Hearing Assessment among Sudanese Rheumatoid Arthritis Patients versus Non-Rheumatoid Arthritis Individuals

Background: Rheumatoid arthritis (RA) disease is one of the most common chronic autoimmune diseases that affect many body systems including the auditory system. Objectives: To assess hearing thresholds and to ascertain types of hearing loss among Sudanese rheumatoid arthritis patients attending rheumatology clinic in Omdurman military hospital and matching them with non-rheumatoid arthritis subjects. Methodology: This descriptive and analytic (comparative) hospital based cross sectional study conducted from October 2020 to April 2021 which include 66 RA patients with age range (21 - 60 years) matched with 41 non-rheumatoid arthritis group sharing same characteristics (nation, gender and age). Pure tone audiometry, tympanometry and acoustic reflexes were done for all RA patients and matched groups. Statistical analysis of the data was carried out using the association and correlation tests for associations and t-test for independent samples. Results: Thirty-six (54.5%) of RA patients had hearing impairment versus 9 (22%) non-RA in PTA test. Twenty-four RA cases (36.3%) showed asymmetrical hearing threshold and graph in PTA between right and left ears. Thirty-four (51.5%) right and 36 (54.5%) left ears were normal degree followed by 23 (34.8%) in the right and 24 (36.4%) in the left ears were mild degree hearing loss. Among hearing impaired RA patients;20 right ears (62.5%) and 19 left ears (65.5%) had sensorineural hearing loss (SNHL), conductive hearing loss 11 (34.4%) right ears and 9 (31%) left ears. Mixed HL was in 1 right ear (3.1%) and 1 left ear (3.5%). The most common degree of SNHL type was mild in (75%) and (78.9%) in right and left ears respectively, moderate and moderate severe were (20%) in the right and (15.7%) in the left ears. Fifty-eight right ears (87.9%) and 56 left ears (84.8%) had type A tympanogram while 7 (10.6%) right ears and 9 left ears (13.6%) were type As tympanogram, one right and one left ears had type Ad tympanogram. Acoustic reflex was impaired in 17 right ears and 17 left ears (25.8% for both). There were significant statistical differences in most of the specific frequency means between the study group and non-rheumatoid group in the right and left ears p-value 0.05). Also there was no significant statistical association between anti-rheumatic drugs used and hearing threshold of RA patients (p-value > 0.05). Conclusion: Hearing impairment especially sensorineural type is common in Sudanese rheumatoid arthritis patients. Conductive hearing loss is less common and most likely due to ossicles diarthrodial joint stiffness. No influence of the disease activity or used anti-rheumatic drugs on hearing threshold of the RA patients was detected in this study.

用AP-N_1(或ABR波I)潜伏期检测响度重振

本文对50例平坦型感音神经性聋病人用声反射阈以及AP-N_1潜伏期检查响度重振进行了分析,结果显示:声反射阈重振阳性率为76％,纯音听阈与声反射阈阳性率的关系为:随着听阈的增高声反射阈阳性率下降;耳蜗电图在高声强时AP-N_1潜伏期完全在正常范围的占56％,若以患耳与正常耳在同一阈上dB数比较,则100％小于正常耳,显示重振阳性。如果两指标结合检测,响度重振阳性率也明显提高。我们认为用AP-N_1潜伏期检测响度重振方法可行、理论依据充分,且用它检测响度重振的阳性率明显高于声反射阈。

Detection of Early Noise-Induced Hearing Impairment in Pilots

Objective To detect early signs of noise-induced hearing loss(NIHL) in military pilots without hearing complaints. Methods Pure tone audiometry and acoustic reflex thresholds were tested in 36 military pilots (72 ears) with noise exposure history but no complaints of hearing loss. Conventional test frequencies (0.25-8 kHz) and extended high frequencies (EHF, 10 and 12.5 kHz) were included in audiometry. White noise and pure tones at 0.5, 1, 2, and 4 kHz were used for acoustic reflex tests. Twenty normal hearing subjects(40 ears) with no exposure to occupational noise were used as controls. Results Pure tone thresholds at all conventional frequencies and at EHFs were elevated in the pilots, with the maximum shift at 4 kHz, compared with controls (p < 0.01). The pilots also showed elevated ART to white noise and decreased differentials between white noise and pure tone ARTs (p< 0.01). Conclusion Early signs of NIHL are present in some symptom-free military pilots. High frequency hearing threshold shift, elevated white noise ART and decreased differential between white noise and pure tone ARTs may be objective indicators of early NIHL.

Normative eSRT Value among MED-EL Pediatric Population in Indonesia

Introduction: Early stimulation of the auditory sense is essential for the development of language and speech. In children with a cochlear implant, the most common issue is whether the hearing has been optimized or not, as they are still unable to provide reliable feedback regarding their hearing ability. Thus, electrically evoked stapedius reflex threshold (ESRT) based fitting has been used as one of the available methods in programming a cochlear implant (CI) audio processor. As eSRT is an objective test, patient cooperation was not needed making it especially beneficial for children with CI who have limitations in providing feedback. Now that eSRT has been applied commonly almost worldwide, the goal of this study is to determine the normative value of eSRT among the pediatric population in Indonesia. Methods: A total of 32 pediatric CI users in the age range 3 - 11 years implanted with Med-El cochlear implant were included in this study. ESRT was performed during follow-up mapping between September 2021 and January 2022 in the Med-El Indonesia hearing center. Results: The result of the present study showed an average normative value of 20.55 qus. This finding is consistent with the values obtained in previous studies. Conclusion: The result found can be used as a valuable indicator of average optimised MCL among the pediatric population.