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

  • Otology
  • Published:
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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.

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References

  1. Takatsu M, Higaki M, Kinoshita H et al (2005) Ear involvement in patients with rheumatoid arthritis. Otol Neurotol 26:755–761. doi:10.1097/01.mao.0000178138.19848.bd

    Article  PubMed  Google Scholar 

  2. Rigual NR (1987) Otolaryngologic manifestations of rheumatoid arthritis. Ear Nose Throat J 66:18–22

    Google Scholar 

  3. Coletti V, Fiorino FG, Bruni L et al (1997) Middle ear mechanics in subjects with rheumatoid arthritis. Audiology 36:136–146

    Article  Google Scholar 

  4. Frade C, Martin C (1998) Diagnostic value of the multi-frequency tympanometry in active rheumatoid arthritis. Auris Nasus Larynx 25:131–136. doi:10.1016/S0385-8146(98)00020-0

    Article  PubMed  CAS  Google Scholar 

  5. Ozcan M, Karakus MF, Gunduz OH et al (2002) Hearing loss and middle ear involvement in rheumatoid arthritis. Rheumatol Int 22:16–19. doi:10.1007/s00296-002-0185-z

    Article  PubMed  Google Scholar 

  6. Raut VV, Cullen J, Cathers G (2001) Hearing loss in rheumatoid arthritis. J Otolaryngol 30:289–294. doi:10.2310/7070.2001.19580

    Article  PubMed  CAS  Google Scholar 

  7. Kastanioudakis I, Skevas A, Danielidis V et al (1995) Inner ear involvement in rheumatoid arthritis: a prospective clinical study. J Laryngol Otol 109:713–718. doi:10.1017/S0022215100131135

    Article  PubMed  CAS  Google Scholar 

  8. Kakani RS, Mehra YN, Deodhar SD et al (1990) Audiovestibular functions in rheumatoid arthritis. J Otolaryngol 19:100–102

    PubMed  CAS  Google Scholar 

  9. Magaro M, Zoli A, Altomonte L et al (1990) Sensorineural hearing loss in rheumatoid arthritis. Clin Exp Rheumatol 8:487–490

    PubMed  CAS  Google Scholar 

  10. Elwany S, El Garf A, Kamel T (1986) Hearing and middle ear function in rheumatoid arthritis. J Rheumatol 13:878–881

    PubMed  CAS  Google Scholar 

  11. Reiter D, Konkle DF, Myers AR et al (1980) Middle ear immittance in rheumatoid arthritis. Arch Otolaryngol 106:114–117

    PubMed  CAS  Google Scholar 

  12. Bayazit YA, Yilmaz M, Gunduz B et al (2007) Distortion product otoacoustic emission findings in Behçet’s disease and rheumatoid arthritis. ORL J Otorhinolaryngol Relat Spec 69(4):233–238. doi:10.1159/000101544

    PubMed  Google Scholar 

  13. Arnett FC, Edworthy SM, Bloch DA et al (1988) The American Rheumatism Association 1987 Revised Criteria for the Classification of Rheumatoid Arthritis. Arthritis Rheum 31:315–324. doi:10.1002/art.1780310302

    Article  PubMed  CAS  Google Scholar 

  14. Ritchie DM, Boyle JA, Mclnnes JM et al (1968) Clinical studies with an articular index for the assessment of joint tenderness in patients with rheumatoid arthritis. Q J Med 37:393–406

    PubMed  CAS  Google Scholar 

  15. Steinbrocker O, Traeger CH, Batterman RC (1949) Therapeutic criteria in rheumatoid arthritis. J Am Med Assoc 140:659–662

    PubMed  CAS  Google 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 1423–1428

    Google Scholar 

  17. Green DS (1983) Pure tone air conduction testing. In: Katz J (ed) Handbook of clinical audiology, 2nd edn. Waverly Press, Baltimore, pp 98–108

    Google Scholar 

  18. Nomura K, Nakao M, Yano E (2005) Hearing loss associated with smoking and occupational noise exposure in a Japanese metal working company. Int Arch Occup Environ Health 78(3):178–184. doi:10.1007/s00420-005-0604-z

    Article  PubMed  Google 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

  20. Siamopoulou-Mavridou A, Skevas A, Moutsopoulos HM (1990) Middle ear function in patients with juvenile chronic arthritis. Ann Rheum Dis 49:620–623. doi:10.1136/ard.49.8.620

    Article  PubMed  CAS  Google Scholar 

  21. Heyworth T, Liyanage SP (1972) A pilot survey of hearing loss in patients with rheumatoid arthritis. Scand J Rheumatol 1:81–83. doi:10.3109/03009747209103000

