. Pure-tone audiograms, transient evoked otoacoustic emissions (TEOAEs) and rheumatological assessment including disease duration and the DAS28 disease activity score were carried out. Subjective hearing loss was a common symptom with a prevalence of 29.6% (95% CI 17.8–42.2%). The prevalence of conductive hearing loss was 1.9% (95% CI 0.3–9.7%)). Subjects with RA had worse hearing than expected at low and middle frequencies (250 Hz to 2 kHz). TEOAEs were absent in 15 of 84 (18%, 95% CI 11–27%) normal ears. No relationship was demonstrated between hearing thresholds and markers of disease activity or other rheumatological parameters. Hearing loss is common in young people with RA and should be sought by clinicians caring for this patient population. TEOAEs are absent in a higher proportion of patients than expected, and this may be a marker of early asymptomatic hearing loss. It may be conductive or sensorineural and may take any configuration, including low-frequency loss.
KeywordsHearing loss Rheumatoid arthritis
Thanks are due to Sally Kerry, Senior Lecturer in Medical Statistics at St George’s Hospital, for her advice concerning statistical analysis. The first author was supported in presenting some results from this study at the International Association of Physicians in Audiology meeting in Mexico 2006 by the TWJ Foundation and the British Society of Audiology.
- 3.Magaro M, Altomonte Z, Mirone L et al (1990) Sensorineural hearing loss in rheumatoid arthritis. Clin Exp Rheum 8:487–490Google Scholar
- 8.Toone E, Hayden D, Ellman H (1965) Ototoxicity of chloroquine. Arthritis Rheum 8:475–476Google Scholar
- 9.Kastianioudakis I, Skevas A, Danielidis V et al (1995) Inner ear involvement in rheumatoid arthritis: a prospective clinical study. J Laryngol Otol 109:713–718Google Scholar
- 15.British Society of Audiology (2004) Recommended procedure for pure tone air and bone conduction threshold audiometry with and without masking and determination of uncomfortable loudness levels. Accessed online at http://www.thebsa.org.uk July 2007
- 16.Davis A (1995) Hearing in adults. Whurr, London, UKGoogle Scholar
- 19.Robinette M (1992) Clinical observations with transient otoacoustic emissions with adults. Semin Hear 13:23–36Google Scholar