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Ger TY, Lien KH, Chi CC. Association of Psoriasis With Hearing Loss: A Systematic Review and Meta-Analysis. J Cutan Med Surg 2023; 27:330-339. [PMID: 37231542 DOI: 10.1177/12034754231177613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND The relation between psoriasis and hearing loss has been unclear. OBJECTIVE To investigate the association of psoriasis with hearing loss. METHODS We searched MEDLINE and Embase on 12th November 2022 for studies on the association between psoriasis and hearing loss. We conducted a random-effects model meta-analysis to calculate pooled mean difference (MD) in the pure tone thresholds, pooled odds ratio for sensorineural hearing loss, and pooled hazard ratio for sudden sensorineural hearing loss related to psoriasis. RESULTS We included 12 case-control/cross-sectional and 3 cohort studies with 202,683 subjects. Psoriasis was associated with hearing loss at 500 Hz (pooled MD 2.21, 95% CI (CI) 0.13 to 4.29), 1000 Hz (pooled MD 2.97, 95% CI 1.01 to 4.93), 2000 Hz (pooled MD 5.13, 95% CI 2.45 to 7.82), 4000 Hz (pooled MD 9.3, 95% CI 5.1 to 13.51), and 6000 Hz (pooled MD 11.04, 95% CI 5.05 to 17.03). Patients with psoriasis had increased odds for sensorineural hearing loss (pooled odds ratio 3.85, 95% CI 1.07-13.9) and risk for sudden sensorineural hearing loss (pooled hazard ratio 1.45; 95% CI 1.22-1.71). CONCLUSION Psoriasis is associated with hearing loss, especially at high frequencies.
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Affiliation(s)
- Tzong-Yun Ger
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- Graduate Institute of Biomedical Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Kuang-Hsu Lien
- Department of Otolaryngology - Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ching-Chi Chi
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Çağlar Yağcı H, Yağcı İ, Özdamar Oİ, Tosyalı Salman C, Ertuğrul Ö. Hearing loss can also be seen in patients with nonradiographic axial spondyloarthropathies as well as radiographic axial spondyloarthropathies. Arch Rheumatol 2023; 38:257-266. [PMID: 37680508 PMCID: PMC10481684 DOI: 10.46497/archrheumatol.2023.10186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/06/2023] [Indexed: 09/09/2023] Open
Abstract
Objectives Hearing loss has been described in patients with radiographic axial spondyloarthropathies (R-AxSpA) but has not been studied in patients with non-radiographic axial spondyloarthropathies (NR-AxSpA); accordingly, the aim of the study was to compare hearing loss in patients with NR-AxSpA, R-AxSpA, and healthy individuals. Patients and methods This cross-sectional observational study was conducted with 68 participants (30 males, 38 females; mean age: 39.8±7.4 years) between March 2021 and March 2022. Of the participants, 16 were patients with NR-AxSpA, 15 were patients with R-AxSpA, and 37 were healthy controls. Disease activity and radiological and audiological features were analyzed. The audiological assessment included pure-tone audiometric tests at octave frequencies of 250 to 8000 Hz and transient evoked otoacoustic emissions. Results Hearing loss was found in three (8%) in the healthy group, five (31.3%) in the NR-AxSpA group, and 10 (66.7%) in the R-AxSpA group. The chi-square analysis showed a statistical significance (p=0.001). Values of audiometric tests yielded significant differences between the control and R-AxSpA group and also the control and NR-AxSpA group. For the air conduction studies, the statistical significance began at 1000 Hz in the R-AxSpA group. It was found that in the NR-AxSpA group, the statistical difference started in higher frequencies. The bone conduction audiometric studies were similar to air conduction studies. Transient evoked otoacoustic emission studies showed that the R-AxSpA group was significantly affected compared to the control and NR-AxSpA groups. There was no statistical difference between the control and NR-AxSpA groups. Conclusion Both NR-AxSpA and R-AxSpA patients had hearing loss; however, in pure-tone audiometric tests, the abnormalities began in lower frequencies in the R-AxSpA group than in the NR-AxSpA group.
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Affiliation(s)
- Hanife Çağlar Yağcı
- Department of Physical Medicine and Rehabilitation, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Türkiye
| | - İlker Yağcı
- Department of Physical Medicine and Rehabilitation, Marmara University Faculty of Medicine, Istanbul, Türkiye
| | - Osman İlkay Özdamar
- Department of Otorhinolaryngology-Head and Neck Surgery, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Türkiye
| | - Cansu Tosyalı Salman
- Department of Audiology, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Türkiye
| | - Özlem Ertuğrul
- Department of Audiology, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Türkiye
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Doğan E, Közen MA, Mungan Durankaya S, Kenar G, Birlik AM. Evaluation of middle ear and hearing status of ankylosing spondylitis patients with wideband tympanometry and pure tone audiometry tests. Eur Arch Otorhinolaryngol 2022. [PMID: 36385656 DOI: 10.1007/s00405-022-07750-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/07/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the middle and inner ear function and hearing status of Ankylosing spondylitis (AS) patients. METHODS 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 16,000 Hz. The absorbance rates and resonance frequencies of middle ear were measured with the wideband tympanometry (WBT) test. AS group was divided into subgroups based on the disease activity, duration of follow-up, medications used for AS, and the subgroups were compared according to hearing status and absorbance and resonance frequencies of middle ears. RESULTS A statistically significant difference was found between the AS and control groups in terms of air and bone conduction thresholds at frequencies of 250, 500, 1000, 2000, and 4000 Hz and the mean PTA1, PTA2, and PTA3 values (p < 0.05). In contrast, no statistically significant difference was observed between two groups in terms of high-frequency thresholds (8000-16,000 Hz). Although the middle ear resonance frequency obtained from the WBT test was higher in the AS group compared to the control group, no significant difference was observed (p > 0.05). The severity of disease adversely affected the hearing threshold at 250, and 500 Hz for air conduction, at 500 Hz for bone conduction threshold, and at PTA1 (p < 0.05). The duration and severity of disease did not affect absorbance values of WBT (p > 0.05). CONCLUSION To our knowledge, this is the first study to demonstrate the effects of AS patients on the middle ear function with WBT and to report middle ear absorbance values and resonance frequency changes in AS patients. The higher resonance frequency values found by WBT in AS patients may be due to the stiffness that develops as a result of middle ear involvement. According to pure tone and high-frequency audiometry findings, it has been seen that AS leads to SNHL especially at low frequencies.
