Functions of the inner ear in psoriatic arthritis (2022)

Table of Contents
Auris Nasus Larynx Abstract Objective Methods Results Conclusion Introduction Section snippets Material and methods Results Discussion Conclusion Conflict of interest Funding References (37) Hear Res Psoriatic Arthritis Current concept on pathogenesis oriented therapeutic options Arthritis Rheum Psoriatic arthritis update Bull NYU Hosp Joint Dis Sensorineural hearing loss in rheumatoid arthritis Clin Exp Rheumatol Audiovestibular manifestations in patients with ankylosing spondylitis Medicine (Baltimore) Sensorineural hearing disorders in systemic lupus erythematosus. A controlled study Clin Exp Rheumatol Hearing loss in the Sjogren syndrome Ann Intern Med Cochleovestibular dysfunction in ankylosing spondylitis Audiol Neurootol Juvenile psoriatic arthritis and acquired sensorineural hearing loss in a teenager: is there an association? Clin Exp Rheumatol Sensorineural hearing loss associated with psoriatic arthritis J Laryngol Otol Investigations into audiovestibular manifestations in patients with psoriatic arthritis J Rheumatol Evaluation of hearing and outer hair cell function of cochlea in patients with psoriatic arthritis Clin Exp Otorhinolaryngol Extended high-frequency (9–20kHz) audiometry reference thresholds in 645 healthy subjects Int J Audiol Reference hearing thresholds in an extended frequency range as a function of age J Acoust Soc Am High-frequency sensorineural hearing loss in patients with ankylosing spondylitis: is it an extrarticuler feature of disease? Rheumatol Int Hearing risk among young personal listening device users: effects at high-frequency and extended high-frequency audiogram thresholds J Int Adv Otol Concurrent effect of noise exposure and smoking on extended high-frequency pure-tone thresholds Int J Audiol Autoimmune sensorineural hearing loss: the otology–rheumatology interface Rheumatology (Oxford) Cited by (2) Serum sclerostın levels ın chronıc otıtıs medıa wıth and wıthout cholesteatoma Evaluation of audiovestibular system in psoriasis patients without joint involvement Recommended articles (6) FAQs Videos
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Auris Nasus Larynx

Volume 43, Issue 6,

December 2016

, Pages 626-631

Abstract

Objective

This study aimed to investigate whether there is a negative impact as a result of psoriatic arthritis disease of the inner ear function.

Methods

Twenty-four successive patients and 38 healthy volunteers, younger than 60 years of age, who were followed up for at least for one year in the outpatient clinics of physical therapy and rehabilitation with the diagnosis of PsA according to CASPAR criteria (17) and who did not complain of any hearing impairment were included in the study. Distortion-product otoacoustic emission (DPOAE) values between 1kHz and 4kHz, tympanometric examination results, stapes reflex values, speech reception threshold (SRT) and speech discrimination (SD) values, pure-tone values between 250 and 8000Hz and high-frequency values between 10,000, 12,500 and 16,000Hz were analyzed. Statistical comparisons between both groups were performed using chi-square test and Mann–Whitney U test. p<0.05 was accepted as the level of statistical significance.

(Video) Psoriatic Arthritis

Results

Our study population consisted of 24 [9 male (37.5%) and 15 female (62.5%)] patients with a mean age of 47.21±11.28 (range, 28–59) years and 38 [16 male (42.1%) and 22 female (57.9%)] healthy volunteers with a mean age of 44.39±8.12 (range, 29–59) years as the control group. Mean duration of arthritis was 7.62±4.88 years. In the evaluation of hearing frequencies of the patients between 4000 and 6000Hz, a statistically significant difference was found relative to the control group (p<005). DPOAE values of the patients were analyzed within the 1000–4000Hz interval. When compared with the control group, a statistically significant difference was found at 3000 and 4000Hz (p<005).

Conclusion

Our study provides strong evidence suggesting the necessity of monitorization of these patients regarding sensorineural hearing loss so as to take measures against the development of hearing loss during early stage, which may be another disability in patients with PsA, which is itself a potential cause of severe disability.

Introduction

Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy of peripheral joints, spine and enthesis organs. It is encountered in nearly 30% of the patients diagnosed with psoriasis. It is characterized by various subtypes and variable clinical course and results usually by a chronic and progressive process. The disease leads to loss of function and independence and reduction in quality of life [1], [2]. Sensorineural hearing losses (SNHLs) can be seen in various rheumatic diseases, mainly rheumatoid arthritis [3]. Psoriatic arthritis, as is the case with ankylosing spondylitis (AS), is in the group of spondyloarthropathies, which affect functions of the inner ear [4].

