Auditory pathway in rheumatoid arthritis. A comparative study and surgical perspectives.
CONCLUSIONS
Rheumatoid arthritis (RA) patients present with both conductive and sensorineural deafness.


OBJECTIVE
To evaluate the prevalence and features of hearing impairment in patients with RA.


METHODS
A total of 28 RA patients underwent a rheumatological evaluation, including determination of rheumatoid factor, protein 2-glycoprotein I level and the Lee index. An audiological assessment consisting of pure-tone audiometry (PTA) and determination of auditory brainstem responses (ABRs) and transient evoked otoacoustic emissions (TEOAEs) was performed. The results were compared with those of 28 age- and sex-matched healthy subjects. Four selected RA patients underwent stapedectomy; PTA and TEOAEs were evaluated 6 months postoperatively.


RESULTS
Increased air conduction thresholds at 250, 500 and 1000 Hz were found in RA subjects in comparison to controls (p<0.001). RA patients showed higher air-bone gaps in PTA (p<0.05) and an increased Wave I latency in ABRs (p=0.03). Decreased reproducibility (p<0.001) and amplitude (p<0.001) of TEOAEs were found in RA subjects in comparison to controls. A significant correlation between disease duration and echo amplitude was noticed (r=0.389). After stapedectomy, a reduction in the air-bone conduction gap (11 vs 2 dB HL) was noticed; no significant difference in TEOAEs was found.
Salvinelli
Fabrizio
F
Department of Otolaryngology, School of Medicine, Campus Bio-Medico University, Rome, Italy.
D'Ascanio
Luca
L
Casale
Manuele
M
Vadacca
Marta
M
Rigon
Amelia
A
Afeltra
Antonella
A
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000503:physiopathology; D001301:Audiometry, Pure-Tone; D001306:Auditory Pathways / Q000503:physiopathology*; D016022:Case-Control Studies; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D005260:Female; D006314:Hearing Loss, Conductive / Q000209:etiology* / Q000503:physiopathology; D006319:Hearing Loss, Sensorineural / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017084:Otoacoustic Emissions, Spontaneous / Q000502:physiology; D015995:Prevalence; D012044:Regression Analysis