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Nam SH, Kim GH, Park HJ, Kim YG. Idiopathic Inflammatory Arthritis in the Auditory Canal in a Patient With Hearing Impairment: A Case Report and Literature Review. J Rheum Dis 2022; 29:116-122. [PMID: 37475898 PMCID: PMC10327615 DOI: 10.4078/jrd.2022.29.2.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/23/2021] [Accepted: 04/29/2021] [Indexed: 07/22/2023]
Abstract
Inflammatory arthritis can affect the auditory system during the disease course. Although most cases show asymptomatic hearing impairment, it can result in hearing loss. Here we describe the case of a 70-year-old female with hearing impairment associated with idiopathic inflammatory arthritis in her auditory system. She had suffered from hearing difficulties for decades; however, the causes of her hearing impairment had not been evaluated. Pure tone audiometry showed severe sensorineural hearing loss requiring a cochlear implant. The workup for the cochlear implant revealed erosive changes in the incudomalleolar and incudostapedial joints with soft tissue swelling on temporal bone computed tomography. Bone pathology revealed plasmacytic infiltration and granulomatous inflammation. Laboratory examinations showed elevated levels of inflammatory markers; otherwise, she had negative results for all autoantibodies. In patients with idiopathic hearing loss, inflammatory arthritis of the middle ear without peripheral arthritis can provide a clue regarding the cause of the hearing loss.
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Affiliation(s)
- So Hye Nam
- Division of Rheumatology, Department of Internal Medicine, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Korea
| | - Gi Hwan Kim
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hong Ju Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yong-Gil Kim
- Division of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Yan F, Reddy PD, Nguyen SA, Ward C, Meyer TA. Hearing Loss in Patients With Ankylosing Spondylitis: A Systematic Review and Metaanalysis. J Rheumatol 2021; 48:40-47. [PMID: 32414955 DOI: 10.3899/jrheum.200276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To determine the prevalence of hearing loss (HL) in patients with ankylosing spondylitis (AS) and to describe frequency-specific hearing threshold changes in this patient population compared to patients without AS. METHODS A systematic review querying 4 databases (PubMed, OVID Medline, Scopus, Cochrane) was performed to identify studies evaluating HL in patients with AS. Metaanalysis was performed to identify overall prevalence rate and OR of HL, as well as to compare mean differences in frequency-specific hearing thresholds between patients with and without AS. RESULTS Our metaanalysis included 14 studies and 1083 patients (598 with AS vs 485 without AS). The pooled prevalence of HL in patients with AS was 42.4% (95% CI 29.2-56.2). Patients with AS had a significantly higher OR of HL than patients without AS (OR 4.65, 95% CI 2.73-7.91). Mean differences in pure-tone hearing thresholds ranged from 0-5 decibels (dB) for frequencies of 0.25-4 kHz, and from 5-15 dB for frequencies of 6-16 kHz. CONCLUSION Patients with AS have higher odds of having HL than patients without AS. The AS population also presents with significantly impaired hearing thresholds across all conventional and extended pure-tone frequencies. This may manifest as slight to moderate HL. Results of this systematic review might justify increased attention to audiologic manifestations of patients with AS.
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Affiliation(s)
- Flora Yan
- F. Yan, BA, P.D. Reddy, BS, S.A. Nguyen, MD, T.A. Meyer, MD, PhD, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina;
| | - Priyanka D Reddy
- F. Yan, BA, P.D. Reddy, BS, S.A. Nguyen, MD, T.A. Meyer, MD, PhD, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina
| | - Shaun A Nguyen
- F. Yan, BA, P.D. Reddy, BS, S.A. Nguyen, MD, T.A. Meyer, MD, PhD, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina
| | - Celine Ward
- C. Ward, MD, Department of Medicine, Division of Rheumatology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Ted A Meyer
- F. Yan, BA, P.D. Reddy, BS, S.A. Nguyen, MD, T.A. Meyer, MD, PhD, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina
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Ertugrul G, Ertugrul S, Soylemez E. Evaluation of audiovestibular system in psoriasis patients without joint involvement. Dermatol Ther 2020; 33:e13396. [DOI: 10.1111/dth.13396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 03/28/2020] [Accepted: 04/06/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Goksen Ertugrul
- Department of Dermatology Karabuk University Training and Research Hospital Karabuk Turkey
| | - Suha Ertugrul
- Department of Otorhinolaryngology Karabuk University, Faculty of Medicine Karabuk Turkey
| | - Emre Soylemez
- Department of Audiology Karabuk University Training and Research Hospital Karabuk Turkey
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Tönük ŞB, Yorgancıoğlu ZR. Biomechanical Factors in Psoriatic Disease: Defective Repair Exertion as a Potential Cause. Hypothesis Presentation and Literature Review. ACR Open Rheumatol 2019; 1:452-461. [PMID: 31777825 PMCID: PMC6858026 DOI: 10.1002/acr2.11056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 06/11/2019] [Indexed: 12/17/2022] Open
Abstract
Joining main clinical manifestations of psoriatic skin disorder are inflammatory arthritis and nail lesions. Repetitive microdamage has been postulated as a main triggering factor in lesions of psoriatic arthritis. This concept of psoriatic disease might also be admissible for triggering nail lesions because the nail is a frequently traumatized structure. Here, we aimed to describe the conjectural injury mechanisms of nail complex with regard to acting biomechanical factors. Tissue repair response to physical microdamage may be altered in psoriatic disease. It is plausible to consider that a defective repair process in the dysregulated prepsoriatic tissue may lead to innate immune activation and further development of autoinflammatory lesions, although excessive inflammation is known to impair wound healing. Recently published data have revealed the importance of mechanosensitive Wingless-type (Wnt) signaling in the pathophysiology of psoriasis and ankylosing spondylitis. The Wnt signaling system is involved in morphogenesis, repair, and regeneration as a biologic process main regulator. Wnt5a seems to be a dominating mediator in both psoriatic plaques and during the spondylitis process that might also be a linking molecule of psoriatic response to mechanical stress. Future studies should focus on complex responsive interactions of tissue repair regulators regarded in psoriatic disease.
