Evaluation of auditory and cochlear function in patients with rheumatoid arthritis

Objective: Both sensorineural and conductive hearing losses have been reported in patients with rheumatoid arthritis, but sensorineural hearing loss is more common (24-60%), and it is reported to occur due to the effect of rheumatoid arthritis on the inner ear. The aim of our study is to evaluate the auditory system in patients with rheumatoid arthritis. Materials and Methods: The study consisted of 2 groups. 40 volunteer participants diagnosed with seropositive rheumatoid arthritis who visited the rheumatology clinic at Necmettin Erbakan University Meram Medical Faculty, and a control group consisting of 40 volunteer participants with normal hearing, supported by taking a medical history. Between December 2021 and December 2022, pure tone audiometry, tympanometry, contralateral and ipsilateral acoustic reflex tests, and TEOAE tests were performed on the seropositive rheumatoid arthritis patient group and healthy group, who were referred to us and were between the ages of 18-60, after a complete ear, nose, and throat examination. With pure tone audiometry test, air and bone conduction thresholds, speech reception threshold, speech discrimination percentage, uncomfortable loudness levels, and most comfortable levels were also evaluated. Each test result was separately compared between the groups. Results: In the RA patient group, SNHL was detected in a total of 14 individuals (27 ears, 33.75%) with bilateral SNHL in 13 patients (32.5%) and unilateral SNHL in one patient. Two RA patients had bilateral mixed-type (5%) hearing loss. In the control group, bilateral SNHL was detected in 2 patients (5%). In TEOAE testing, no response was obtained from the right ear in 32.5% of RA patients and 5% of the control group, and the difference between the groups was significant (p<0.05). Similarly, no response was obtained from the left ear in 25% of RA patients and 5% of the control group, and the difference between the groups was significant (p<0.05). In the speech audiometry tests performed according to the groups to determine whether there was a difference in hearing, the statistical analysis showed that the values of the right and left ear in RA patients were significantly higher than those in the control group, and the speech discrimination scores were significantly lower than those in the control group. Conclusion: The data obtained from this study indicates that the auditory system is negatively affected in patients with rheumatoid arthritis (RA), mostly through sudden sensorineural hearing loss (SNHL). Therefore, patients diagnosed with RA should be informed about the possibility of involvement and undergo audiological examination and tests. As more studies are conducted in this direction, clearer data on possible involvement of the middle and inner ear can be obtained. Regular monitoring and early intervention may help prevent further damage and increase the chances of successful treatment.