Elsevier

American Journal of Otolaryngology

Volume 25, Issue 6, November–December 2004, Pages 411-417
American Journal of Otolaryngology

Original contributions
High-frequency hearing loss and middle ear involvement in rheumatoid arthritis

https://doi.org/10.1016/j.amjoto.2004.06.001Get rights and content

Abstract

Purpose

We aimed to evaluate the possible changes in the middle ears of patients with rheumatoid arthritis (RA) and to measure their hearing functions by eleven different test frequencies including standard and high frequencies.

Materials and methods

The study group was comprised of 74 patients with RA. The control group was comprised of 45 healthy subjects. We performed speech test, tympanometry, acoustic reflex test, and standard and high-frequency pure tone audiometric tests in the study and the control groups.

Results

It was observed that significant increases in the thresholds of pure tones in all test frequencies for the study group versus the controls (P <.0001). In terms of the duration of the disease, hearing loss of the patients with disease duration of 1 to 5 years was higher than that of the controls and exceeded beyond the level of 20 dB especially in high frequencies starting from 10,000 Hz. In patients with disease duration of 6 to 10 years, the beginning point for hearing loss was 4,000 Hz. The patients with disease duration of 11 to 15 years and of above 16 years had high hearing thresholds in all frequencies. We found normal pressure in the middle ears of the study and the control groups.

Conclusion

Sensorineural type hearing loss developed in patients with RA especially in high frequencies. We also determined a diminished compliance in the middle ears of those patients, but this was not in a level of a conducting type hearing loss.

Section snippets

Materials and methods

The present study was performed in a total of 74 patients, at Fırat Medical Centre Ear, Nose, and Throat Clinic and Audiology Unit, Fırat University. The sampling method was explained, and informed consent was obtained from each patient.

Results

The study group was comprised of 74 patients (70 women and 4 men) with RA (mean age: 47.95 ± 12.86 years, range: 27–60). The control group was comprised of 45 sex- and age-matched healthy subjects including 41 women and 4 men (mean age: 45.24 ± 10.18 years, range: 26–60). The mean disease duration was 10.08 ± 7.23 years in the study group (range: 1–26 years).

Discussion

Hearing impairment in patients with rheumatoid arthritis is a subject of debate, and its nature and extent has not been fully delineated. Although some authors stress the sensorineural nature of the hearing loss, others consider the middle ear as the primary target of the disease.2, 9, 10, 13 In the ossicular joint of a patient with RA, dissolution of disk material was observed together with proliferation of synovial-type elements of the disk and articular surfaces, with formation of

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