In patients in the spondyloarthropathy group, underlying vasculitis and autoimmune mechanisms may cause audiovestibular symptoms [5], [6]. Limited number of studies have been performed on cochleovestibular dysfunction in patients with spondyloarthropathy. A few studies have been performed with AS patients [4], [7].

As far as we know, in previously presented two case reports and two studies, presence of SNHL was demonstrated in patients with PsA [8], [9], [10], [11]. In these studies, despite conclusions asserting that involvement of the inner ear is more frequent in high-frequency hearing thresholds, hearing thresholds over 8000Hz have not been evaluated. Knowledge about high-frequency hearing values of the patients, who do not describe clinical symptoms of hearing loss, can help to detect the presence of early hearing loss and measures against hearing loss can be taken. Extended high frequencies refer to sounds beyond 8000Hz and extended high-frequency audiometry (EHFA) has proved to be a promising tool for the early detection of hearing disorders. EHFA are regularly used for ototoxic monitoring and extended high frequencies are useful for assessing hearing loss of different etiologies, such as aging, occupational noise, renal failure, sequels of otitis media, and evaluation of hearing disorder among the relatives of patients with hearing loss of genetic origin [12], [13]. Valiente et al. evaluated 645 subjects without significant otologic history at extended high frequencies (9–20kHz) and reported that it would be possible to establish international standard thresholds for extended high frequencies [12]. Adam et al. also investigated the ear involvement, especially at conventional and extended higher frequencies, and they found SNHL only at extended higher frequencies in patients with AS [14]. Further, there are a lot of studies in literature about extended high frequencies [15], [16].

Therefore, we evaluated the ear involvement at conventional and extended high frequencies.

The aim of this study was to investigate ear involvement in patients with PsA. We compared distortion-product otoacoustic emission (DPOAE) values as a measure of acoustic distortion, audiogram values between 125 and 16,000Hz frequencies, tympanometric examination results, stapes reflex, speech reception threshold (SRT) and speech discrimination (SD) values between the patient and the control groups. Since ear involvement in autoimmune diseases and spondiloarthritis usually presents with unilateral, bilateral, or asymmetrical but bilateral involvement in the majority of cases [10], [17], we analyzed right and left ears separately in the patient and control groups.

Section snippets

Material and methods

Twenty-four successive patients younger than 60 years of age, who were followed up for at least for one year in the outpatient clinics of physical therapy and rehabilitation with the diagnosis of PsA according to CASPAR criteria [18] and who did not complain of any hearing impairment and 38 healthy volunteers were included in the study. Our study was approved by the Local Ethics Committee and undersigned informed consent forms were obtained from the patients and their parents.

Patients with a

Results

Our study population consisted of 24 [9 male (37.5%) and 15 female (62.5%)] patients with a mean age of 47.21±11.28 (range, 28–59) years and 38 [16 male (42.1%) and 22 female (57.9%)] healthy volunteers with a mean age of 44.39±8.12 (range, 29–59) years as the control group. Mean duration of arthritis was 7.62±4.88 years. Bilateral SNHL was found in 3 of the 24 patients in PsA group. It was no asymmetrical and it was symmetrical in 3 patients.

In the evaluation of hearing frequencies of the

Discussion

Psoriatic arthritis is a form of inflammatory arthritis related to psoriasis with rheumatoid factor negativity [13]. Prevalence of PsA changes between 0.04 and 0.1% [1], [2] PsA belongs to the group of spondyloarthritis, which also includes reactive arthritis and AS [19]. Although the etiopathogenesis of PsA is not known exactly, presumptive pathogenic role of genetic, immunologic and environmental factors has been contemplated [19]. T cells and proinflammatory cytokines play a role in the

Conclusion

In conclusion, significant differences in the pure-tone audiogram values at 4000Hz and 6000Hz and DPOAE values at 3000Hz and 4000Hz detected in patients with PsA demonstrate involvement of the functions of the inner ear. Our study provides strong evidence suggesting the necessity of monitorization of these patients regarding sensorineural hearing loss so as to take measures against the development of hearing loss during early stage, which may be another disability in patients with PsA, which is

Conflict of interest

The authors declare no competing interest.