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Ajmani S, Keshri A, Srivastava R, Aggarwal A, Lawrence A. Hearing loss in ankylosing spondylitis. Int J Rheum Dis 2019; 22:1202-1208. [DOI: 10.1111/1756-185x.13560] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 02/22/2019] [Accepted: 03/02/2019] [Indexed: 01/20/2023]
Affiliation(s)
- Sajal Ajmani
- Department of Clinical Immunology & Rheumatology Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow India
| | - Amit Keshri
- Department of Neurotology Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow India
| | - Rakesh Srivastava
- Department of Neurotology Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow India
| | - Amita Aggarwal
- Department of Clinical Immunology & Rheumatology Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow India
| | - Able Lawrence
- Department of Clinical Immunology & Rheumatology Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow India
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Yagueshita L, Lucinda LR, Azevedo V, Wiemes GR, Wiemes NR, Polanski JF. Audiologic profile in patients with ankylosing spondylitis: A controlled study of 30 patients. Ear Nose Throat J 2019; 97:E18-E22. [PMID: 30273437 DOI: 10.1177/014556131809700905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Recent studies have identified sensorineural hearing loss as a possible manifestation of ankylosing spondylitis. We conducted a study of 30 patients with ankylosing spondylitis to characterize their audiologic profile and to correlate their disease activity and functional indices with their hearing thresholds. The study group was made up of 18 men and 12 women, aged 25 to 58 years (mean: 46.5), who were diagnosed with ankylosing spondylitis. We compared their findings with a socially and demographically matched group of 30 healthy controls. All 60 participants underwent an audiologic assessment, consisting of pure-tone audiometry, speech audiometry, and tympanometry. We used validated indices to assess disease activity and functional status, and we compiled information on the time of diagnosis and the types of medications used to treat the ankylosing spondylitis. We found that the average of the mean air-conduction thresholds at 0.5, 1, 2, and 4 kHz in the ankylosing spondylitis group was significantly worse than that of the controls (p = 0.004). A statistically significant difference was observed at frequencies greater than 3 kHz (p < 0.05). A subgroup of case patients who used only a tumor necrosis factor-alpha inhibitor exhibited better hearing thresholds than patients who used other drugs (p = 0.01). Differences in functional and disease activity scores between case patients with and without hearing loss were not statistically significant. We found that patients with ankylosing spondylitis did indeed have a greater prevalence of sensorineural hearing loss but that it was not correlated with either disease activity or functional status.
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Affiliation(s)
- Lumy Yagueshita
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital de Clínicas, Federal University of Paraná, 181 General Carneiro St., Curitiba, Paraná 8006 0900, Brazil
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Semenov YR, Hsiang EY, Huang A, Herbosa CM, Hui X, Kwatra SG, Cohen B, Anadkat MJ. Association Between Psoriasis with Arthritis and Hearing Impairment in US Adults: Data from the National Health and Nutrition Examination Survey. J Rheumatol 2019; 46:587-594. [DOI: 10.3899/jrheum.171228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2018] [Indexed: 01/23/2023]
Abstract
Objective.Emerging data has linked inflammatory arthritis with hearing impairment (HI). The objective of this study was to investigate the relationship between psoriasis with arthritis (PsA) and HI in the US population. Given the known association of HI and depression, a secondary aim is to investigate the effect of PsA on mental well-being.Methods.Cross-sectional study using the National Health and Nutrition Examination Survey for adults aged ≥ 20 years (n = 10,747). Association of PsA with above outcomes was examined using multivariable generalized linear and ordinal logistic regression models, adjusted for demographics and medical comorbidities. Structural equation models examined the extent to which HI mediated the effect of PsA on mental health.Results.Individuals with PsA were more likely to report hearing difficulties (OR 1.50, p = 0.043), visit a mental health provider (OR 1.62, p = 0.084), have 1.62 more days of poor mental health over the previous month (p = 0.033), and have depression (OR 2.01, p = 0.015) compared to controls. HI mediated 6.5%, 8.3%, and 5.0% of the effect of PsA on the above mental health outcomes, respectively.Conclusion.PsA is independently associated with a significantly increased risk of HI, which partially mediates an association with worsened psychiatric outcomes.
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Karataş D, Doğan İ, Ekinci A, Yetiş A, Özcan M. Evaluation of auditory and cochlear functions in ankylosing spondylitis patients according to the site of involvement. Eur Arch Otorhinolaryngol 2017; 274:3875-81. [PMID: 28889257 DOI: 10.1007/s00405-017-4733-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 08/29/2017] [Indexed: 01/13/2023]
Abstract
Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease of unknown origin with a prevalence rate about 1% in the population. Audiovestibular dysfunction is encountered in AS and sensorineural hearing loss is the most common form. The present study aimed to evaluate auditory and cochlear function in AS patients according to the site of involvement. A total of 47 patients followed for AS in the rheumatology outpatient clinic and 30 healthy controls were enrolled in the study. Subgroups of AS were identified according to the site of involvement. The participants underwent complete otolaryngological examination together with audiometry, otoacoustic emission and tympanometry tests. Disease Activity Index (BASDAI) was determined in the AS group. Hearing loss was detected in seven patients (15%) in the AS group and in four subjects (8%) in the control group. There was statistically significant difference between the patient and control groups in terms of mean bone conduction hearing level at 4000 hertz (Hz) in the right and left ears (p = 0.028, p = 0.049). There was no significant difference between the subgroups of AS in terms of overall auditory and cochlear functions. No correlation was determined between auditory values and Disease Activity Index and CRP (p > 0.05 for all). Our results reveal that AS has minimal effect on auditory and cochlear functions. The effects of subgroups of AS on auditory functions were comparable. The authors concluded that BASDAI and CRP are not convenient in monitoring auditory functions of AS patients.
