Examination of Hearing in a Rheumatoid Arthritis Population: Role of Extended-High-Frequency Audiometry in the Diagnosis of Subclinical Involvement (original) (raw)
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Hearing status in patients with rheumatoid arthritis
Caspian Journal of Internal Medicine, 2019
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.
Relationship Between Disease Activity and Hearing Impairment in Patients with Rheumatoid Arthritis
International journal of advanced research, 2022
The characteristics of hearing impairment (HI) in rheumatoid arthritis (RA) are still poorly understood, and their association with disease activity is based on conflicting information. This study compared HI between RA patients and controls and between active and remission RA groups using multi-frequency audiometry. This study enrolled 88 RA patients and 50 controls. The pure-tone hearing thresholds at 500 to 4000 Hz for air (AC) and bone (BC) conduction were compared between RA and controls as well as between active and remission RA patients using DAS28-CRP scores. The puretone hearing thresholds for AC and BC were significantly higher at high frequencies (2000 and 4000 Hz) in the RA group for both ears compared with controls. In addition, the BC threshold at 1000 Hz for the right ear was higher in the RA group than controls. When active and remission RA patients were compared, the thresholds were higher only at 4000 Hz for both ears for AC and BC in patients with active RA. The air-bone gap differed significantly at 2000 and 4000 Hz in both ears. This study demonstrated that patients with RA have a heightened risk of HI, and disease activity increases this risk, particularly at high frequencies. Clinicians who manage RA should be aware of HI and consider performing audiological evaluations in RA patients with active disease in particular.
Clinical rheumatology, 2015
The characteristics of hearing impairment (HI) in rheumatoid arthritis (RA) are still poorly understood, and their association with disease activity is based on conflicting information. This study compared HI between RA patients and controls and between active and remission RA groups using multi-frequency audiometry. This study enrolled 88 RA patients and 50 controls. The pure-tone hearing thresholds at 500 to 4000 Hz for air (AC) and bone (BC) conduction were compared between RA and controls as well as between active and remission RA patients using DAS28-CRP scores. The pure-tone hearing thresholds for AC and BC were significantly higher at high frequencies (2000 and 4000 Hz) in the RA group for both ears compared with controls. In addition, the BC threshold at 1000 Hz for the right ear was higher in the RA group than controls. When active and remission RA patients were compared, the thresholds were higher only at 4000 Hz for both ears for AC and BC in patients with active RA. The ...
Early detection of cochlear hearing loss in rheumatoid arthritis patients: a cross-sectional study
The Egyptian Journal of Otolaryngology
Background Rheumatoid arthritis (RA) is an inflammatory autoimmune disorder that has cardinal articular and peri-articular symptoms. Extra-articular manifestations (EAMs) are also reported among RA patients. In the current study, we assessed hearing function in 50 RA patients. An extensive audiological assessment including pure tone audiometry (PTA), extended high-frequency audiometry (EHFA), tympanometry, and acoustic reflex in addition to the oto-acoustic emission (OAEs) were done. Results Our data demonstrates that among the 50 participants with median disease duration of 8 years, about 80% had normal hearing using PTA and EHFA. However, 46% of them had—interestingly—demonstrated absent OAEs, suggesting early stages of cochlear hearing loss. Conclusion We conclude that rheumatoid arthritis can cause hearing impairment that can be early diagnosed by TEOAEs.
The Effects of Rheumatoid Arthritis in Hearing Loss: Preliminary Report
JCDR, 2018
Abstract: Introduction: Rheumatoid Arthritis (RA) is a chronic inflammation that can cause systemic manifestations. Auditory system can also be affected by this disease. Sensorineural and conductive hearing loss have been reported but the results remain controversial. Aim: The aim of this study was to find out the correlation between RA and hearing loss. Materials and Methods: This cross-sectional, analytical, and prospective study included 19 subjects with RA and 19 subjects with other joints disease as comparison from January to June 2015. Pure tone audiometry and tympanometry examinations were conducted for all subjects. Pearson Chisquare test was used to analyse the correlation between RA and hearing impairment as well as the correlation between diseases duration, Erythrocyte Sedimentation Rate (ESR), and platelet count; and hearing threshold. Independent samples t-test was used to analyse the difference in mean of air and bone conduction thresholds, air-bone gap values, as well as hearing thresholds in both groups. Results: Hearing impairment was 78.9% in RA group and 21.1% in comparison group (p<0.05). Sensorineural hearing loss was the most common finding in RA (52.6%). There were significant correlations of disease duration and ESR with hearing loss degree in RA (p<0.05). The significant difference was obtained in air-bone gap values at 500 Hz to 4000 Hz (p<0.05). Conclusion: Rheumatoid arthritis can cause hearing loss.
