Background The incidence of hearing loss (HL) has been on the rise in patients with rheumatoid arthritis (RA). However, limited information exists regarding the pathogenic mechanisms of HL in RA patients1,2.
Objectives This study sought to evaluate the prevalence and characteristics of HL in RA patients compared with a control group and to identify factors associated with the degree of HL in RA patients.
Methods We enrolled 64 RA patients and 70 healthy controls in a prospective manner. Each subject was tested with pure tone audiometry including high frequencies ranging from 0.5 to 16 kHz. For each set of tests, mean values for air conduction at each frequency and tympanometric values were calculated to exclude middle ear disease. In the RA group, auto-antibodies, erythrocyte sedimentation rate, high-sensitivity C-reactive protein, and RA disease activity were measured, and carotid ultrasonography was performed for the detection of indicators of subclinical atherosclerosis, including arterial stiffness index beta (β-index) and carotid intima-media thickness (cIMT).
Results The prevalence of HL was higher in the RA group than the control group (37.1% vs. 65.6%, p=0.001). The hearing threshold value difference between groups was significant at frequencies of 0.5, 1, 2, 4, and 8 kHz (p<0.05). Age showed the strongest correlation to HL at all frequencies in RA patients (p<0.01). cIMT was also strongly related to HL at all frequencies, whereas β-index was related to HL only at high frequencies (8, 12, and 16 kHz), acting as an early marker of HL (both p<0.05).
Conclusions HL was more prevalent in the RA group than the control group. cIMT and β-index were strongly correlated with HL in the RA group, which implies that subclinical atherosclerosis may play an important role in HL in RA patients.
Özkırış M, Kapusuz Z, Günaydın İ, Kubilay U, Pırtı İ, Saydam L. Does rheumatoid arthritis have an effect on audiovestibular tests? Eur Arch Otorhinolaryngol. 2014;271:1383–7
Pascual-Ramos V, Contreras-Yáñez I, Rivera-Hoyos P, Enríquez L, Ramírez-Anguiano J. Cumulative disease activity predicts incidental hearing impairment in patients with rheumatoid arthritis (RA). Clin Rheumatol. 2014;33:315–21.
Disclosure of Interest None declared