Hearing loss in patients with Behçet's disease: an audiological and transient evoked otoacoustic emission study

Bilateral sudden sensorineural hearing loss in patient with Behçet disease

Bacckground: Approximately 80% to 85% of sudden sensorineural hearing loss (SSNHL) is idiopathic, but immune-mediated mechanisms are thought to be involved. Behçet disease is an autoinflammatory vasculitis that may involve vessels of the inner ear. It can cause sensorineural hearing loss (SNHL) and an increased risk of SSNHL. Study Sample: We report a 21-year-old man who was diagnosed with Behçet disease in childhood and presented to our clinic with a 10-day history of abrupt hearing deterioration in both ears. Pure-tone audiometry showed severe to profound bilateral SNHL. Results: Oral prednisolone was prescribed for 3 weeks. Concurrent intratympanic steroid injections (ITSIs) were administered in each ear every 2 days for 5 days. A total of 15 daily sessions of hyperbaric oxygen therapy (HBOT) were completed. Acupuncture was performed every 2 days for 1 month. After these combined therapies, the patient's hearing threshold by 20 dB and his speech recognition threshold were improved. Conclusions: Some patients with SSNHL recover no hearing improvement after routine treatment, and alternative treatments including ITSI, HBOT, and acupuncture can be considered as optional. We used an aggressive multimodal approach to treat severe bilateral SSNHL in patient with Behçet disease.

Sensory neural hearing loss in Behcet's disease successfully controlled with infliximab, case report and review of literature

Behcet's disease is a systemic autoimmune disorder occasionally associated with otological manifestations, including sensorineural hearing loss. We are reporting a case of Behcet's disease, which was complicated by sensorineural hearing loss and managed successfully with anti-TNF agent Infliximab.

Evaluation of hearing loss and tinnitus in Behcet's disease

OBJECTIVE

The aim of this study is to evaluate sensorineuralhearing loss (SHNL) and tinnitus in patients with Behcet's disease (BD), while also determining the association between the clinical symptoms of BD and the disease duration with the development of hearing loss.

MATERIALS AND METHODS

The study included 44 patients with BD and 42 healthy volunteers as the control group. The level of tinnitus-induced annoyance and the effects of tinnitus on daily life were evaluated with Visual Analog Scale (VAS) and the Tinnitus Reaction Questionnaire (TRQ). The hearing levels of all participants were measured with high-frequency audiometry and transient auto-acoustic emission tests.

RESULTS

The patients with BD were significantly more affected by SNHL and tinnitus than the controls (p < 0.05). The correlation between disease duration and age among those with SNHL was statistically significant (p < 0.05). No association was found between the clinical findings and SNHL and tinnitus (p > 0.05) in the BD patients.

CONCLUSION

In the present study, high-frequency SNHL was found to be common in among the patients with BD. SNHL in BD is positively correlated with the patients' age of the and the disease duration.

Determination of hearing levels in patients with Familial Mediterranean Fever

OBJECTIVE

Familial Mediterranean Fever is the most common congenital, periodic fever condition that affects over 100,000 people worldwide. In the literature, there is limited number of studies about hearing levels in children with Familial Mediterranean Fever. In the present study, we aimed to investigate hearing levels and cochlear functions by using Distortion product Otoacoustic Emission and High Frequency Audiometry (250-20,000 Hz) in pediatric patients with Familial Mediterranean Fever.

METHODS

The study included 62 children with Familial Mediterranean Fever and 27 healthy children with similar age and gender. After otoscopic examination, both groups underwent audiological evaluation including High Frequency Audiometry (250-20,000 Hz) and Distortion product Otoacoustic Emissions. The results obtained were assessed among groups. In addition, these results were compared regarding colchicine use, age at the onset of disease and duration of the diseases in the Familial Mediterranean Fever group.

RESULTS

Of the Familial Mediterranean Fever patients, 93.5% were on colchicine therapy and mean duration of colchicine use was 19.9 ± 13.9 months. The mean age at diagnosis was 6.57 ± 2.86 years (min-max: 2-14) and mean duration of disease was 23 ± 17 months (min-max: 6-84). Pure tone audiometry values, and hearing levels between 9000 and 20,000 Hz were similar and within normal range in both groups. The Distortion product Otoacoustic Emissions responses at the frequencies of 1020, 2040, 3000, 4080 and 5040 Hz were similar for both groups.

CONCLUSION

To the best of our knowledge, this is the first study evaluating hearing levels at the frequencies of 18k Hz and 20k Hz in children with Familial Mediterranean Fever in the literature. In children with Familial Mediterranean Fever, Pure tone audiometry values, hearing values obtained at all frequencies from 250 to 20,000 Hz, and Distortion product Otoacoustic Emissions levels were within normal range. Furthermore, hearing levels were found to be similar to those in healthy children.

Cochlear involvement in Familial Mediterranean Fever: a new feature of an old disease

OBJECTIVES

In this study we first aimed to assess the cochlear functions in children with Familial Mediterranean Fever. The second aim was to investigate the correlation between the hearing levels and some clinical features of Familial Mediterranean Fever including the duration of the disease, age at onset, genetic analysis and colchicine use.

METHODS

Thirty-four children with Familial Mediterranean Fever and 27 age matched children were included in the study. Following otologic examination, all children underwent audiometric evaluation, including Pure Tone Average measurements and Distortion Product Otoaoustic Emission testing. Audiological results of the two groups were compared and correlation between the audiologic status and clinical parameters of the disease like the duration of disease, age at onset, mutations and colchicine treatment were studied.

RESULTS

Pure tone audiometry hearing levels were within normal levels in both groups. Hearing thresholds of Familial Mediterranean Fever patients were found to be increased at frequencies 8000, 10,000, 12,500 and 16,000 (p<0.05). In otoacoustic emission evaluation, distortion products and signal-noise ratio of FMF children were lower in the tested frequencies, from 1400 Hz to 4000 Hz (p<0.05). Interaction of the disease duration and age of disease onset was found to predict hearing levels, distortion products and signal-noise ratios of children with Familial Mediterranean Fever (F value=2.034; p=0.033).

CONCLUSIONS

To our knowledge this is the first study demonstrating cochlear involvement in children with Familial Mediterranean Fever which showed increased hearing thresholds at higher frequencies in audiometry together with decreased distortion products and signal-noise ratios demonstrated by distortion product otoacoustic emission testing. Similar studies must be carried out on adult patients to see if a clinical hearing impairment develops. The possible mechanisms that cause cochlear involvement and the effect of colchicine treatment on cochlear functions must be enlightened.