Assessment of the audiovestibular system in patients with rheumatoid arthritis

Tarek M El Dessouky, Enas Abu El Khair, Rabab Ahmed Koura, Sara Ahmed El Sharkawy

The Egyptian Journal of Otolaryngology 2017 33(4):650-655

Objective This study was designed to assess hearing and vestibular function in patients with rheumatoid arthritis (RA) in comparison with a control group. In addition, we correlated these findings in disease activity and severity. Materials and methods Totally, 40 RA patients (35 women and five men) diagnosed according to the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria and 20 healthy controls (11 women and nine men), whose age ranged from 25 to 66 years with a mean age of 45.5±12.4 years, were included in the study. Each individuals was tested with pure tone audiometry. Mean values of air and bone conduction at each frequency and tympanometric values were calculated for the study groups. Videonystagmography (VNG) test including smooth pursuit, saccade, optokinetic tests, positioning tests, positional test, and water caloric tests was also carried out. Results The mean air conduction threshold values at high frequencies (4000 and 8000 Hz) in the RA group were lower than in the control group. The difference between mean air conduction threshold values of the control group and the RA group at high frequencies was statistically significant (P<0.05). There was no statistically significance between the two groups as regards speech reception threshold, speech discrimination (DIS), and tympanometric values (P>0.05). VNG testing revealed central abnormalities in 12 (30%) patients, peripheral abnormalities in nine (22.5%) patients, and mixed abnormalities in one (2.5%) patient. There was no association between VNG abnormalities in patients with RA and age, sex, duration of disease, accompanying vertigo complaint, and the laboratory findings (P>0.05). Conclusion There is an association between RA and audiovestibular system dysfunction regardless clinical and demographic situation of patients. We assume that the shearing and vestibular disturbances in RA are more prevalent than previously recognized. High-frequency hearing loss in RA patients could be an indicator of cochlear involvement.

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