title: Audiovestibular manifestations in patients with ankylosing spondylitis.
abstract: Ankylosing spondylitis (AS) is a chronic inflammatory disease of unknown origin affecting up to 1% of the population. Little is known about audiovestibular impairment in patients with AS, especially the presence of cochleovestibular dysfunction in these patients. To investigate audiovestibular manifestations in AS, we studied a series of 50 consecutive patients who fulfilled the modified New York diagnostic criteria for AS and 44 matched controls. Individuals with history of cardiovascular disease, cerebrovascular complications, peripheral artery disease, renal insufficiency, syphilis, Meniere and other vestibular syndromes, infections involving the inner ear, barotrauma, or in treatment with ototoxic drugs were excluded. Most patients with AS were men (80%). The mean age at the time of study was 52.5 years, and mean age at the onset of symptoms was 34.4 years. Twenty-nine (58%) patients showed abnormal hearing loss in the audiogram compared to only 8 (18%) controls (p < 0.001). Values of audiometric tests (pure-tone average and speech reception threshold) yielded significant differences between patients and controls (p < 0.001). It is noteworthy that the audiogram shape disclosed a predominant pattern of high-frequency sensorineural hearing loss in AS patients (50%) compared to controls (18%) (p = 0.002). Also, AS patients exhibited abnormal vestibular tests more commonly than controls. AS patients had an increased frequency of head-shaking nystagmus (20%) compared to controls (0%) (p < 0.001). Moreover, patients (26%) showed a significantly increased frequency of abnormal caloric test compared to controls (0%) (p < 0.001). Finally, a significantly increased frequency of abnormal clinical test of sensory integration and balance with a predominant vestibular loss pattern was observed in patients (36%) compared to controls (5%) (p < 0.001). In conclusion, the current study demonstrates strong evidence for inner ear compromise in patients with AS.
authors.affiliation: From Division of Otolaryngology (JCAD, MPBF) and Division of Rheumatology (TRVR, JAMF), Hospital Xeral-Calde, Lugo; Division of Epidemiology and Computational Biology, (IGA, JL), School of Medicine, University of Cantabria, Santander, CIBER Epidemiología y Salud Publica (CIBERESP); and Internal Medicine Division (TDdT) and Rheumatology Division (MAGG), Hospital Universitario Marqués de Valdecilla, University of Cantabria, Santander, Spain.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Amor-Dorado
authors.forename: Maria P
authors.initials: MP
authors.lastname: Barreira-Fernandez
authors.forename: Tomas R
authors.initials: TR
authors.lastname: Vazquez-Rodriguez
authors.forename: Ines
authors.initials: I
authors.lastname: Gomez-Acebo
authors.forename: Jose A
authors.initials: JA
authors.lastname: Miranda-Filloy
authors.forename: Teresa
authors.initials: T
authors.lastname: Diaz de Teran
authors.forename: Javier
authors.initials: J
authors.lastname: Llorca
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Gonzalez-Gay
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006311:Hearing Disorders / Q000150:complications*; D006320:Hearing Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D013167:Spondylitis, Ankylosing / Q000150:complications*; D013997:Time Factors; D015837:Vestibular Diseases / Q000150:complications