Assessment of Vestibular System in Patients with Rheumatoid Arthritis (RA) Using Electronystagmography (ENG)

Background: Although sensorineural hearing loss has been widely investigated in those with rheumatoid arthritis, studies assessing the vestibular system in patients with rheumatoid arthritis are limited. The Aim of this Study: To evaluate the vestibulocochlear system in patients with rheumatoid arthritis and to study whether there is a correlation between hearing levels, ENG test results and markers of disease activity. Material and Methods: The study group consisted of 45 patients with RA (38 females, 7 males with mean age 47.52± 10.60yrs.) and 30 healthy volunteers as a control group (26 women and 4 men with mean age 44.65+6.03yrs.). The following procedures were carried out: Otoscopic examination, pure tone audiometry, acoustic immitance tests and vestibular evaluation through the electronystagmography (ENG) to all study and control groups. Results: A significant difference was found between the two groups with regard to pure-tone averages at mid and high frequencies in each ear, ENG revealed abnormalities in 21 patients (47.7%), 6 of which were central (13%), 6 of which were peripheral (13%) while mixed abnormalities were present in 9 (20%). These results demonstrated that there was an association between RA and cochleovestibular dysfunction. No correlation was found between cochleovestibular dysfunction and age, sex, disease duration and activity. Conclusion: RA appears to be associated with senserionural hearing loss (SNHL) and vestibular pathologies therefore; neurotologic evaluation should be performed at the time of diagnosis of RA. In instance of a positive history of hearing loss and/or vertigo, audiovestibular tests can be applied and any cochleovestibular dysfunction should be monitored.