The involvement of ear and throat in rheumatoid arthritis I. Hearing in patients with rheumatoid arthritis

Since Copeman's report on patients with hearing impairment as "rheumatoid otoarthritis?" has introduced, there have been a few reports on hearing impairment in patients with rheumatoid arthritis such as Goodwill et al. and Djupesland et aI. in European countries. On the contrary in our country there is no reference in association with hearing impairment of rheumatoid arthritis in rheumatic or otological literatures. An audiometric survey was carried out in 76 patients admitted in the Misasa branch hospital of Okayama university school of medicine on the classical or definite rheumatoid arthritis. Patients were excluded from the series if they had scarred or perforated tympanic membrane and history of otorrhea. Thus 67 patients have come to study. As control group, 15 healthy persons in hearing for each ten years, 15-24, 25-34, 35-44, 45-54, 55-64, and over 60 years, were selected and as a physiological hearing limit, rejection limit of hearingloss in dB. was made. Among 67 patients, 111 ears had hearingloss within the above mentioned rejection limit. In 23 ears, hearingloss in dB. were partial or as a whole out of the limit. They have all air-bone-conduction gap. After inflation of Eustachien tube, in most of them air conduction ability showed nearly the same level of bone conduction. In three cases even by inflation, airconduction level did not move. In one case the left side had effusion liquid and its RAreaction was positive. TwO of the former patients and the one whose effusion liquid had positive RA-test followed up for about 3 years. In the former two cases, hearing impairment got worse little by little and recovery by inflation was not seen. On both cases Gelle's test was positive. In the latter hearing impairment slowly got worse. This had lasted for about two months and had recoverd. In the se four cases heairng impairment was probably related to the rheumatoid arthritis and no other causes could be found