Extended high frequency audiometry can diagnose sub-clinic involvement in a seemingly normal hearing systemic lupus erythematosus population

Vega, Mar Lasso de la; Villarreal, I.; Moya, Julio López; García-Berrocal, José Ramón

doi:10.1080/00016489.2016.1219049

Cited by 21 publications

(13 citation statements)

References 16 publications

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“…5 The most common otologic symptom found in clinical studies of patients with SLE is sensorineural hearing loss (SNHL), the reported prevalence of which ranges from 6% to 70%. [10][11][12][13][14][15][16] 13 in a series of 84 patients, described bilateral and slowly progressive hearing loss; the same author in a previous paper described patients with SLE who developed sudden unilateral SNHL. 19 45 2007 55.5% SNHL for all frequencies (14%); SNHL for 500, 1000, and 2000 Hz (57%); SNHL for 4000 and 8000 Hz (28%) Khalidi et al 9 1 2008 n/a Profound bilateral SNHL for 500, 1000, 2000, and 3000 Hz; female Maciaszczyk et al 10 35 2011 71.4% Progressive SNHL with 500-, 2000-, and 4000-Hz frequency preservation Abbasi et al 11 45 2013 26.7% SNHL (11.1%), otorrhea (8.9%), tinnitus (6.7%) Lin et al 2 7168 2013 n/a Higher incidence of SNHL in women aged 34 years.…”

Section: Clinical Findingsmentioning

confidence: 95%

“…The most common otologic symptom found in clinical studies of patients with SLE is sensorineural hearing loss (SNHL), the reported prevalence of which ranges from 6% to 70%. 10 – 16 Table 2 summarizes the different subtypes of hearing loss found in patients with SLE in multiple studies performed from 1995 to 2013 ( Table 2 ). Various authors have reported different pathways of SNHL in patients affected by SLE: hearing loss may either be slowly progressive or acute.…”

Section: Audiovestibular Disorders In Patients With Slementioning

confidence: 99%

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Systemic Lupus Erythematosus and hearing disorders: Literature review and meta-analysis of clinical and temporal bone findings

Stadio

Ralli

2017

J Int Med Res

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ObjectiveThis literature review and meta-analysis was performed to evaluate the correlations among hearing and vestibular clinical symptoms, temporal bone findings, and pathological mechanisms in patients with systemic lupus erythematosus (SLE).Study designRelevant papers in the literature were retrospectively reviewed. Clinical hearing aspects in patients with SLE and relevant temporal bone studies in the same field were analyzed.MethodsPubMed and Google Scholar searches were performed using the following keywords: “auto-immune disease,” “systemic lupus erythematosus (SLE),” “hearing loss,” “temporal bone study,” “vertigo,” “dizziness,” “tinnitus,” “ear symptoms,” “treatment,” “diagnosis,” “symptoms,” “etiopathogenesis,” “Wegener granulomatosis,” “Sjogren,” “polyarteritis nodosa,” “Cogan syndrome,” and “granulomatosis.” Also included were reviews in which the following terms were present: “SLE,” “temporal bone,” and “hearing symptoms.”Review and conclusionThis literature review and meta-analysis focused on the pathological mechanisms through which SLE can damage inner ear structures and determinate hearing and vestibular symptoms. The main mechanisms involved in inner ear damage include the autoimmune response, deposition of immune complexes in the vessels and, to a lesser extent, cytotoxic damage.

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Section: Clinical Findingsmentioning

confidence: 95%

Section: Audiovestibular Disorders In Patients With Slementioning

confidence: 99%

Systemic Lupus Erythematosus and hearing disorders: Literature review and meta-analysis of clinical and temporal bone findings

Stadio

Ralli

2017

J Int Med Res

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“…Screening by title and abstract excluded 573 articles. A full-text review of remaining studies further eliminated 18 articles, leaving a total of 17 articles 6–8,10,11,17–28 for inclusion in the final analysis. A diagram outlining the summary of the search process is shown in Supplementary Figure S1.…”

Section: Resultsmentioning

confidence: 99%

“…Only studies that provided sufficient data on audiological outcomes of interest were included in the meta-analysis. Of the 17 studies, 14 studies 6–8,10,17,19–21,23–28 were used to analyze the risk of HL in patients with SLE, nine studies 6,8,11,17,19,22,24,27,28 were used to pool frequency-specific air- and bone-conduction PTT data, and two studies 8,24 were used to compare the serological and clinical profiles of patients with SLE with and without HL.…”

