Relationship Between Disease Activity and Hearing Loss in Rheumatoid Arthritis Patients A Case Control Study

Abstract

Objectives Rheumatoid arthritis (RA) is well known to affect many different organ systems. Previous work suggests that this includes the auditory system. The objectives of this work are to evaluate the pattern of hearing impairment in patients with rheumatoid arthritis and also to examine the possible associations between hearing impairment and related RA features especially disease activity. Materials and methods Thirty RA patients (mean age of 44.5 ± 9.9 years; female sex (90%)) and 17 healthy controls (mean age of 41.5±9.1 years; female sex (76.4%)) were included in our study. The 2 groups were matched for age and sex (p>0.05). Otoscopic examination was normal in all participants. No subject of the 2 groups has had any abnormalities at otoscopic examination. Hearing impairment was evaluated by pure tone audiometry and tympanometry including the static compliance, middle ear pressure, stapedial reflex threshold test. In all patients the clinical features, laboratory data, X-rays, disease activity index-DAS 28 were performed. Results Hearing loss was more prevalent in RA patients compared to healthy controls (56.7 vs 11.8%; p=0.005). RA patients have conductive, sensorineural and mixed hearing loss in respectively 43.4, 3.3 and 10 % of cases. Association analysis between hearing characteristics and remission in RA patients shows that RA patients in remission have significantly lower mean hearing thresholds (12.8±5.2dB vs 18.8±6.9 dB ; p=0.04). Conclusion This study suggests that hearing loss risk is higher in RA patients and seems to be associated to disease duration. Hearing loss in RA was directly proportional to the disease activity index-DAS 28. Audiological evaluation must be performed periodically to identify possible audiological damage