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Abstract
OBJECTIVE Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease. Via autoimmune mediators, AS can damage the auditory system similar to other systems. Otoacoustic emission studies in AS patients showed that the damage that causes hearing loss was in the outer hair cells. The medial olivocochlear (MOC) reflex is used to evaluate the MOC efferent system (MOES), which includes the outer hair cells. The aim of this study was to evaluate the presence of subclinical damage in the inner ear with the aid of the MOC reflex test in AS patients with no hearing complaints. PATIENTS AND METHODS Thirty-four patients with AS and a control group of 30 healthy volunteers with similar demographic characteristics were evaluated in the study. Otoacoustic emission responses, MOC reflex results, and frequency-specific and total suppression findings were compared between the groups. The relationship between clinical and laboratory findings for the AS patients, and the MOC reflex data were also investigated. RESULTS Reduced MOC reflex response (p = 0.04) and suppression (p = 0.019) were detected in AS patients. When the clinical and laboratory findings for the AS patients and the MOC reflex test results were compared, a significant correlation was found only between the MOC reflex and the erythrocyte sedimentation rate. CONCLUSION The results showed that AS can damage the inner ear, especially the MOES, and can reduce the MOC reflex response without clinical hearing loss.
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Affiliation(s)
- M S Beyazal
- Department of Physical Medicine and Rehabilitation, Recep Tayyip Erdogan University, Sehitler Caddesi, No: 74, 53020, Islampasa Mahallesi, Rize, Turkey.
| | - A Özgür
- Department of Otorhinolaryngology, Recep Tayyip Erdogan University, Rize, Turkey
| | - S Terzi
- Department of Otorhinolaryngology, Recep Tayyip Erdogan University, Rize, Turkey
| | - M Çeliker
- Department of Otorhinolaryngology, Recep Tayyip Erdogan University, Rize, Turkey
| | - E Dursun
- Department of Otorhinolaryngology, Recep Tayyip Erdogan University, Rize, Turkey
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Amor-dorado JC, Barreira-fernandez MP, Llorca J, Gonzalez-gay MA. Oculographic, Clinical Test of Sensory Integration and Balance and Computerized Dynamic Posturography Findings in Patients With Psoriatic Arthritis. Otol Neurotol 2017; 38:448-53. [DOI: 10.1097/mao.0000000000001296] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Bozan N, Alpaycı M, Aslan M, Cankaya H, Kıroglu AF, Turan M, Ayral A, Senkoy E, Ilter S. Mean platelet volume, red cell distribution width, platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios in patients with ankylosing spondylitis and their relationships with high-frequency hearing thresholds. Eur Arch Otorhinolaryngol 2016; 273:3663-3672. [PMID: 27034281 DOI: 10.1007/s00405-016-3980-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 03/09/2016] [Indexed: 12/30/2022]
Abstract
The mean platelet volume (MPV), red cell distribution width (RDW) and neutrophil-to-lymphocyte ratio (NLR) comprise laboratory markers in ankylosing spondylitis (AS). There is a controversy in the literature regarding which type of ear involvement is characteristic of AS. The aim of this study was to simultaneously investigate the MPV, RDW, platelet to lymphocyte (PLR) and NLR in patients with AS and their relationships with high-frequency hearing thresholds. Thirty patients with AS and 35 age-matched healthy subjects were included. Each subject was tested with low- (250, 500, 1000 and 2000 Hz) and high- (4000, 8000, 10,000, 12,000, 14,000 and 16,000 Hz) frequency audiometry. Additionally, the case and control groups were evaluated regarding the average hearing thresholds in bone conduction. The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were measured. The RDW, MPV, neutrophils, lymphocytes and platelet counts were evaluated with the complete blood count. Furthermore, the NLR and PLR were calculated. The complete blood count, platelet numbers, ESR, CRP and NLR levels were significantly increased in the AS patients compared with the healthy controls (p < 0.001, p = 0.007, p < 0.001, p < 0.001 and p = 0.047, respectively). There was no statistically significant difference in the RDW, PLR or MPV levels (p > 0.05) in the AS patients compared with the healthy controls. The BASDAI score and disease duration were not correlated with the ESR, CRP levels, MPV, PLR, RDW or NLR in patients with AS (all; p > 0.05). The AS patients had increased average measurement values for the hearing threshold in both ears at frequencies of 250, 500, 1000 and 2000 Hz; however, there was no statistically significant difference (p > 0.05). The average values of the hearing threshold in both ears at the high frequencies of 4000, 6000, 8000, 10,000, 12,000 and 14,000 Hz were significantly increased in the case group; however, it was not significantly increased at 16,000 Hz. The current study is the first to investigate the PLR, NLR, MPV and RDW levels in acute AS. We identified a significantly increased NLR, leukocyte count, ESR and CRP in AS patients. Sensorineural hearing loss, especially at extended high frequencies, is common in patients with AS and may represent an extra-articular feature of the disease. The combined use of NLR with the leukocyte count and other clinical assessments may facilitate the diagnostic process of ankylosing spondylitis.
