Pure tone and high-frequency audiometry findings in celiac patients

Celiac disease is an autoimmune disease of the small intestine, and occurs in individuals with a genetic predisposition due the intake of gluten, which is present in grains such as wheat, barley, and oats. Although it is defined as a disease of the gastrointestinal system, it may also affect the central and peripheral nervous systems in later ages. The inner ear is a sensitive organ to autoimmune attacks, and the sensorineural hearing loss may occur as a complication of autoimmune diseases. This study aimed to evaluate the hearing functions in adults diagnosed with celiac disease who have been on a gluten-free diet for the last six months. One hundred twelve ears (control group) belonging to 56 volunteers between the age of 18-50 years with normal hearing and 110 ears (experimental group) belonging to 55 individuals diagnosed with celiac disease, who were on a gluten-free diet and who were in the same age group were included in this study. All patients underwent otolaryngological examination prior to the study. The patients? hearing functions were evaluated using acoustic immittance, pure tone, high-frequency, and speech audiometry tests. There was a significant increase (deterioration) in the pure tone air conduction hearing threshold in all frequencies except 2000 Hz (250, 500, 1000, 4000, 6000 Hz) in the left ear of patients with celiac disease compared to the control group, and the increase was significant in all frequencies in the right ear (p<0.05). However, since the hearing thresholds were in the normal hearing range, they were not regarded as clinically significant. There was a significant increase (deterioration) in the high-frequency (8000, 10000, 12000, 14000, 16000 Hz) hearing threshold in patients with celiac disease compared to the control group (p<0.05). In female patients with celiac disease, there was a significant increase in the 16000 Hz high-frequency hearing threshold compared to men (p<0.05). As a result, we concluded that the presence of celiac disease increased the hearing thresholds, that is, caused deterioration in the hearing thresholds. It is striking that the increase (deterioration) in the hearing thresholds are more prominent at higher frequencies. These findings imply that the detection of high-frequency hearing thresholds may be useful to determine the effects of celiac disease on the auditory system and they may be used for early diagnosis.