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The graph shows air conduction (AC) and bone conduction (BC) mean thresholds of both groups A and B.
Source publication
The aim of the study was to evaluate hearing thresholds in 38 patients with rheumatoid arthritis, divided according to disease activity into active (group A, n = 20) and non-active (group B, n = 18) patients. Pure tone audiometry, tympanometry and complete rheumatological assessment were performed. All patients presented poorer auditory thresholds...
Context in source publication
Context 1
... A had mean air conduction thresholds between 32.4 (AE22.2) and 60.6 (AE26.6) dBHL, with the poorest threshold at 8000 Hz, and mean bone conduction thresholds between 16.1 (AE9.6) and 34.4 (AE 19.1) dBHL, with the poorest threshold at 4000 Hz. Group B had mean air conduction thresholds between 24.2 (AE5.8) and 55 (AE25.9) dBHL, with the poorest threshold at 8000 Hz, and mean bone conduction thresholds between 14.2 (AE6.6) and 39.2 (AE14.2) dBHL, with the poorest threshold at 4000 Hz (Fig. ...
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The test performance of a wideband acoustic transfer function (ATF) test and 226-Hz tympanometry was assessed in predicting the presence of conductive hearing loss, based on an air-bone gap of 20 dB or more. Two ATF tests were designed using an improved calibration method over a frequency range (0.25-8 kHz): an ambient-pressure test and a tympanome...
To test the hypothesis proposed in a recent French study that a history of recurrent otitis media (OM) in childhood increases susceptibility to hearing loss from frequent exposure to a personal stereo (PS) during development to early adulthood.
A subcohort of 358 young adults selected from a historic cohort study, all 18 years old and with a well-d...
Background:
The effect of postmenopausal osteoporosis on the middle ear mechano-acoustic system is unknown. The aim of this study is to investigate whether or not middle ear resonance frequency is affected in females with postmenopausal osteoporosis.
Methods:
The study included postmenopausal women aged 45-60 years, separated into 2 groups as fe...
Citations
... It is unclear why autoimmune reactions in joints also occur in the inner ear; however, it is thought that autoreactive lymphocytes circulating throughout the body are induced in the inner ear by certain factors. It has previously been reported that 82 % of patients were accompanied by high-pitched sensorineural hearing loss [48], while stria vascularis destruction has been observed in 71.4 % of RA mouse models. Based on these findings, lymphocyte infiltration may have occurred. ...
... Regarding correlations of hearing loss in RA patients, it correlated only with disease duration and activity via DAS28, however no correlations existed with age, RF positivity, ESR, rheumatoid nodules, degree of disability, or certain types of medications. Despite concordance with some studies (1,4,5) , other studies found different correlations (25,26) , or used different functional or disability indices (3) . Furthermore, the present study reported disease duration as a predictor of hearing loss among RA patients. ...
... Although Yildirim et al. [24] detected hearing impairment at high frequency (4000 Hz) in active RA patients by comparing the audiometric findings of 62 patients with active disease to 26 individuals in remission using the (DAS28CRP) test. However, Salvinelli et al. [25] studied 20 active RA patients, 18 inactive, and 38 healthy controls. He stated that RA patients had higher auditory thresholds than controls but did not demonstrate a statistically significant difference in hearing thresholds between active and inactive patients. ...
Objectives:To compare hearing thresholds between control subjects and rheumatoid arthritis (RA) patients, and between active and remission status. Materials and Methods:Thirty(30) Rheumatoid patients (RA group) and Twenty (20) healthy subjects (control group) were included in the study. Both groups were subjected to audiological testing: Pure tone audiometry, extended high frequency audiometry and auditory brain stem response (ABR). In RA group, the disease activity was assessed using DAS28-CRP. Results:The air conduction pure-tone hearing thresholds were significantly higher at frequencies: 2000, 4000, 8000 Hz in the RA than control group. The extended high frequency audiometry hearing thresholds were significantly higher in Rheumatoid patients at 12000 and 16000 Hz. ABR showed a significant difference between the RA and control group regarding the absolute wave Vlatency only (P<0.05).The thresholds of pure tone audiometry and extended high frequency audiometry were higher in active patients than patients with remission, with significant difference at 12000 and 16000 Hz. A significant difference was observed between the active patients and patients with remission for the absolute wave Vlatency only. There was a significant positive correlation between the hearing threshold, ABR wave V latencyand the activity of the RA patients (P<0.05). Conclusion: RA patients are at risk of hearing impairement, especially those with active disease.
... Since the relationship among RA and hearing impairment is as again argumentative (1,15,16) and just a little systematic inquiries have contrasted the proficiency and feasible impairment of the auditory system in patients with RA, so the goal of present study was to specify and compare hearing impairment in these group of patients and healthy controls employing pure tone audiometry (PTA), speech audiometry and tympanometry. ...
Background:
Previous studies showed that one of the complications of rheumatoid arthritis disease was auditory disorder. The goal of the present study was to compare the auditory status in patients with rheumatoid arthritis and healthy individuals.
Methods:
In the present case-control study, 30 normal persons and 60 persons with rheumatoid arthritis with mean age of 46.72 and standard deviation of 6.76 of both genders were appraised using pure tone audiometry, tympanometry and speech audiometry. The mean disease duration in patients with rheumatoid arthritis was 12.51±6.09 years.
Results:
The frequency of hearing loss in rheumatoid arthritis group was significantly more than the control group (p=0.001). All patients had sensorineural hearing loss. Only in 5% of rheumatoid arthritis group, abnormal tympanometry (as type) was reported. Speech discrimination score analysis showed significant difference between the patients with rheumatoid arthritis and controls. In terms of hearing threshold level, the mean hearing threshold level (in 2000, 4000 and 8000 Hz frequencies) of the patients with rheumatoid arthritis was significantly higher than control group in both ears (p<0.05). A positive significant correlation was found among mean hearing threshold level in 4000 and 8000 Hz frequencies and rheumatoid arthritis duration in both ears.
Conclusion:
The frequency of hearing loss and the average hearing threshold in RA patients were higher than healthy individuals. The most common type hearing loss is sensorineural.
... Acute audiovestibular failure has also been reported in primary antiphospholipid syndrome [7,8]. SNHL of the middle and high frequencies and patulous Eustachian tube have been described in patients with systemic sclerosis and less frequently mixed hearing loss [9]. Other diseases such as ankylosing spondylitis and Sjögren's syndrome also showed audiovestibular manifestations [3]. ...
... suggested. Moreover, the inner ear itself could be the site of immune complex deposition [9,21]. Lowfrequency SNHL was found in three cases with RA and might be related to endolymphatic hydrops (which is known to be associated with RA) with later progression to higher frequencies. ...
Background
Audiovestibular manifestations are reported in autoimmune diseases including hearing loss and vestibular symptoms.
Objectives
This study is designed to evaluate the audiovestibular manifestations in patients with different autoimmune diseases especially asymptomatic cases.
Subjects and Methods
This work included two groups: study group (29 cases with different autoimmune diseases) and control group (20 healthy subjects). All participantswere subjected to basic audiologic evaluation, Sinusoidal harmonic acceleration (SHA) test of the rotatory chair at different frequencies (.01-.64Hz).
Results
patients with ADs showed elevated hearing thresholds (>25dBHL) at all tested frequencies. As regard SHA test, only 5 cases from the study grop showed normal results, while the rest of cases showed vestibular hypofunction (bilateral in 22 cases and unilateral in 3 cases).
Conclusion
Audiovestibular symptoms are common in different autoimmune diseases even asymptomatic cases. SHA test showed that vestibular affection is much more frequent than expected. So, regular screening of hearing and vestibular functions in patients with autoimmune should be done, for better and early management.
