title: Auditory pathway in rheumatoid arthritis. A comparative study and surgical perspectives.
abstract: 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.
authors.affiliation: Department of Otolaryngology, School of Medicine, Campus Bio-Medico University, Rome, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Salvinelli
authors.forename: Luca
authors.initials: L
authors.lastname: D'Ascanio
authors.forename: Manuele
authors.initials: M
authors.lastname: Casale
authors.forename: Marta
authors.initials: M
authors.lastname: Vadacca
authors.forename: Amelia
authors.initials: A
authors.lastname: Rigon
authors.forename: Antonella
authors.initials: A
authors.lastname: Afeltra
mesh_terms: 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