Skip to main content Accesibility Help

Inner ear involvement in rheumatoid arthritis: a prospective clinical study

  • Ioannis Kastanioudakis (a1), Antonios Skevas (a1), Vasilios Danielidis (a1), Eleni Tsiakou (a2), A. Alexandros Drosos (a2) and M. Haralampos Moustopoulos (a3)...

Sensorineural hearing loss in rheumatoid arthritis (RA) has been reported to be the result of the extraarticular manifestation of the disease (rheumatoid nodular vasculitis) or due to drug ototoxicity.

In an attempt to investigate the presence of sensorineural hearing loss and the possible causes for it we investigated prospectively 45 RA patients (42 female; three male) with a mean age of 52.5±10.7 years and a mean disease duration of 8.5±7.3 years. All patients underwent a complete physical examination and audiological evaluation which included pure tone audiometry and impedance audiometry (tympanogram, static compliance, acoustic reflex, reflex decay, acoustic reflex latency test.

We found a sensorineural hearing loss >20 dB HL in 44.4 per cent (40/90) ears. In all cases the site of hearing loss was the cochlea and in most of them it was bilateral and symmetric (16 patients out of 45 had bilateral sensorineural hearing loss i.e. 35.5 per cent.

There was no correlation between sensorineural hearing loss and age, sex, disease duration, articular and extra-articular manifestations and the presence of autoantibodies in our patients. In addition, no correlation was found between sensorineural hearing loss and drug therapy for one at least of the following drugs: NSAIDs, d-penicillamine, plaquenil and methotrexate.

We noticed a prologation of acoustic reflex latency in five patients (10 per cent) which was found to be correlated with the temporomandibular joint involvement and the presence of rheumatoid factor (RF).

We conclude that inner ear involvement in RA is expressed by: (1) mild symmetric, bilateral sensorineural hearing loss of cochlear type in 35.5 per cent of patients; (2) normal acoustic reflex thresholds; (3) nondecay; and (4) prologation of acoustic reflex latency which appeared in a small number of patients (10 per cent).

Corresponding author
Professor Antonios Skevas, Department of Otolaryngology, Medical School, University of Ioannina, PO Box 1186, 45110 Ioannina, Greece. Fax: 0651-45140
Hide All
Arnett, F. C., Edworthy, S. M., Bloch, D. A., McShane, D. J., Fries, J. F., Cooper, N. S., Healey, L. A., Kaplan, S. R., Liang, M. H., Luthra, H. S., Medsger, T. A. Jr., Mitchell, D. M., Neustant, D. H., Pinals, R. S., Schaller, J. G., Sharp, J. T., Wilder, R. L., Hunder, G. G. (1988) The American Rheumatism Association revised criteria for the classification of rheumatoid arthritis. Arthritis Rheumatoid 31: 315324.
Copeman, W. S. C. (1963) Rheumatoid otoarthritis. British Medical Journal 2: 15261527.
Decker, J. C., Malone, D. G., Haraoui, B., Wahl, S. M., Schreiber, L., Klippel, J. H., Steinberg, A. D., Wilder, R. L. (1984) NIH conference: rheumatoid arthritis: evolving concepts of pathogenesis and treatment. Annals of Internal Medicine 101: 810824.
Drosos, A. A., Lunchbury, J. S., Panayi, G. S., Moustopoulos, H. M. (1992) Rheumatoid arthritis in Greek and British patients. Arthritis Rheumatoid 35: 745748.
Elwany, S., Garf, A., Kamel, T. (1986) Hearing and middle ear function in rheumatoid arthritis. Journal of Rheumatology 13: 878881.
Goodwill, G. J., Lord, I. J., Knilljones, R. P. (1972) Hearing in rheumatoid arthritis. A clinical and audiometric survey. Annals of Rheumatology Disease 31: 170173.
Gussen, R. (1977) A typical ossicle joint lesions in rheumatoid arthritis with sicca syndrome (Sjögren's syndrome). Archives of Otolaryngology 103: 281283.
Hegworth, T., Lijanage, S. P. (1972) A pilot survey of hearing loss in patients with rheumatoid arthritis. Scandinavian Journal of Rheumatology 1: 8183.
Magaro, M., Zoli, A., Altomonte, L., Mirone, L., Corvino, G., Di Girolamo, S., Giacomini, P., Alessandrini, M. (1990) Sensorineural hearing loss in rheumatoid arthritis. Clinical and Experimental Rheumatology 8: 487490.
Moffat, D. A., Ramsden, N. T., Rosenmberg, J. N., Booth, B., Gibson, W. P. R. (1977) Otoadmittance measurements in patients with rheumatoid arthritis. Journal of Laryngology and Otology 91: 917927.
Reiter, D., Konkle, D., Myers, A., Schimmer, B., Sugar, J. (1986) Middle ear immittance in rheumatoid arthritis. Archives of Otolaryngology 106: 114117.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed