Hearing toss in Sjogren's syndrome patients. A comparative study

Objective In an attempt to investigate the presence of hearing loss in primary Sjogre n's syndrome (SS) patients and to determine the factors that might be invol ved in its pathogenesis, we prospectively evaluated 45 female SS patients w ith a mean age of 56.8 +/- 9.23 years and a mean disease duration of 8.32 /- 5.39 years. Methods Forty patients underwent a complete ear-nose-throat physical examination an d audiological evaluation with: (a) pure tone audiometry thresholds at octa ve frequencies of 250 to 8000 Hz; (b) impedance audiometry (tympanogram, st atic compliance, acoustic reflexes, reflex decay; and (c) speech audiometry and auditory brainstem response where indicated. In addition, glandular an d extraglandular manifestations of the disease and drug therapy were record ed Finally, all patients were tested for the presence of autoantibodies, in cluding: rheumatoid factor; antinuclear antibodies, antibodies to Bo(SSA), La(SSB) nuclear antigens, anticardiolipin antibodies and antineutrophil cyt oplasmatic antibodies. The results were compared with those of 40 healthy, age-matched women. Results We found sensorineural hearing loss (SNHL) in 9 patients (22.5%): 4 patient s bilaterally, 4 patients in the left ear only and one in the right ear onl y. In all cases the site of the ear damage was cochlear A correlation betwe en SNHL and the duration of the disease was found, while there was no corre lation with age, systemic manifestations of the disease or the presence of autoantibodies. In addition, no correlation was found between SNHL and drug therapy. Conclusion Approximately one-fourth of our SS patients presented SNHL of cochlear orig in affecting mainly the high frequencies. This prevalence was lower than th at reported by other investigators. SNHL was associated only with disease d uration. Further investigation is needed to attain a better understanding o f the mechanism of inner ear involvement in SS patients.