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Affiliation(s)
- Nazim Bozan
- Department of Otorhinolaryngology, Medical Faculty, Yuzuncu Yıl University, Van, Turkey
| | - Mahmut Alpaycı
- Physical Medicine and Rehabilitation, Medical Faculty, Yuzuncu Yıl University, Van, Turkey
| | - Mehmet Aslan
- Department of Internal Medicine, Medical Faculty, Yuzuncu Yıl University, 6500, Van, Turkey.
| | - Hakan Cankaya
- Department of Otorhinolaryngology, Medical Faculty, Yuzuncu Yıl University, Van, Turkey
| | - Ahmet Faruk Kıroglu
- Department of Otorhinolaryngology, Medical Faculty, Yuzuncu Yıl University, Van, Turkey
| | - Mahfuz Turan
- Department of Otorhinolaryngology, Medical Faculty, Yuzuncu Yıl University, Van, Turkey
| | - Abdurrahman Ayral
- Department of Otorhinolaryngology, Medical Faculty, Yuzuncu Yıl University, Van, Turkey
| | - Emre Senkoy
- Physical Medicine and Rehabilitation, Medical Faculty, Yuzuncu Yıl University, Van, Turkey
| | - Server Ilter
- Physical Medicine and Rehabilitation, Medical Faculty, Yuzuncu Yıl University, Van, Turkey
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Gunes A, Gundogdu I, Mutlu M, Ozturk EA, Cakci A, Akin I. Functions of the inner ear in psoriatic arthritis. Auris Nasus Larynx 2016; 43:626-31. [PMID: 26915283 DOI: 10.1016/j.anl.2016.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 01/27/2016] [Accepted: 02/03/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This study aimed to investigate whether there is a negative impact as a result of psoriatic arthritis disease of the inner ear function. METHODS Twenty-four successive patients and 38 healthy volunteers, younger than 60 years of age, who were followed up for at least for one year in the outpatient clinics of physical therapy and rehabilitation with the diagnosis of PsA according to CASPAR criteria (17) and who did not complain of any hearing impairment were included in the study. Distortion-product otoacoustic emission (DPOAE) values between 1kHz and 4kHz, tympanometric examination results, stapes reflex values, speech reception threshold (SRT) and speech discrimination (SD) values, pure-tone values between 250 and 8000Hz and high-frequency values between 10,000, 12,500 and 16,000Hz were analyzed. Statistical comparisons between both groups were performed using chi-square test and Mann-Whitney U test. p<0.05 was accepted as the level of statistical significance. RESULTS Our study population consisted of 24 [9 male (37.5%) and 15 female (62.5%)] patients with a mean age of 47.21±11.28 (range, 28-59) years and 38 [16 male (42.1%) and 22 female (57.9%)] healthy volunteers with a mean age of 44.39±8.12 (range, 29-59) years as the control group. Mean duration of arthritis was 7.62±4.88 years. In the evaluation of hearing frequencies of the patients between 4000 and 6000Hz, a statistically significant difference was found relative to the control group (p<005). DPOAE values of the patients were analyzed within the 1000-4000Hz interval. When compared with the control group, a statistically significant difference was found at 3000 and 4000Hz (p<005). CONCLUSION Our study provides strong evidence suggesting the necessity of monitorization of these patients regarding sensorineural hearing loss so as to take measures against the development of hearing loss during early stage, which may be another disability in patients with PsA, which is itself a potential cause of severe disability.
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Affiliation(s)
- Akif Gunes
- Department of Otorhinolaryngology, Golbasi Hasvak State Hospital, Ankara, Turkey.
| | - Ibrahim Gundogdu
- Department of Physical Medicine and Rehabilitation, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Murad Mutlu
- Department of Otorhinolaryngology, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Erhan Arif Ozturk
- Department of Physical Medicine and Rehabilitation, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Aytul Cakci
- Department of Physical Medicine and Rehabilitation, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Istemihan Akin
- Department of Otorhinolaryngology, Kafkas University Medical School, Kars, Turkey
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Özgür A, Serdaroğlu Beyazal M, Terzi S, Coşkun ZÖ, Dursun E. Vestibular evoked myogenic potentials in patients with ankylosing spondylitis. Eur Arch Otorhinolaryngol 2016; 273:2953-7. [PMID: 26742904 DOI: 10.1007/s00405-015-3882-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 12/23/2015] [Indexed: 11/30/2022]
Abstract
Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease with unknown etiology. Although sacroiliac joint involvement is the classic sign along with the formed immune mediators, it may result in immune-mediated inner ear disease and may cause damage to the audiovestibular system. Vestibular evoked myogenic potentials (VEMP) is a clinical reflex test used in the diagnosis of vestibular diseases and is performed by recording and evaluating the muscle potentials resulting from the stimulation of the vestibular system with different stimuli. The aim of this study is to evaluate the cervical VEMP test results in AS patients without vestibular symptoms. Thirty-three patients with AS and a control group of 30 healthy volunteers with similar demographic characteristics were evaluated in the study. VEMP wave latency, P13-N23 wave amplitude, and VEMP asymmetry ratio (VAR) values were compared between the groups. The relationship between clinical and laboratory findings of the AS patients and VEMP data were also investigated. Compared with healthy people, this study shows the response rate of patients with ankylosing spondylitis was reduced in the VEMP test, and P13-N23 wave amplitude showed a decrease in AS patients who had VEMP response (p < 0.001). There was no correlation between the clinical and laboratory findings and VEMP findings in patients with ankylosing spondylitis. The data obtained from this study suggest that AS may lead to decreased sensitivity of the vestibular system.
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Affiliation(s)
- Abdulkadir Özgür
- Department of Otorhinolaryngology, Recep Tayyip Erdogan University, Islampasa Mahallesi, Sehitler Caddesi, No: 74, PB: 53020, Rize, Turkey.
| | | | - Suat Terzi
- Department of Otorhinolaryngology, Recep Tayyip Erdogan University, Islampasa Mahallesi, Sehitler Caddesi, No: 74, PB: 53020, Rize, Turkey
| | - Zerrin Özergin Coşkun
- Department of Otorhinolaryngology, Recep Tayyip Erdogan University, Islampasa Mahallesi, Sehitler Caddesi, No: 74, PB: 53020, Rize, Turkey
| | - Engin Dursun
- Department of Otorhinolaryngology, Recep Tayyip Erdogan University, Islampasa Mahallesi, Sehitler Caddesi, No: 74, PB: 53020, Rize, Turkey
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Demontis A, Trainito S, Del Felice A, Masiero S. Favorable effect of rehabilitation on balance in ankylosing spondylitis: a quasi-randomized controlled clinical trial. Rheumatol Int 2016; 36:333-9. [DOI: 10.1007/s00296-015-3399-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 11/16/2015] [Indexed: 10/22/2022]
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Somuk BT, Özer S, Soyalıc H, Sapmaz E, Goktas G, Admis A, Gurbuzler L. Vestibular evoked myogenic potentials in pediatric patients with familial Mediterranean fever. Int J Pediatr Otorhinolaryngol 2015; 79:879-882. [PMID: 25851176 DOI: 10.1016/j.ijporl.2015.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 03/23/2015] [Accepted: 03/24/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We aimed to investigate whether the chronic autoinflammatory process in familial Mediterranean fever (FMF), which affects numerous systems, results in vestibular dysfunction in pediatric patients being followed up for diagnosis of FMF using VEMP recordings. METHODS 30 patients (60 ears) diagnosed with FMF and 20 (40 ears) healthy volunteers were included in the study. Following routine ear, nose, and throat examination, transient-evoked otoacoustic emissions (TEOAE) and vestibular-evoked myogenic potential (VEMP) tests were performed. RESULTS A total of 30 FMF pediatric patients (13 male, 17 female) and 20 controls (8 male, 12 female) were included in the study. The mean age of FMF patients was 12.13 ± 2.88 years, while that of the controls was 12.90 ± 2.80 years. All of the otoacoustic emission results of the patient and control groups were "pass VEMP recordings received in both ears of patients with FMF (60 ears) and both ears of controls (40 ears). There was no statistically significant difference for latencies or amplitudes for either patients or controls (p > 0.05). CONCLUSION In order to research the effect of FMF on vestibular functions, we measured VEMP. However, we did not detect alterations of VEMP in FMF patients.
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Affiliation(s)
- Battal Tahsin Somuk
- Department of Otorhinolaryngology, Gaziosmanpasa University, School of Medicine, Tokat, Turkey.
| | - Samet Özer
- Department of Pediatry, Gaziosmanpasa University, School of Medicine, Tokat, Turkey
| | - Harun Soyalıc
- Department of Otorhinolaryngology, Gaziosmanpasa University, School of Medicine, Tokat, Turkey
| | - Emrah Sapmaz
- Department of Otorhinolaryngology, Gaziosmanpasa University, School of Medicine, Tokat, Turkey
| | - Goksel Goktas
- Department of Otorhinolaryngology, Gaziosmanpasa University, School of Medicine, Tokat, Turkey
| | - Ayhan Admis
- Department of Oudiology, Gaziosmanpasa University, School of Medicine, Tokat, Turkey
| | - Levent Gurbuzler
- Department of Otorhinolaryngology, Gaziosmanpasa University, School of Medicine, Tokat, Turkey
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Amor-Dorado JC, Barreira-Fernandez MP, Pina T, Vázquez-Rodríguez TR, Llorca J, González-Gay MA. Investigations into Audiovestibular Manifestations in Patients with Psoriatic Arthritis. J Rheumatol 2014; 41:2018-26. [PMID: 25179845 DOI: 10.3899/jrheum.140559] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective.Although psoriatic arthritis (PsA) is a common chronic inflammatory rheumatic disease, little is known about audiovestibular impairment in this condition. We aimed to establish whether audiovestibular manifestations were present in patients with PsA.Methods.A set of 60 consecutive patients who fulfilled the Moll and Wright criteria for PsA and 60 matched controls were studied. During the period of recruitment, individuals were excluded who had a history of cardiovascular disease, cerebrovascular complications, peripheral artery disease, renal insufficiency, syphilis, Meniere disease and other vestibular syndromes, infections involving the inner ear, barotrauma, or were in treatment with ototoxic drugs.Results.Most patients with PsA were men (63%). The mean age at the time of our study was 52.9 years and the mean age at the onset of symptoms was 33 years. Thirty-six (60%) of the 60 patients showed abnormal hearing loss in the audiogram compared to only 5 (8.3%) of the 60 controls (p < 0.001). Values of audiometric tests (pure-tone average and speech reception threshold) yielded significant differences between patients and controls (p < 0.001). The audiogram disclosed a bilateral and symmetrical sensorineural hearing loss (SNHL) in PsA with predominant pattern of high frequency SNHL in patients with PsA (46.7%) compared to controls (8.3%, p < 0.001). Patients with PsA exhibited abnormal vestibular tests more commonly than controls. A significantly increased frequency of abnormal computerized dynamic posturography with a predominant vestibular loss pattern was also observed in patients (23.3%) compared to controls (0%, p < 0.001).Conclusion.Our current study demonstrates strong evidence for inner ear damage in patients with PsA.
