幼年特发性关节炎患者的听力损失与中耳受累情况

Hearing loss and middle ear involvement in patients with juvenile idiopathic arthritis.

作者信息

Ikiz Ahmet Omer, Unsal Erbil, Kirkim Gunay, Erdag Taner Kemal, Guneri Enis Alpin

机构信息

Dokuz Eylul University School of Medicine, Department of Ear Nose Throat and Head and Neck Surgery, 35340 Izmir, Turkey.

出版信息

Int J Pediatr Otorhinolaryngol. 2007 Jul;71(7):1079-85. doi: 10.1016/j.ijporl.2007.03.017. Epub 2007 May 4.

DOI:10.1016/j.ijporl.2007.03.017

PMID:17482280

Abstract

OBJECTIVE

Evaluation of the hearing status and middle ear function of patients with juvenile idiopathic arthritis.

METHODS

The study group was comprised of 38 ears of 19 patients (6 males, 13 females) aged between 5 and 23 years. The control group was comprised of 30 ears of 15 healthy subjects (5 males, 10 females) aged between 5 and 22 years. All subjects were examined audiologically using tympanometry, stapedial reflex, acoustic reflex decay, pure-tone audiometry, high frequency audiometry and transient evoked otoacoustic emission tests.

RESULTS

There were statistically significant (p<0.05) number of ears (32%) with abnormal tympanograms in the patient population while all tympanograms were normal, type A in the control group. Seven type As, 2 type Ad, and 3 type C tympanograms were seen in the patient population. In pure tone audiometry tests there was no subject having neither a conductive nor sensorineural hearing loss individually in both groups. But as a group, patients with juvenile idiopathic arthritis showed statistically significant elevation of air conduction thresholds at frequencies of 250, 500, 6000, 14,000 and 16,000 Hz for right ears; and at 500, 2000, 12,500 and 16,000 Hz for left ears; and larger air-bone gaps at 500 and 2000 Hz for right ears; and at 500 Hz for left ears (p<0.05). Comparison of bone conduction thresholds and otoacoustic emission tests between both groups did not reveal any statistically significant difference (p>0.05).

CONCLUSION

This study suggests a dual effect of disease on both the middle and inner ear of patients with juvenile idiopathic arthritis. Presence of abnormal tympanograms together with worse air conduction thresholds at lower frequencies as well as larger air bone gaps at frequencies of 500 and 2000 Hz suggest subclinical middle ear involvement; while hearing losses at 6000 Hz and very high frequencies of 12,500, 14,000 and 16,000 Hz suggest inner involvement at an early stage.

摘要

目的

评估青少年特发性关节炎患者的听力状况和中耳功能。

方法

研究组由19例年龄在5至23岁之间的患者（6例男性，13例女性）的38只耳朵组成。对照组由15名年龄在5至22岁之间的健康受试者（5例男性，10例女性）的30只耳朵组成。所有受试者均接受了听力学检查，包括鼓室图、镫骨肌反射、声反射衰减、纯音听力测定、高频听力测定和瞬态诱发耳声发射测试。

结果

患者组中鼓室图异常的耳朵数量（32%）具有统计学意义（p<0.05），而对照组所有鼓室图均正常，为A型。患者组中可见7例A型、2例Ad型和3例C型鼓室图。在纯音听力测定测试中，两组中均没有个体单独出现传导性或感音神经性听力损失。但作为一个群体，青少年特发性关节炎患者右耳在250、500、6000、14000和16000Hz频率处的气导阈值有统计学意义的升高；左耳在500、2000、12500和16000Hz频率处；右耳在500和2000Hz频率处以及左耳在500Hz频率处的气骨导差更大（p<0.05）。两组之间骨导阈值和声发射测试的比较未显示任何统计学意义的差异（p>0.05）。