Our findings showed that audiometric profiles obtained from CMA are highly correlated, without statistical differences, to those obtained with PTA. More than 81% of patients explored (91.67% at 250 Hz) exhibited differences below 10 dB(HL) between tests at all exploration frequencies, while a low number of cases showed differences over 20 dB(HL).

Objective. The aim of this study is to analyze the high-frequency hearing levels in patients with rheumatoid arthritis and to determine the relationship between hearing loss, disease duration, and immunological parameters. Materials and Methods. A descriptive cross-sectional study including fifty-three patients with rheumatoid arthritis was performed. The control group consisted of 71 age- and sex-matched patients from the study population (consecutively recruited in Madrid “Area 9,” from January 2010 to February 2011). Both a pure tone audiometry and an extended-high-frequency audiometry were performed. Results. Extended-high-frequency audiometry diagnosed sensorineural hearing loss in 69.8% of the patients which exceeded the results obtained with pure tone audiometry (43% of the patients). This study found significant correlations in patients with sensorineural hearing loss related to age, sex, and serum anti-cardiolipin (aCL) antibody levels. Conclusion. Sensorineural hearing loss must be considered within the clinical context of rheumatoid arthritis. Our results demonstrated that an extended-high-frequency audiometry is a useful audiological test that must be performed within the diagnostic and follow-up testing of patients with rheumatoid arthritis, providing further insight into a disease-modifying treatment or a hearing loss preventive treatment.

We report a case of a 23-year-old man with unilateral hearing loss since childhood. Otoscopic examination was entirely normal. Audiometric testing showed a conductive hearing loss in his left ear, with an average pure-tone audiometry of air conduction of 80 dB and a maximum air-bone gap of 60 dB at 1,000 Hz. Tuning fork tests confirmed conductive hearing loss. Tympanometry showed increased compliance in the left ear and an absent ipsilateral stapedial reflex. Temporal bone imaging using contiguous 1-mm sections of the left temporal bone revealed an absence of the long process of the incus and a possible absence of stapes suprastructure (Fig. 1, C and D). The facial nerve had a normal course through the middle ear and mastoid (Fig. 1, A and B). During surgery, we found that stapes superstructure and long process of incus were absent, and in their place, there was a fibrous tissue ( Fig. 2A). There was also a mobile footplate and a normal chorda tympani and facial nerve (Fig. 2B). Incus body was fixed to a normal malleus as shown by a preoperative computed tomographic scan FIG. 1. Temporal bone computed tomographic scan, left ear, axial view. A and B, Normal facial nerve (white arrowhead) in the middle ear. Incudomalleolar joint can be seen. C and D, View of the vestibule at the oval window level (asterisk). The white arrow indicates fibrous tissue instead of long process of the incus.