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Fatemi G, Gensler LS, Learch TJ, Weisman MH. Spine fractures in ankylosing spondylitis: a case report and review of imaging as well as predisposing factors to falls and fractures. Semin Arthritis Rheum 2014; 44:20-4. [PMID: 25087159 DOI: 10.1016/j.semarthrit.2014.03.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 03/03/2014] [Accepted: 03/19/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Ankylosing spondylitis (AS), an inflammatory arthritis that affects the axial skeleton, predisposes patients with severe disease to falls and spinal fractures. Advanced imaging has improved the process of fracture detection. In spite of increased knowledge about early diagnosis and management of AS, little attention is being paid to the environmental hazards that pose a risk for patient outcome. OBJECTIVES To identify risk factors for falls and fractures and evaluate imaging modalities in the detection of fractures in AS patients. METHODS A case report and review of the literature using PubMed for English articles from 2000 to 2013 regarding AS patients׳ risk factors for falls and fractures and imaging modalities used to diagnose fracture in this population. RESULTS Potential impairments in balance and coordination in the AS population include vestibular dysfunction, thoracolumbar kyphosis, and deficits in proprioception. A common and significant environmental risk factor for falls includes the use of a tub-shower arrangement. Furthermore, osteoporosis is a well-known complication of AS, which can predispose to a fracture. Lastly, there are no comprehensive studies that have evaluated the ability of advanced imaging modalities to identify an acute spine fracture in this patient population. CONCLUSIONS AS patients with advanced disease are at an increased risk of falls and fractures due to many factors including but not limited to a rigid spine and difficulty with peripheral vision. A tub-shower arrangement commonly found in homes and hotel rooms is a major hazard. A consistent approach to diagnosis of fractures involving advanced imaging recommendations should be considered.
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Affiliation(s)
- Gita Fatemi
- Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048
| | | | - Thomas J Learch
- Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048
| | - Michael H Weisman
- Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048.
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Morales-Angulo C, Vergara Pastrana S, Obeso-Agüera S, Acle L, González-Gay MÁ. Otorhinolaryngological Manifestations in Patients With Behçet Disease. Acta Otorrinolaringologica (English Edition) 2014. [DOI: 10.1016/j.otoeng.2014.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kapusuz Gencer Z, Özkırış M, Günaydın I, Saydam L. The impact of ankylosing spondylitis on audiovestibular functions. Eur Arch Otorhinolaryngol 2014; 271:2415-20. [DOI: 10.1007/s00405-013-2743-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 09/26/2013] [Indexed: 10/26/2022]
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Morales-Angulo C, Vergara Pastrana S, Obeso-Agüera S, Acle L, González-Gay MÁ. [Otorhinolaryngological manifestations in patients with Behçet disease]. Acta Otorrinolaringol Esp 2013; 65:15-21. [PMID: 24094428 DOI: 10.1016/j.otorri.2013.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 06/13/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION AND OBJECTIVES Behçet disease (BD) is a systemic immune-mediated vasculitis of unknown origin characterised by recurrent orogenital ulceration, ocular inflammation and skin lesions. The aim of our study was to identify ear, nose and throat (ENT) manifestations associated with BD. PATIENTS AND METHODS Retrospective review of the medical records of all patients diagnosed with BD who attended a tertiary public hospital in Cantabria (Spain) over a period of 22 years. Clinical manifestations, in particular those concerning ENT, were retrieved from medical records. A medical literature review of ENT manifestations was conducted. RESULTS Thirty-three patients (age range: 17-64 years) were included in the study. Most of them presented oral ulcers (97%). Eight patients (24%) presented oropharyngeal ulcers and 5 patients (15%) experienced audiovestibular symptoms (high frequency sensorineural hearing loss, vertigo and bilateral vestibular hypofunction). One patient had symptoms compatible with vestibular neuronitis as the presentation manifestation of Neuro-Behçet. In 4 patients (12%) the presence of odynophagia secondary to the presence of oropharyngeal lesions, initially interpreted as acute or recurrent tonsillitis, was the first manifestation of the disease, alone or associated with cutaneous or ocular lesions. CONCLUSIONS In addition to the characteristic oral ulcers present in most patients with BD, ulcers in the oropharynx, occasionally interpreted as acute pharyngitis, are also common in these patients. Audiovestibular manifestations frequently appear during the course of the disease and may be the first symptom of central nervous system involvement.
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Affiliation(s)
- Carmelo Morales-Angulo
- Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander, España.
| | - Sandra Vergara Pastrana
- Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - Sergio Obeso-Agüera
- Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - Leticia Acle
- Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander, España
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Cho HJ, Yo I, Ryu H, Lee J, Beak HJ. A Case of Sudden Sensorineural Hearing Loss in a Patient with Axial Spondyloarthritis. J Rheum Dis 2013. [DOI: 10.4078/jrd.2013.20.2.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Hyon Joung Cho
- Department of Rheumatology, Seoul National University, Bundang Hospital, Bundang, Korea
| | - Inku Yo
- Department of Rheumatology, Gachon University School of Medcine, Gil Medical Center, Incheon, Korea
| | - Heejung Ryu
- Department of Rheumatology, Gachon University School of Medcine, Gil Medical Center, Incheon, Korea
| | - Juuhyoung Lee
- Department of Otorhinolaryngology, Gachon University School of Medcine, Gil Medical Center, Incheon, Korea
| | - Han Joo Beak
- Department of Rheumatology, Gachon University School of Medcine, Gil Medical Center, Incheon, Korea
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Kahveci OK, Demirdal US, Duran A, Altuntas A, Kavuncu V, Okur E. Hearing and cochlear function of patients with ankylosing spondylitis. Clin Rheumatol 2012; 31:1103-8. [PMID: 22526477 DOI: 10.1007/s10067-012-1984-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2012] [Revised: 03/21/2012] [Accepted: 03/30/2012] [Indexed: 10/28/2022]
Abstract
Ankylosing spondylitis (AS) is a chronic systemic inflammatory disorder that primarily affects the spine and sacroiliac joints. Recent studies described audiovestibular impairment in AS patients. The aim of this study was to evaluate the hearing and function of the cochlear system in patients with AS. Thirty-seven AS patients and 20 healthy controls were evaluated prospectively. Otorhinolaryngologic examinations were performed in all patients together with pure tone audiometry, speech discrimination test, tympanometry, and distortion product otoacoustic emission (DPOE). Disease duration, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores, and hematologic findings (CRP and ESR) were also collected. Pure tone audiometry findings of the patients and controls were significantly different in all frequencies (p < 0.01). Speech discrimination scores were also significantly different (p < 0.01). No significant difference was found between DPOE responses of the patients and controls (p > 0.05). There was no correlation between disease duration, BASDAI scores, hematological findings, and audiometry findings (p > 0.05). This study demonstrated that there is an association between AS and hearing loss, but the cochlea is not the main source of hearing loss.
