Doğan Ersoy, Közen Melih Arif, Mungan Durankaya Serpil, Kenar Gökçe, Birlik Ahmet Merih
Department of Otorhinolaryngology, Dokuz Eylul University School of Medicine, 35320, Balcova-Izmir, Turkey.
Department of Audiometry, Vocational School of Health Services, Dokuz Eylül University, İzmir, Turkey.
Eur Arch Otorhinolaryngol. 2023 May;280(5):2273-2281. doi: 10.1007/s00405-022-07750-8. Epub 2022 Nov 16.
The aim of this study was to evaluate the middle and inner ear function and hearing status of Ankylosing spondylitis (AS) patients.
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.
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 PTA, PTA, and PTA 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 PTA (p < 0.05). The duration and severity of disease did not affect absorbance values of WBT (p > 0.05).
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.
本研究旨在评估强直性脊柱炎(AS)患者的中耳和内耳功能及听力状况。
本研究纳入了62例AS患者的124只耳以及45名健康受试者的90只耳(对照组)。采用纯音和高频听力测定法在250至16000Hz的倍频程频率下评估参与者的听力水平。通过宽带鼓室图(WBT)测试测量中耳的吸收率和共振频率。根据疾病活动度、随访时间、用于AS的药物将AS组分为亚组,并根据听力状况以及中耳的吸收率和共振频率对亚组进行比较。
在250、500、1000、2000和4000Hz频率的气导和骨导阈值以及平均PTA、PTA和PTA值方面,AS组和对照组之间存在统计学显著差异(p<0.05)。相比之下,两组在高频阈值(8000 - 16000Hz)方面未观察到统计学显著差异。尽管AS组通过WBT测试获得的中耳共振频率高于对照组,但未观察到显著差异(p>0.05)。疾病严重程度对250Hz和气导500Hz、骨导阈值500Hz以及PTA的听力阈值有不利影响(p<0.05)。疾病的持续时间和严重程度不影响WBT的吸收率值(p>0.05)。
据我们所知,这是第一项通过WBT证明AS患者对中耳功能的影响并报告AS患者中耳吸收率值和共振频率变化的研究。WBT在AS患者中发现的较高共振频率值可能是由于中耳受累导致的僵硬。根据纯音和高频听力测定结果,已发现AS尤其在低频导致感音神经性听力损失。