Early hearing loss detection in rheumatoid arthritis and primary Sjögren syndrome using extended high frequency audiometry

Abstract

The aim of this study is to evaluate the hearing behavior of rheumatoid arthritis (RA) and primary Sjögren syndrome (PSS) patients and compare them with a healthy control group and with each other. A comparative cross-sectional study was performed with a group of 117 female RA patients, a group of 60 female PSS patients, and a 251 female healthy control group. Every subject underwent a series of studies including high-frequency audiometry, speech audiometry, and tympanometry. The high-frequency audiometry measured 250 to 16,000 Hz. The 117 patients with RA and the 60 with PSS were diagnosed according to American College of Rheumatology criteria / ACR 2010, and the validated classification of the American-European Consensus Group. Hearing loss was present in 36.8% of the RA group in 500-3000 Hz, 68.4% in 4000-8000 Hz, and 94.9% in 10,000-16,000 Hz. Hearing loss was present in 60% of the PSS group in 500-3000 Hz, 70% in 4000-8000 Hz, and 100% in 10,000-16,000 Hz. The hearing impairment prevalence of both groups was significantly different (p < 0.05) when compared with the healthy control group. We also compared the hearing thresholds between RA and PSS patients, finding a significant hearing threshold increase in 500-3000 Hz of the PSS group. This study consolidates the association between RA and PSS with hearing impairment. A deeper hearing loss was reported in PSS than in RA patients, demonstrating a greater auditory and speech recognition repercussion.

Evaluation of Medial Olivocochlear Efferent System and Hearing Loss in Patients with Primary Sjögren's Syndrome

“…However, we also examined these findings because of some communication problems among our subjects with pSS. Consequently, most of the subjects with pSS had hearing loss in both ears at very high frequencies (9000-12,500 Hz), which is in accordance with other studies [8,9]. A significant difference at 125-250-500 Hz between the groups was obtained, differently from some other studies [6].…”

“…The present study also investigated middle ear pressures, static compliances, and statistical analyses of these values between the groups. Little research has examined tympanometry results comprehensively [7,8]. Only evidence about the type of tympanogram was presented in these studies.…”

“…Not only was a type A curve obtained from all of the subjects in current study, but also the static compliances of the pSS group were lower than those of the controls. Many studies presented their results in most rheumatoid arthritis subjects as only type A tympanometry curves [8], but the tympanic membrane structure, motility, or middle ear fluids and muscle mechanisms can suffer in cases of pSS. Similarly, some studies reported that conductive hearing loss was observed in some subjects and they supposed that it could be due to dryness of the mucous membranes of the Eustachian tube and middle ear fluids [20].…”

“…However, there is little research on medial olivocochlear efferent system function in pSS [8,12]. Therefore, this study is the first to evaluate the functions of the MOC efferent system related to neurosensory functions in pSS by using contralateral suppression of DPOAEs.…”

Brainstem auditory evoked potentials in patients with primary Sjögren’s syndrome without central nervous system involvement

“…Hearing damage and neuropathy of the eighth cranial nerve are very rare manifestations of pSS. They can occur in up to 25% of patients with pSS, but the exact frequency of these abnormalities is unknown [3][4][5].…”