Funding

No financial support was received for this paper.

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    (Video) Psoriatic Arthritis Signs and Symptoms | Johns Hopkins Medicine

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    FAQs

    How does psoriatic arthritis affect the ears? ›

    The disease process of psoriatic arthritis may cause inner ear damage that may harm patients' ability to maintain balance and normal hearing. Because psoriatic arthritis is often difficult to distinguish from rheumatoid arthritis, vestibular symptoms may be 1 way to aid in distinguishing these 2 separate conditions.

    How does arthritis affect the ears? ›

    Rheumatoid arthritis inflammation may damage the tiny joints in the ear. A rheumatoid nodule can develop inside the ear. Drugs that reduce RA symptoms, including aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs)2 and hydroxychloroquine3, may occasionally bring on tinnitus and/or hearing loss.

    Can psoriatic arthritis cause ringing in the ears? ›

    Tinnitus And Its Connection to Psoriatic Arthritis. There is growing evidence that people with psoriatic arthritis (PsA) may be at risk for hearing problems. In fact, research shows that people living with PsA are more likely to have hearing loss than people who either do not have this condition or who have psoriasis.

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    Can psoriasis affect your inner ear? ›

    Psoriasis is a painful, chronic skin condition that can flare up inside and around the ear. When it does this, it is more difficult to treat than psoriasis elsewhere on the body. The condition can also lead to temporary and permanent hearing loss.

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    Protecting hearing in psoriatic arthritis

    It's likely immune-related inflammation damages the inner ear in people with psoriatic arthritis. This damage can lead to hearing loss and balance problems. So, controlling inflammation may go a long way in protecting your hearing if you have psoriatic arthritis.

    Can arthritis affect the bones in the ear? ›

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    Does inflammation in the ear cause ringing? ›

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    Connecting the inner ear

    Studies have shown that people living with a psoriatic disease can suffer from damage to their inner ears. For some, this damage can appear as hearing loss. However, it can also cause other issues including dizziness and vertigo.

    Is Vertigo a symptom of psoriatic arthritis? ›

    Psoriatic arthritis (PsA) is inflammatory arthritis often associated with a skin condition called psoriasis. One PsA symptom is joint pain. It can also cause whole-body (systemic) symptoms such as vertigo and dizziness.

    When should I be concerned about ringing in my ears? ›

    You've experienced ringing in the ears for more than a week

    Perhaps you have water in your ear from last night's pool party or a buildup of wax. However, if you've experienced a constant ringing, static or buzzing sound for at least a week, you should contact a doctor to see if there is an underlying condition.

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    Calcipotriol (Dovonex) or a combination of betamethasone and calcipotriene (Taclonex) is often used on the ear. These medications work by slowing skin growth and flattening existing lesions. They also provide pain and itch relief.

    Does vitamin D cream help psoriasis? ›

    Topical oils and ointments for psoriasis containing vitamin D can also help treat flares. Vitamin D can slow the growth of new cells, so vitamin D oil applied directly to the flare can help thin the plaque.

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    Itchy ears can sometimes be a sign of an ear infection. Bacteria and viruses cause them, usually when you have a cold, the flu, or allergies. One kind, swimmer's ear, can happen when water stays in your ear after you swim. Too much moisture wears away your ear canal's natural layer of defense against germs.

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    Earwax blockages, infections and psoriasis can all cause pain in your ears. Many of us have suffered from occasional ringing in the ears or, perhaps, noticed extra wax buildup or itchiness in our ear canal.

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    Psoriasis occurs when skin cells are replaced more quickly than usual. It's not known exactly why this happens, but research suggests it's caused by a problem with the immune system. Your body produces new skin cells in the deepest layer of skin.

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    Psoriasis and PsA are associated with an increased risk of neurological conditions such as stroke, Parkinson's disease, schizophrenia, and migraine.

    Can psoriasis in the ear cause vertigo? ›

    Connecting the inner ear

    Studies have shown that people living with a psoriatic disease can suffer from damage to their inner ears. For some, this damage can appear as hearing loss. However, it can also cause other issues including dizziness and vertigo.

    Is Vertigo a symptom of psoriatic arthritis? ›

    Psoriatic arthritis (PsA) is inflammatory arthritis often associated with a skin condition called psoriasis. One PsA symptom is joint pain. It can also cause whole-body (systemic) symptoms such as vertigo and dizziness.

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    What organs does psoriatic arthritis affect? ›

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