Sensorineural Hearing Loss in Patients with Inflammatory Bowel Disease: A Subclinical Extraintestinal Manifestation

Abstract

Isolated case reports in which symptomatic hearing loss develops suddenly during the course of inflammatory bowel disease (IBD) have been reported, but the presence of subclinical sensorineural hearing loss (SNHL) associated with IBD has been investigated in only two preliminary studies. In order to research this further, we aimed to investigate the presence of subclinical SNHL in IBD by comparison with a control group and to examine possible relations between the bowel disease parameters and hearing loss.Otoscopy, tympanometry, and pure tone audiometry were carried out in 39 patients with IBD (21 Crohn's disease [CD], 18 ulcerative colitis [UC]) and 25 healthy age- and sex-matched controls. All patients and control subjects had normal otoscopy findings and tympanometry was unremarkable, excluding middle ear disease and conductive hearing loss. Analysis of each frequency examined showed that the average hearing thresholds were increased significantly in the study group compared to those of the control group at higher frequencies (2, 4, and 8 kHz). When these parameters were compared with the control group according to subgroups of IBD, a significant difference was determined for the UC group at frequencies of 2, 4, and 8 kHz and for the CD group only at the frequency of 4 kHz. Although there was a trend of increment in SNHL as the age of the patient and duration and extent of UC increased, no significant correlation was observed between SNHL and these parameters or sex, activity, involvement site, medication history of IBD, and coexistence of other extraintestinal manifestations. In conclusion, it was demonstrated that a subclinical SNHL may be associated with UC and somewhat with CD, affecting mainly the high frequencies. In light of this finding, it may be advisable to investigate labyrinth functions as well as other extraintestinal manifestations in patients with IBD.

A clinical study on association between hearing loss and inflammatory bowel disease in a population attending a hospital

“…Immune mediated inner ear disease includes clinical conditions associated with rapidly progressive unilateral or bilateral forms of sensorineural hearing loss (SNHL), or even acute total deafness. [16][17][18] A systemic auto-immune disorder including IBD may present in onethird of the cases. 19 The clinical manifestation of the disease is most often bilateral and progressive.…”

“…Akbayir N et al investigated 39 IBD patients using otoscopy, tympanometry, and pure tone audiometry. 17 It was demonstrated that a subclinical sensorineural hearing loss might be associated with UC and somewhat with CD affecting mainly the high frequencies. In the light of this finding the authors suggest that all IBD patients should be investigated with labyrinth functions.…”

The effect of a gluten-free diet on a patient complaining of severe tinnitus

“…We can hypothesize that the inner ear, like other extraintestinal sites involved in GS, could become the target of an immune mediated response. Likewise, a subclinical sensorineural hearing loss, affecting mainly the high frequencies, has been associated with irritable bowel syndrome 17 , a syndrome in which GS has been suggested as a possible pathogenic factor 18 . Tinnitus is a symptom of multifactorial origin.…”

Ulcerative Colitis Associated with Isolated Unilateral Hypoglossal Nerve Palsy

“…Recent studies have focused on probable manifestations of UC in the nervous system, although few have noted neuropathy, and other EIMs have been reported (1-4). To the best of our knowledge, there are no reports of neuropathy of the hypoglossal nerve occurring in association with UC, although some studies have that noted the occurrence of cranial nerve disorders, such as optic neuritis, and sensorineural hearing loss (1,(5)(6)(7)(8)(9)(10)(11). Furthermore, one study found that demyelinating diseases occur more frequently in patients with UC than in non-UC patients (12).…”