Evaluation of auditory and cochlear functions in patients with rheumatoid arthritis

Both sensorineural and conductive hearing loss have been reported in patients with rheumatoid arthritis (RA), with sensorineural hearing loss (SNHL) being more common (24-60%).

This study aimed to evaluate auditory and cochlear functions in patients with seropositive RA.

Forty seropositive RA patients and forty healthy volunteers were included. All participants underwent a complete ear, nose, and throat examination followed by pure tone audiometry, tympanometry, contralateral and ipsilateral acoustic reflex testing, and transient evoked otoacoustic emission (TEOAE) testing. Audiological evaluation included air and bone conduction thresholds, speech reception threshold, speech discrimination scores, uncomfortable loudness levels, and most comfortable loudness levels.

Mild high-frequency sensorineural threshold elevations were observed in 14 patients (27 ears, 33.75%), predominantly affecting frequencies of 4-6 kHz. Although statistically significant differences were observed across frequencies, threshold elevations were predominantly mild and mainly involved high frequencies. Two RA patients (5%) showed bilateral mixed-type hearing loss. In the control group, two participants (5%) had bilateral sensorineural threshold elevations.

The findings suggest subtle and predominantly high-frequency auditory and cochlear changes in patients with rheumatoid arthritis. Routine audiological evaluation and follow-up may be useful for early detection of subclinical auditory involvement.