... The anomalous compressive effect exercised on labyrinthine fluids by the stiffened ossicular chain, combined with the chemical damage because of the inflammatory mediators produced by inflamed stapedio-ovalar articulation. 11 Takatsu et al, showed that IL-6 and matrix matalloproteinase-3 may harm inner ear cells by an oxidative process, whereas MMP-3, RF and anti-ccp antibody are not significant in pathogenesis of SNHL. 12 Our study has found no difference in incidence of hearing impairment with regarding to RF and anti-ccp status of the patients with RA. ...
Background: Rheumatoid Arthritis (RA) is a chronic multisystem disease commonly affecting the synovial joints. Involvement of middle ear ossicular chain in RA may lead to hearing loss. The effects of hearing loss are profound, with consequences in the social, functional, and psychological well-being of the persons affected. Both conductive and sensorineural types of hearing impairments have been found in these patients in various studies. This study aimed at evaluating the prevalence of hearing impairment in our patients.Methods: Pure tone and impedance audiograms were taken for 100 RA patients who came to the outpatient department. They were divided into three groups based on their disease activity (DAS28). The hearing thresholds were compared among these groups. Tympanographic features and acoustic reflexes were recorded. Disease duration was also taken into account for asessing the severity of hearing impairment.Results: Out of 100 patients, 52 patients had significant hearing impairment audiometrically, of which 44 had sensorineural, 1 conductive and 7 mixed impairments. No significant difference was found between the hearing thresholds and the disease activity but those with high disease activity had higher incidence of abnormal tympanograms (72.2%) and absence of acoustic reflex (55.5%). Prevalence of hearing impairment was found to be increased with increasing disease duration, with steep rise between 5 and 10 years of disease duration.Conclusions: Hearing impairment affects the quality of life adversely. Severity of hearing impairment is significantly associated with having a hearing-related handicap and with self-reported communication difficulties. Thus, hearing assessment if done routinely can improve the outcome in these patients.
... [4][5][6] With respect to the auditory system, previous studies have shown conflicting findings, in both hearing loss (HL) and the RA disease activity and severity. [7][8][9][10] There is a wide variation in the reported prevalence of HL in patients with RA. Sensorineural hearing loss (SNHL) is the most common hearing impairment in patients with RA, ranging from 25% to 72%, 11 whereas conductive HL and mixed HL are less frequently reported. ...
Objectives
Population studies on hearing loss (HL) associated with rheumatoid arthritis (RA) are lacking. This study investigated the risk of developing HL in patients with RA using a nationwide population cohort.
Setting
The population-based insurance claims data in the Taiwan National Health Insurance Research Database.
Design
Retrospective cohort study followed up RA cohort and control cohort without RA frequency matched by sex, age and diagnosis year.
Study population
18 267 patients with RA newly diagnosed in 2000–2006 and 73 068 controls without RA.
Main outcomes
Incidences of HL by the end of 2011 and the RA cohort to non-RA cohort HRs after adjusting for sex, age and comorbidities.
Results
The HL incidence was higher in the RA cohort than in the non-RA cohort (3.08 vs 1.62 per 1000 person-years), with an adjusted HR (aHR) of 1.91 (95% CI 1.70 to 2.14) for the RA cohort relative to the non-RA cohort after controlling for age, sex and comorbidities. Men and the elderly are at a higher risk. Cardiovascular comorbidities were associated with a further increased HL risk for patients with RA. Medications were associated with reduced HL incidence; patients with RA who used non-steroidal anti-inflammatory drugs (NSAIDs) had an aHR of 0.12 (95% CI 0.07 to 0.20), compared with non-users.
Conclusions
This study demonstrates that patients with RA are at an increased risk of developing HL. Findings highlight the need of disease-modifying treatment and scheduled auditory examinations for HL prevention and early detection for patients with RA.
... patients with RA may have extra-articular manifestations involving other organ systems [3], such as auditory system alteration, although with a different putative mechanism of damage [4][5][6]. With respect to the auditory system, previous studies have shown conflicting findings, both as to the types of hearing loss and as to the RA disease activity and severity associated with hearing levels [7][8][9][10]. ...
