Rheumatoid Arthritis: A Disease That Bites Joints but Can Also Lick Hearing

Abstract

Background: Rheumatoid arthritis (RA), a multisystem disorder of unknown etiology, is a chronic polyarthritic condition. Hearing loss (HL) among RA patients is a common finding (prevalence of 60%–62%) with conductive HL (CHL) being more common than sensorineural HL (SNHL). Objectives: The present study was conducted in this context as an attempt (i) to find the prevalence of HL among RA patients, (ii) to assess the type of HL in RA patients, and (iii) to find any correlation between duration of illness, gender, and age of patients. Materials and Methods: This was a case–control study which included 25 RA patients and 25 normal controls. All subjects underwent complete clinical examination and audiological evaluation which included pure-tone audiometry (PTA), tympanometry, and acoustic reflex. Results: Out of 25 cases, 66% had HL (CHL - 50% and SNHL - 16%) while 34% had normal hearing. On tympanometry, 9 out of 25 cases showed as type of curve while the remaining 16 had A type on the right side. On the left side, 7 out of 25 cases showed as type of curve and 18 had A type. Acoustic reflex was absent in 15, delayed in 3, and present in 7 on the right side. On the left, it was absent in 12, delayed in 4, and present in 8. All the controls had normal hearing threshold (<25 dB), A-type tympanogram, and acoustic reflex present in both ears. Conclusion: This study indicates that a large number of RA patients are destined to have ear involvement. Hence, auditory screening using PTA should be done routinely in RA patients and early diagnosis of these patients can help in better rehabilitation.