Hostname: page-component-848d4c4894-4hhp2 Total loading time: 0 Render date: 2024-05-15T13:34:08.508Z Has data issue: false hasContentIssue false
  • English
  • Français

Inner ear involvement in rheumatoid arthritis: a prospective clinical study

Published online by Cambridge University Press:  29 June 2007

Ioannis Kastanioudakis ,
Antonios Skevas ,
Vasilios Danielidis ,
Eleni Tsiakou ,
A. Alexandros Drosos  and
M. Haralampos Moustopoulos
Ioannis Kastanioudakis
Affiliation:
Department of Otolaryngology, Medical School, University of Ioannina, Athens, Greece.
Antonios Skevas*
Affiliation:
Department of Otolaryngology, Medical School, University of Ioannina, Athens, Greece.
Vasilios Danielidis
Affiliation:
Department of Otolaryngology, Medical School, University of Ioannina, Athens, Greece.
Eleni Tsiakou
Affiliation:
Internal Medicine, Medical School, University of Ioannina, Athens, Greece.
A. Alexandros Drosos
Affiliation:
Internal Medicine, Medical School, University of Ioannina, Athens, Greece.
M. Haralampos Moustopoulos
Affiliation:
Department of Pathophysiology, National University of Athnes, Athens, Greece.
*
Professor Antonios Skevas, Department of Otolaryngology, Medical School, University of Ioannina, PO Box 1186, 45110 Ioannina, Greece. Fax: 0651-45140
Get access Rights & Permissions [Opens in a new window]

Abstract

Sensorineural hearing loss in rheumatoid arthritis (RA) has been reported to be the result of the extraarticular manifestation of the disease (rheumatoid nodular vasculitis) or due to drug ototoxicity.

In an attempt to investigate the presence of sensorineural hearing loss and the possible causes for it we investigated prospectively 45 RA patients (42 female; three male) with a mean age of 52.5±10.7 years and a mean disease duration of 8.5±7.3 years. All patients underwent a complete physical examination and audiological evaluation which included pure tone audiometry and impedance audiometry (tympanogram, static compliance, acoustic reflex, reflex decay, acoustic reflex latency test.

We found a sensorineural hearing loss >20 dB HL in 44.4 per cent (40/90) ears. In all cases the site of hearing loss was the cochlea and in most of them it was bilateral and symmetric (16 patients out of 45 had bilateral sensorineural hearing loss i.e. 35.5 per cent.

There was no correlation between sensorineural hearing loss and age, sex, disease duration, articular and extra-articular manifestations and the presence of autoantibodies in our patients. In addition, no correlation was found between sensorineural hearing loss and drug therapy for one at least of the following drugs: NSAIDs, d-penicillamine, plaquenil and methotrexate.

We noticed a prologation of acoustic reflex latency in five patients (10 per cent) which was found to be correlated with the temporomandibular joint involvement and the presence of rheumatoid factor (RF).

We conclude that inner ear involvement in RA is expressed by: (1) mild symmetric, bilateral sensorineural hearing loss of cochlear type in 35.5 per cent of patients; (2) normal acoustic reflex thresholds; (3) nondecay; and (4) prologation of acoustic reflex latency which appeared in a small number of patients (10 per cent).

Keywords

Arthritis, rheumatoidHearing loss, sensorineural
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 109 , Issue 8 , August 1995 , pp. 713 - 718
Copyright
Copyright © JLO (1984) Limited 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Arnett, F. C., Edworthy, S. M., Bloch, D. A., McShane, D. J., Fries, J. F., Cooper, N. S., Healey, L. A., Kaplan, S. R., Liang, M. H., Luthra, H. S., Medsger, T. A. Jr., Mitchell, D. M., Neustant, D. H., Pinals, R. S., Schaller, J. G., Sharp, J. T., Wilder, R. L., Hunder, G. G. (1988) The American Rheumatism Association revised criteria for the classification of rheumatoid arthritis. Arthritis Rheumatoid 31: 315–324.CrossRefGoogle ScholarPubMed
Copeman, W. S. C. (1963) Rheumatoid otoarthritis. British Medical Journal 2: 1526–1527.Google Scholar
Decker, J. C., Malone, D. G., Haraoui, B., Wahl, S. M., Schreiber, L., Klippel, J. H., Steinberg, A. D., Wilder, R. L. (1984) NIH conference: rheumatoid arthritis: evolving concepts of pathogenesis and treatment. Annals of Internal Medicine 101: 810–824.Google Scholar
Drosos, A. A., Lunchbury, J. S., Panayi, G. S., Moustopoulos, H. M. (1992) Rheumatoid arthritis in Greek and British patients. Arthritis Rheumatoid 35: 745–748.CrossRefGoogle ScholarPubMed
Elwany, S., Garf, A., Kamel, T. (1986) Hearing and middle ear function in rheumatoid arthritis. Journal of Rheumatology 13: 878–881.Google ScholarPubMed
Goodwill, G. J., Lord, I. J., Knilljones, R. P. (1972) Hearing in rheumatoid arthritis. A clinical and audiometric survey. Annals of Rheumatology Disease 31: 170–173.CrossRefGoogle ScholarPubMed
Gussen, R. (1977) A typical ossicle joint lesions in rheumatoid arthritis with sicca syndrome (Sjögren's syndrome). Archives of Otolaryngology 103: 281–283.Google Scholar
Hegworth, T., Lijanage, S. P. (1972) A pilot survey of hearing loss in patients with rheumatoid arthritis. Scandinavian Journal of Rheumatology 1: 81–83.Google Scholar
Magaro, M., Zoli, A., Altomonte, L., Mirone, L., Corvino, G., Di Girolamo, S., Giacomini, P., Alessandrini, M. (1990) Sensorineural hearing loss in rheumatoid arthritis. Clinical and Experimental Rheumatology 8: 487–490.Google ScholarPubMed
Moffat, D. A., Ramsden, N. T., Rosenmberg, J. N., Booth, B., Gibson, W. P. R. (1977) Otoadmittance measurements in patients with rheumatoid arthritis. Journal of Laryngology and Otology 91: 917–927.Google Scholar
Reiter, D., Konkle, D., Myers, A., Schimmer, B., Sugar, J. (1986) Middle ear immittance in rheumatoid arthritis. Archives of Otolaryngology 106: 114–117.CrossRefGoogle Scholar