[Relationships between ankylosing spondylitis and ear disease].

OBJECTIVE

To explore whether patients with ankylosing spondylitis (AS) have hearing loss and the pattern of hearing loss.

METHODS

Questionnaire, physical examination of the ear, nose and throat, hearing test and sero-immunity examinations were conducted in 34 patients (68 ears) with AS.

RESULTS

Among 34 patients, 11 cases reported decrease in the sound perception, and 24 cases (41 ears, 60.3%) had hearing loss as evidenced by the pure tone audiometry. In those patients with hearing loss, 2 ears with perforation of tympanic membrane showed conductive hearing loss and the remainder 39 ears showed sensorineural hearing loss in which 26 ears (66.7%) experienced high frequency hearing loss. Auditory brainstem responses were normally presented in 26 case, whereas abolished in 1 case (2 ears) with severe hearing loss. Examinations of sero-immunity showed a positive response in HLA-B27, but negative responses in the antinuclear antibody and rheumatoid factor. The percentage of the C-reactive protein increase was 81.8%. Autoantibodies anaginst the inner ear were positive in 9 cases (28.1%). In addition, all other immunological examinations revealed certain changes.

CONCLUSION

More than half of the patients with AS had sensorineural hearing loss, particularly in the high frequency range. This hearing loss is paralleled by abnormal immunology and is a local expression of systemic autoimmune disease. Therefore, periodical hearing tests are necessary for these patients.