Investigation of middle ear involvement with pure tone audiometry and wideband tympanometry in patients with ankylosing spondylitis

INVESTIGATION OF MIDDLE EAR INVOLVEMENT WITH PURE TONE AUDIOMETRY AND WIDEBAND TYMPANOMETRY IN PATIENTS WITH ANKYLOSING SPONDYLITIS Dr. Melih Arif Kozen Dokuz Eylül University, Faculty of Medicine, Department of Otolaryngology İnciraltı, İZMİR Objective and Hypothesis The present study aimed to investigate the effect of ankylosing spondylitis, on middle ear functions. Method One hundred twenty-four ears of 62 patients with AS and 90 ears (control group) of 45 healthy subjects were included in the study. The hearing levels of the participants were assessed with pure tone and high-frequency audiometry at the octave frequency between 250 and 16000 Hz. The absorbance rates and resonance frequencies of middle ear were measured with the wideband tympanometry test. In order to investigate the effect of disease activity, duration of follow-up, medications used for ankylosing spondylitis on hearing, absorbance rates and resonance frequency of middle ear, the ankylosing spondylitis group was divided into groups and comparisons were made. Results Conductive hearing loss was not observed in any of the ears tested. When pure tone average values (arithmetic mean of the hearing levels at frequencies 500, 1000, 2000 and 4000 Hz) were compared, mild sensorineural hearing loss was detected in 10 ears of the AS group (% 8) and in 4 ears of the control group (% 4). When the means of octave frequencies between 8-16 kHz. were compared, SNHL was detected in 99 ears of the patient group (79.8%) and 62 ears of the control group (68%). Although hearing thresholds at all frequencies were detected to be higher in the patient group, this difference was only significant at the frequencies between 250 and 4000 Hz (p<0.05). The absorbance rate of the patient group at 250 Hz. octave band was found to be significantly lower than the control group (p<0.05). A significant decline was observed at 2000Hz octave band in the patients with more than 10 years of disease duration. The ear side, gender, used medication did not have any influence on the audiometric and wideband immitancemetric findings. Conclusion Low frequency hearing thresholds were found to be elevated and absorbance ratios at 250 Hz octave band were found to be decreased in ankylosing spondylitis patients. Multicenter studies with larger group of patients are required to clarify ear involvement due to ankylosing spondylitis. Keywords Ankylosing spondylitis, Wideband Tympanometry, Absorbance, Hearing Loss