Endocrinology Clinics, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey.
Otorhinolaryngology & Head and Neck Surgery Clinics, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey.
ORL J Otorhinolaryngol Relat Spec. 2022;84(3):238-246. doi: 10.1159/000517931. Epub 2021 Aug 11.
Hearing loss may be associated with autoimmune diseases, but it was less studied in Hashimoto's thyroiditis (HT). We aimed to evaluate hearing impairment and audiological alterations in adults with euthyroid HT.
Adult patients with euthyroid HT (normal thyroid functions, positive antithyroid peroxidase (anti-TPO)/anti-thyroglobulin, and sonographic findings) were compared with controls. We excluded pregnant or older patients (>40 years), those with a history of otological/audiological disease or surgery, otitis media, acoustic trauma, chronic illnesses, use of alcohol, cigarette, medications, rheumatoid factor, antinuclear, antimitochondrial, antiparietal, antineutrophil cytoplasmic, anti-smooth muscle, or antigliadin antibodies, abnormal biochemical or otological findings. Tympanometry which indicates tympanic peak pressure (TPP, daPa), acoustic reflex testing (ART), pure-tone average (PTA), and transient evoked otoacoustic emission (TEOAE) were performed. We grouped the participants according to ART (positive/negative), TEOAE (normal/undetected), and PTA (≤20/>20 decibel).
Air conduction thresholds on the right ear at 500, 4,000, 6,000, and 8,000 Hz, PTA, and the left ear at 250, 4,000, 6,000, and 8,000 Hz were higher in euthyroid HT (n = 36) than in controls (n = 40) (p < 0.05). We found less negative TPP and a higher ratio of negative ART in euthyroid HT (p < 0.05). Euthyroid HT predicted undetected TEOAE and increased hearing threshold on the right ear at 500 and 8,000 Hz (p < 0.001). TEOAE detected audiological abnormality at a higher rate. Anti-TPO was positively correlated with TPP and air conduction thresholds, except the right ear at 8,000 Hz.
DISCUSSION/CONCLUSION: Hearing and audiological tests may be impaired in euthyroid HT. We recommend close monitoring of audiological functions in these patients. TE-OAE more specifically indicates audiological abnormality.
听力损失可能与自身免疫性疾病有关,但在桥本甲状腺炎(HT)中研究较少。我们旨在评估甲状腺功能正常的 HT 成人的听力障碍和听力改变。
将甲状腺功能正常的 HT 成年患者(甲状腺功能正常,抗甲状腺过氧化物酶(anti-TPO)/抗甲状腺球蛋白阳性,以及超声表现)与对照组进行比较。我们排除了妊娠或年龄较大的患者(>40 岁)、有耳部/听力疾病或手术史、中耳炎、听觉创伤、慢性疾病、酗酒、吸烟、用药史、类风湿因子、抗核抗体、抗线粒体抗体、抗壁细胞抗体、抗中性粒细胞胞质抗体、抗平滑肌抗体或抗麦胶蛋白抗体、生化或耳部异常的患者。进行鼓室压图(TPP,daPa)、听觉反射测试(ART)、纯音平均(PTA)和瞬态诱发耳声发射(TEOAE)。我们根据 ART(阳性/阴性)、TEOAE(正常/未检测到)和 PTA(≤20/>20 分贝)将参与者分组。
右耳 500、4000、6000 和 8000 Hz 的空气传导阈值、PTA 和左耳 250、4000、6000 和 8000 Hz 的空气传导阈值在甲状腺功能正常的 HT(n=36)中高于对照组(n=40)(p<0.05)。我们发现甲状腺功能正常的 HT 中负 TPP 较少,负 ART 比例较高(p<0.05)。甲状腺功能正常的 HT 预测右侧耳 500 和 8000 Hz 的 TEOAE 未检测到和听力阈值增加(p<0.001)。TEOAE 以更高的比例检测到听力异常。抗 TPO 与 TPP 和空气传导阈值呈正相关,除了右侧耳 8000 Hz 外。
讨论/结论:甲状腺功能正常的 HT 可能存在听力和听力测试受损。我们建议对这些患者密切监测听力功能。TE-OAE 更具体地表明听力异常。