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Gazquez I, Soto-Varela A, Aran I, Santos S, Batuecas A, Trinidad G, Perez-Garrigues H, Gonzalez-Oller C, Acosta L, Lopez-Escamez JA. High prevalence of systemic autoimmune diseases in patients with Menière's disease. PLoS One 2011; 6:e26759. [PMID: 22053211 PMCID: PMC3203881 DOI: 10.1371/journal.pone.0026759] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Accepted: 10/03/2011] [Indexed: 11/18/2022] Open
Abstract
Background Autoimmunity appears to be associated with the pathophysiology of Meniere's disease (MD), an inner ear disorder characterized by episodes of vertigo associated with hearing loss and tinnitus. However, the prevalence of autoimmune diseases (AD) in patients with MD has not been studied in individuals with uni or bilateral sensorineural hearing loss (SNHL). Methods and Findings We estimated the prevalence of AD in 690 outpatients with MD with uni or bilateral SNHL from otoneurology clinics at six tertiary referral hospitals by using clinica criteria and an immune panel (lymphocyte populations, antinuclear antibodies, C3, C4 and proinflammatory cytokines TNFα, INFγ). The observed prevalence of rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and ankylosing spondylitis (AS) was higher than expected for the general population (1.39 for RA, 0.87 for SLE and 0.70 for AS, respectively). Systemic AD were more frequently observed in patients with MD and diagnostic criteria for migraine than cases with MD and tension-type headache (p = 0.007). There were clinical differences between patients with uni or bilateral SNHL, but no differences were found in the immune profile. Multiple linear regression showed that changes in lymphocytes subpopulations were associated with hearing loss and persistence of vertigo, suggesting a role for the immune response in MD. Conclusions Despite some limitations, MD displays an elevated prevalence of systemic AD such as RA, SLE and AS. This finding, which suggests an autoimmune background in a subset of patients with MD, has important implications for the treatment of MD.
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Affiliation(s)
- Irene Gazquez
- Genyo, Centro de Genómica e Investigación Oncológica, Pfizer/Universidad de Granada/Junta de Andalucia, Granada, Spain
| | - Andres Soto-Varela
- Division Otoneurology, Department of Otorhinolaryngology, Complejo Hospitalario Universitario Santiago de Compostela, Santiago de Compostela, Spain
| | - Ismael Aran
- Department of Otolaryngology, Complejo Hospitalario de Pontevedra, Pontevedra, Spain
| | - Sofia Santos
- Division Otoneurology, Department of Otorhinolaryngology, Complejo Hospitalario Universitario Santiago de Compostela, Santiago de Compostela, Spain
| | - Angel Batuecas
- Department Otolaryngology, Hospital Univesitario Salamanca, Salamanaca, Spain
| | - Gabriel Trinidad
- Department Otolaryngology, Hospital Universitario de Badajoz, Badajoz, Spain
| | | | - Carlos Gonzalez-Oller
- Otology & Neurotology Group, CTS495, Department of Biotechnology, Hospital de Poniente, El Ejido, Almeria, Spain
| | - Lourdes Acosta
- Otology & Neurotology Group, CTS495, Department of Biotechnology, Hospital de Poniente, El Ejido, Almeria, Spain
| | - Jose A. Lopez-Escamez
- Genyo, Centro de Genómica e Investigación Oncológica, Pfizer/Universidad de Granada/Junta de Andalucia, Granada, Spain
- Otology & Neurotology Group, CTS495, Department of Otolaryngology, Hospital de Poniente, El Ejido, Almería, Spain
- * E-mail:
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Abstract
OBJECTIVES Patients with diffuse cutaneous systemic sclerosis (dcSSc) have distinct clinical manifestations, usually with more aggressive organ involvement and highermortality than limited cutaneous systemic sclerosis (lcSSC). Hearing loss had not yet been evaluated in this subtype, so our aim was to assess the auditory system of dcSSc patients in a controlled study. METHODS Twenty-six patients with dcSSc, according to American College of Rheumatology (ACR) criteria, were evaluated. For each dcSSc patient included in the study, two healthy controls were matched for sex and age (± 2 years). All patients responded to a structured questionnaire regarding otological symptoms and risk factors with regard to hearing loss. A complete ear/nose/throat physical examination was performed followed by speech/pure tone audiometry and impedance measurements. RESULTS The mean age of the dcSSc patients was 47.0 ± 11.9 years; the mean disease duration was 9.4 ± 9.1 years, and there was a clear female predominance (83%). The questionnaire revealed auditory complaints in 54% of the dcSSc patients (25% hearing loss, 21% aural fullness, 21% tinnitus, and 21% dizziness) and normal otoscopy. Nearly half (46%) of the dcSSc patients were diagnosed as having hearing loss on audiogram compared to only 19% in the control group (p = 0.01). All dcSSc with hearing loss had a sensorineural component, eight (73%) with excellent discrimination on the Percentage Index of Speech Recognition (PISR). Descending configuration and Metz recruitment were observed in 54% of these patients, suggesting cochlear involvement. CONCLUSION Patients with dcSSc have a high prevalence of sensorineural audiometric hearing impairment and otological complaints, suggesting that the cochlea is an additional target organ in this disease.
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Affiliation(s)
- T A Monteiro
- Departments of Otorhinolaryngology, University of Sao Paulo Medical School, Sao Paulo, Brazil.
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