Audiovestibular disorders in patients with ankylosing spondylitis.
OBJECTIVE
Audiovestibular disorders have been described in several autoimmune diseases but have not been studied in patients with ankylosing spondylitis (AS). The aim of this study was to evaluate the audiovestibular function in patients with AS.


METHODS
We prospectively evaluated 22 consecutive patients with AS. Clinical, radiologic, and immunogenetic features were analyzed. All patients underwent a complete ear, nose, and throat physical examination and audiologic evaluation that included pure-tone audiometry thresholds at octave frequencies of 250 to 8000 Hz, impedance audiometry (tympanogram, static compliance, acoustic reflexes, and reflex decay), and speech audiometry. Thirty-one healthy volunteers and 26 patients with rheumatoid arthritis (RA) were included as controls.


RESULTS
Patients with AS had a median age of 45.5 years (interquartile range [IQR] 38-54) and a median disease duration of 20 years (IQR 12.5-26.2). Otosclerosis was observed in 2 patients with AS (9.1%), 3 patients with RA (11.5%), but not in any healthy controls (P = not significant). Sensorineural hearing loss (SNHL) was observed in 13 patients with AS (59%), 17 patients with RA (65.4%), and 13 healthy controls (41.9%) without statistically significant differences. Because age can influence audiometric results, patients and controls were divided into 4 age groups. A higher frequency of SNHL was observed in patients with AS from 45 to 59 years compared with healthy controls and patients with RA (87% versus 20%, P = 0.03, versus 70%, P = not significant, respectively).


CONCLUSIONS
Middle-aged patients with AS had a significantly higher frequency of SNHL compared with controls. SNHL should be considered as a possible complication of AS as well as of RA and other autoimmune diseases. Possible toxic effect of nonsteroidal antiinflammatory drugs should also be considered in such patients.
Casellini
Carolina
C
Section of Rheumatology, Instituto de Rehabilitación Psicofísica, Escheverria 995, 1428 Buenos Aires, Argentina.
Citera
Gustavo
G
Rosemffet
Marcos
M
Ruggeri
Santiago
S
Saviotti
Andrea
A
Maldonado Cocco
José A
JA
D000328:Adult; D000367:Age Factors; D000368:Aged; D001299:Audiometry; D016022:Case-Control Studies; D003056:Cochlear Nerve / Q000503:physiopathology*; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010040:Otosclerosis / Q000209:etiology; D011446:Prospective Studies; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000503:physiopathology*; D014725:Vestibular Nerve / Q000503:physiopathology*