Peripheral and Central Auditory Manifestation of Rheumatoid Arthritis
The present study was conducted with the aim to investigate the peripheral and central auditory manifestations in individuals with RA. 40 subjects (age range: 25-45 years), diagnosed with RA and 40 age and sex matched otologically normal subjects participated in the study. Participants underwent a comprehensive audiological test battery comprising of conventional and extended high frequency puretone audiometry, impedance audiometry, otoacoustic emissions (OAEs) and auditory brainstem responses (ABR). Significant difference between the puretone thresholds for the two groups was found at high frequencies (beyond 4 kHz). Majority of the subjects in RA group had absent/reduced amplitude for TEOAE. A highly statistically significant difference was observed between the RA and the control group for the absolute latency of wave I, III and V of the left ear. Considering the high incidence of hearing loss in RA group, a regular referral for audiological evaluations is suggested. Keywords: Rheumatoid arthritis, Sensori neural hearing loss, Acoustic stapedial reflex, Auditory brainstem response, Oto acoustic emissions, High frequency audiometry Abbreviations: RA: Rheumatoid Arthiritis; SNHL: Sensory-Neural Hearing Loss; HL: Hearing Loss; OAE: Oto Acoustic Emissions; ABR: Auditory Brainstem Response; PTA: Pure Tone Audiometry; CHL: Conductive Hearing Loss; ART: Acoustic Reflex Threshold; SNR: Signal to Noise Ratio; IHS: Intelligent Hearing System; IPL: InterPeak Latency; TEOAE: Transient Evoked Oto Acoustic Emissions; ESR; Erythrocyte Sedimentation Rate; RF: Rheumatoid Factor; ANA: Antinuclear Antibody
Hearing Impairment in a Tertiary-Care-Level Population of Mexican Rheumatoid Arthritis Patients
Journal of Clinical Rheumatology, 2012
The objectives of this study were to assess characteristics of hearing impairment (HI) in Mexican Mestizo patients with rheumatoid arthritis. Methods: One hundred thirteen consecutive patients (101 women, aged 43.3 T 13.1 years) without previously identified HI diagnosis had a structured interview and complete rheumatic and audiologic evaluations, which included at least a pure-tone audiometry and standard and high-frequency tympanometry. Hearing impairment was defined if the average thresholds for at least 1 of low-, mid-, or high-frequency ranges were 25-dB hearing level or greater in 1 ear (unilateral) or both ears (bilateral). Hearing impairment was classified as mild or moderate/severe. Appropriate statistics, multivariate analysis, and receiver operating characteristic curves were used. Results: Hearing impairment was detected in 27 patients (24%), was sensorineural-type HI in 25 (93%), bilateral in 14 (52%), and mild in 20 of them (74%). Normal tympanograms (type A) were found in 93 patients (82%), although high-frequency tympanometry was abnormal in 80 patients (71.4%). Patients with HI were significantly older (51.8 T 14.1 vs. 40.7 T 11.7 years, P e 0.001), had more frequent rheumatoid nodules (37% vs. 12.8%, P = 0.001), and had more (median [range]) comorbidities per patient (2 [1Y2] vs. 1 [0Y2], P = 0.03). Multivariate analysis showed that HI was significantly associated to age (odds ratio, 1.1; 95% confidence interval, 1.03Y1.15; P e 0.001). The best cutoff level for HI was 50 years of age and increased to 59 years for moderate/severe HI. Conclusions: A significant proportion of Mexican Mestizo outpatients with rheumatoid arthritis had previously undiagnosed HI, mainly of sensorineural type, of mild severity, and bilateral. Older age was the only prognosticator of HI.
Prevalence of severity and type of hearing loss in Rheumatoid Arthritis patients
Pakistan Journal of Health Sciences
Rheumatoid arthritis (RA) is a chronic heterogeneous autoimmune disease characterized by painful joint inflammation which may cause destructive bone erosions. It also affects the auditory system and cause hearing loss. Objective: To find out the prevalence of Severity and type of Hearing Loss in Rheumatoid Arthritis Patients. Methods: Cross sectional descriptive study was conducted to find the prevalence of Severity and type of Hearing Loss in Rheumatoid Arthritis Patients. The study was performed at DHQ Hospital Bhimber, Mayo Hospital Lahore. The duration of data collection was 6 months (April 2022 to September 2022). Non-probability convenient sampling technique was used for data collection. Patients of both gender with ages 30 to 50 years were included. Patients with rheumatoid arthritis with other co-morbid factors were excluded. Results: Out of 117 patients, there were 33 (28.2%) male patients and 84 (71.8%) female patients. Most patients were in age group 41-45 years 38 (32.5 ...
2014
We previously reported that 24 % of 113 rheumatoid arthritis (RA) patients had hearing impairment (HI). We investigated if disease activity was a predictor of incidental HI. One hundred and four patients completed three consecutive 6 months-apart rheumatic evaluations and concomitant audiometric evaluations which included at least an interview, an otoscopic evaluation, and a pure tone audiometry. HI was defined if the average thresholds for at least one of low-, mid-, or high-frequency ranges were ≥25 decibels (dB) hearing level in one or both ears. Appropriated statistics was used. Internal review board approval was obtained. Patients were most frequently middle-aged (43.4±13.3 years), female (89.4 %), and had median disease duration of 5 years and low disease activity. All were receiving RA treatment. At inclusion, 24 patients had HI which was sensorineural in 91.7% of them. Among the 80 patients without HI at baseline, 10 (12.5 %) developed incidental HI, and they had more disease activity either at baseline ([median, range] disease activity score-28 joints evaluated-C-reactive protein [DAS28-CRP], 3.9 [1.6-7.3] vs. 2.1 [1-8.7], p=0.006) or cumulative previous incidental HI (3.4 [1.8-4.8] vs. 2 [1-6.2], p=0.007) and were more frequently on combined methotrexate and sulfasalazine (20 vs. 1.4 %, p=0.05) than their counterparts. In the adjusted Cox proportional model, cumulative DAS28-CRP was the only variable to predict incidental HI (odds ratio, 1.8; 95 % confidence interval, 1.1-2.7; p=0.01). Almost 13 % of RA patients with short disease duration and low disease activity developed incidental HI during 1 year. Cumulative disease activity predicted incidental HI.