    Article  PubMed  CAS  Google Scholar 

  22. Gussen R (1977) Atypical ossicle joint lesions in rheumatoid arthritis with sicca syndrome (Sjogren syndrome). Arch Otolaryngol 103:284–286

    PubMed  CAS  Google Scholar 

  23. Seçkin U, Ozoran K, Ikinciogullari A et al (2000) Hydroxychloroquine ototoxicity in a patient with rheumatoid arthritis. Rheumatol Int 19:203–204. doi:10.1007/s002960000054

    Article  PubMed  Google Scholar 

  24. Coutinho MM, Duarte I (2002) Hydroxychloroquine ototoxicity in a child with idiopathic pulmonary haemosiderosis. Int J Pediatr Otorhinolaryngol 62:53–57. doi:10.1016/S0165-5876(01)00592-4

    Article  PubMed  Google Scholar 

  25. Wen B, Liang C, He G et al (2005) A randomized controlled trail on vasodilators and steroids for sudden sensorineural hearing loss. Lin Chuang Er Bi Yan Hou Ke Za Zhi 19(16):724–726

    PubMed  Google Scholar 

  26. Jurkiewicz D, Kantor I, Usowski J (2006) Assessment of betahistine dihydrochloride effectiveness in the treatment of disturbance of balance system, based on analysis of doctors and patients questionnaires results. Pol Merkur Lekarski 21(Suppl 1):3–12

    PubMed  Google Scholar 

  27. Sheehy JL (1960) Vasodilator therapy in sensory-neural hearing loss. Trans Am Laryngol Rhinol Otol Soc 1960:570–602

    PubMed  CAS  Google Scholar 

  28. García Callejo FJ, Conill Tobías N, Muñoz Fernández N et al (2007) Hearing impairment in patients with rheumatoid arthritis. Acta Otorrinolaringol Esp 58(6):232–238. doi:10.1016/S0001-6519(07)74919-1

    Article  PubMed  Google Scholar 

  29. Murdin L, Patel S, Walmsley J et al (2008) Hearing difficulties are common in patients with rheumatoid arthritis. Clin Rheumatol 27(5):637–640. doi:10.1007/s10067-007-0802-z

    Article  PubMed  Google Scholar 

  30. Fechter L, Thorne P, Nuttall A (1987) Effects of carbon monoxide on cochlear electrophysiology and blood flow. Hear Res 27:37–45. doi:10.1016/0378-5955(87)90024-4

    Article  PubMed  CAS  Google Scholar 

  31. Cruickshanks KJ, Klein R, Klein BEK et al (1998) Cigarette smoking and hearing loss. The epidemiology of hearing loss study. JAMA 279(21):1715–1719. doi:10.1001/jama.279.21.1715

    Article  PubMed  CAS  Google Scholar 

  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)

  33. Marchant CD, McMillan PM, Shurin PA et al (1986) Objective diagnosis of otitis media in early infancy by tympanometry and ipsilateral acoustic reflex thresholds. J Pediatr 109(4):590–595. doi:10.1016/S0022-3476(86)80218-9

    Article  PubMed  CAS  Google Scholar 

  34. Shurin PA, Pelton SI, Finkelstein J (1977) Tympanometry in the diagnosis of middle-ear effusion. N Engl J Med 296(8):412–417

    Article  PubMed  CAS  Google Scholar 

  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

    Article  PubMed  CAS  Google Scholar 

  37. Li G, Sha SH, Zotova E et al (2002) Salicylate protects hearing and kidney function from cisplatin toxicity without compromising its oncolytic action. Lab Invest 82:585–596. doi:10.1038/labinvest.3780453

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

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

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Authors and Affiliations

  1. ENT Department, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey

    Oğuzhan Dikici & Nuray Bayar Muluk

  2. Birlik Mahallesi, Zirvekent 2. Etap Sitesi, C-3 blok, No: 62/43, 06610, Çankaya/Ankara, Turkey

    Nuray Bayar Muluk

  3. Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey

    Aliye Kapukiran Tosun & Ihsan Ünlüsoy

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  1. Oğuzhan Dikici
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  2. Nuray Bayar Muluk
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  3. Aliye Kapukiran Tosun
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  4. Ihsan Ünlüsoy
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Correspondence to Nuray Bayar Muluk.

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Dikici, O., Muluk, N.B., Tosun, A.K. et al. Subjective audiological tests and transient evoked otoacoustic emissions in patients with rheumatoid arthritis: analysis of the factors affecting hearing levels. Eur Arch Otorhinolaryngol 266, 1719–1726 (2009). https://doi.org/10.1007/s00405-009-0975-y

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  • DOI: https://doi.org/10.1007/s00405-009-0975-y

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