Section: Resultsmentioning

confidence: 99%

“…First, due to the dearth of studies evaluating hearing thresholds of patients with SLE at extended high frequencies (8 to 16 kHz), we were unable to analyze and comment on audiometric changes beyond those measured at conventional frequencies. In one study, 26 SNHL was diagnosed in 70% of patients with SLE using high-frequency audiometry compared to only 30.9% with pure-tone audiometry. Therefore, the prevalence of HL might be higher than observed in the present study, which only analyzed PTT data at frequencies between 0.125 and 8 kHz.…”

Section: Discussionmentioning

confidence: 99%

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Hearing loss in patients with systemic lupus erythematosus: A systematic review and meta-analysis

Yuen

Fried

Nguyen

et al. 2021

Lupus

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Objective To determine the prevalence of hearing loss (HL) in patients with systemic lupus erythematosus (SLE), describe frequency-specific hearing threshold changes in this patient population as compared to age-matched control, and compare the clinical and serological profiles of patients with SLE with and without HL. Methods A systematic review querying four databases (PubMed, Web of Science, Scopus, and Cochrane) was performed. Meta-analysis of available data was performed to determine the overall prevalence and odds ratio (OR) of HL, and compare mean differences in frequency-specific hearing thresholds between patients with SLE and control. Additionally, meta-analysis of proportions allowed for comparison of disease features present in patients with SLE with and without sensorineural HL. Results This review included 17 studies reporting on 1326 patients (635 with SLE and 691 control). The pooled prevalence of HL in patients with SLE was 27%. In comparison to control, patients with SLE had a significantly higher odds of HL (OR 14.6, 95% CI: 8.5 to 25.0). Mean air-conduction hearing thresholds in patients with SLE were significantly elevated relative to control at 125 and 250 Hz. Mean bone-conduction hearing thresholds were significantly elevated in patients with SLE across all measured frequencies except at 3000 and 6000 Hz compared to control. Disease features did not significantly differ between patients with SLE with and without HL. Conclusion Compared to age-matched control, patients with SLE have increased odds of HL, which primarily manifests at low frequencies. Therefore, this patient population requires greater audiologic attention.

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Utility of Extended High‐Frequency Audiograms in Clinical Practice

et al. 2023

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ObjectivesExtended high‐frequency (EHF) audiometry elicits pure‐tone thresholds at frequencies above 8 kHz, which are not included in routine clinical testing. This study explores the utility of EHF audiometry in patients with various audiologic symptoms despite normal‐hearing thresholds at ≤8 kHz.MethodsA retrospective review was performed of all patients receiving conventional (250–8 kHz) and EHF (9–20 kHz) audiometry at a tertiary otological referral center between April 2021 and August 2022. Only patients with audiologic symptoms and pure‐tone thresholds ≤25 dB HL at ≤8 kHz bilaterally on routine testing were included in subsequent analysis. EHF‐PTA was defined for each ear as an average of the air conduction thresholds at 9.0, 10.0, 11.2, 12.5, 14.0, 16.0, 18.0, and 20.0 kHz.ResultsOf the 50 patients who received EHF testing, 40 had audiologic symptoms and normal conventional audiograms at ≤8 kHz. Twenty‐five of the 40 (62.5%) were found to have hearing loss in the highest frequencies. Patients with EHF hearing loss (EHF‐HL) were more likely to report subjective hearing loss. Age was significantly greater in those with EHF‐HL compared with those without EHF‐HL, and age was positively correlated with the degree of EHF‐HL.ConclusionEHF testing correlates with audiologic symptoms in patients with normal testing at ≤8 kHz and may be considered when standard audiometry is normal. Additional data are warranted to create an evidenced‐based, clinical algorithm for EHF audiometry that can guide treatment, direct mitigation strategies, and potentially identify those at higher risk of hearing loss over time.Level of Evidence4 Laryngoscope, 2023

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Extended high frequency audiometry can diagnose sub-clinic involvement in a seemingly normal hearing systemic lupus erythematosus population

Cited by 21 publications

References 16 publications

Systemic Lupus Erythematosus and hearing disorders: Literature review and meta-analysis of clinical and temporal bone findings

Systemic Lupus Erythematosus and hearing disorders: Literature review and meta-analysis of clinical and temporal bone findings

Hearing loss in patients with systemic lupus erythematosus: A systematic review and meta-analysis

Utility of Extended High‐Frequency Audiograms in Clinical Practice

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