Hearing evaluation with pure tone and high frequency audiometry in systemic lupus erythematozus patients

Systemic lupus erythematosus is a chronic, autoimmune disease that can be presented by otoanticor and immuncoplex accumulation damaging the tissue and the organ of the body. The causative agent of the disease is unknown. Systemic lupus erythematosus effects many systems and organs of the body. The incidence in females is 9-10 times more than males. Sensorinoral hearing loss may develop in systemic lupus erythematosus patients due to vasculitis and atrophy of the cochlea, loss of outer hair cells and spiral ganglion. In this study, we aimed to find out the effect of systemic lupus erythematosus disease on hearing functions and the possible risk factors for the development of hearing loss. The study and the control group of 18-40 years of age, 70 systemic lupus erythematosus patients and 70 healthy individuals with normal hearing were included in the study. All the individuals were divided into four age groups, which include 10 men and 10 women in each group. In addition, duration of illness, age at diagnosis, treatment duration, drug treatment and gender were all seperately evaluated in the study group. ENT examinations were performed to all individuals before the study. And standard pure tone audiometry, high frequency audiometry, speech audiometry, tympanomety and acoustic reflex tests were also performed to both the study and the control group found in the study. In the result of the study, both genders with systemic lupus erythematosus are found with normal limits of pure tone averages (air conduction thresholds between 250 and 6000 Hz and bone conduction thresholds 500 and 4000 Hz) and also with normal limit of speech audiometry. With the progression in diagnosis and treatment duration, the hearing thresholds increased at high frequencies (p<0,05). The increase was usually between 12000, 14000 and 16000 Hz for both ears in male and female groups. No significant difference was found between hearing thresholds of the first drug group (steroid + hydrochloroquine) and second drug group (steroid + hydrochloroquine + azathiopine) used for the treatment of systemic lupus erythematosus disease. Out of the 40 women with systemic lupus erythematosus 16 (40%) were found with moderate sensorinoral hearing loss, while out of 30 men with systemic lupus erythematosus only 6 (20%) were found moderate sensorinoral hearing loss. In our study, it was determined that the hearing thresholds were elavated at high frequencies in patients with systemic lupus erythematosus. Due to the adverse effects of systemic lupus erythematosus disease on the cochlea, and most especially on the basal region of the cochlea. Apart from the standard frequencies evaluation we also recommended that it is appropriate to evaluate the high frequencies intervals of the patients with systemic lupus erythematosus disease.