... patients with RA may have extra-articular manifestations involving other organ systems [3], such as auditory system alteration, although with a different putative mechanism of damage [4][5][6]. With respect to the auditory system, previous studies have shown conflicting findings, in both types of hearing loss, and the RA disease activity and severity [7][8][9][10]. ...
... In addition, patients with RA may have extra-articular manifestations involving other organ systems, 3 such as auditory system alteration, although with a different putative mechanism of damage.[4][5][6] With respect to the auditory system, previous studies have shown conflicting findings, in both hearing loss (HL) and the RA disease activity and severity.[7][8][9][10] ...
... With respect to the auditory system, conflicting findings were found, both as to the type of hearing loss that may occur and as to whether markers of RA disease activity and severity correlate with hearing levels [6][7][8]. ...
Abstract Objective This study was designed to assess hearing and vestibular function in patients with rheumatoid arthritis (RA) in comparison with a control group. In addition, we correlated these findings in disease activity and severity. Materials and methods Totally, 40 RA patients (35 women and five men) diagnosed according to the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria and 20 healthy controls (11 women and nine men), whose age ranged from 25 to 66 years with a mean age of 45.5±12.4 years, were included in the study. Each individuals was tested with pure tone audiometry. Mean values of air and bone conduction at each frequency and tympanometric values were calculated for the study groups. Videonystagmography (VNG) test including smooth pursuit, saccade, optokinetic tests, positioning tests, positional test, and water caloric tests was also carried out. Results The mean air conduction threshold values at high frequencies (4000 and 8000 Hz) in the RA group were lower than in the control group. The difference between mean air conduction threshold values of the control group and the RA group at high frequencies was statistically significant (P0.05). VNG testing revealed central abnormalities in 12 (30%) patients, peripheral abnormalities in nine (22.5%) patients, and mixed abnormalities in one (2.5%) patient. There was no association between VNG abnormalities in patients with RA and age, sex, duration of disease, accompanying vertigo complaint, and the laboratory findings (P>0.05). Conclusion There is an association between RA and audiovestibular system dysfunction regardless clinical and demographic situation of patients. We assume that the shearing and vestibular disturbances in RA are more prevalent than previously recognized. High-frequency hearing loss in RA patients could be an indicator of cochlear involvement.
... On the other hand, Ozcan et al. [11] measured an increased prevalence of SNHL in 37 RA patients compared to age-matched controls, but the difference was not significant. Inner ear impairment was assumed [12,13], but the reduced otoacoustic emissions in RA patients [6] could also be caused by CHL. No studies have yet investigated the impact of modern biologic treatments on hearing capability in RA or the dynamic process of hearing impairment in RA patients over the course of the disease. ...
Hearing loss in patients with autoimmune diseases, such as systemic lupus erythematosus (SLE), granulomatosis with polyangiitis (GPA, Wegener's granulomatosis), or rheumatoid arthritis (RA), is controversial. Many studies lack measurements of bone-conduction thresholds to sufficiently differentiate between sensorineural hearing loss and conductive hearing loss. In addition, many studies lack control groups or comparisons to an age-related normal hearing threshold. This study investigates hearing performance with an extended audiological battery using psychoacoustic and objective measures. A total of 22 adults with RA, 16 with GPA, 20 with SLE, and two age- and gender-matched control groups (n = 34 for GPA and RA and n = 42 for SLE) were included. Pure-tone hearing thresholds, speech perception in quiet and noise, tympanometry, and high-resolution otoacoustic emissions were assessed. GPA patients exhibited impaired pure-tone hearing compared to the control group, whereas SLE and RA patients did not. In GPA patients, a larger air-bone gap indicated conductive hearing loss. In addition, speech perception was reduced exclusively in GPA patients. A significant correlation was found between hearing loss and both the cumulative steroid dose and number of organ manifestations in GPA and SLE patients. Our data indicate that GPA and SLE patients are at moderate-to-high risk of conductive hearing loss. In contrast, RA patients are at low risk of disease-associated hearing loss.
