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Otorinolaringologia 1999 December;49(4):169-72


language: Italian

Audiometry and juvenile chronic arthritis

Stura M., Cordone A.*, Salami A.*, D’Agostino R., Porcu A.

Istituto G. Gaslini - Genova - Divisione ORL (Primario: Prof. G. Taborelli) Università degli Studi - Genova * Clinica ORL R (Direttore: Prof. A. Salami)


Background. Juvenile chronic arthritis is an inflammatory process involving synovial articulations also in children. Therefore, it is hypothesized that incudo-malleolar and incudo-stapedial articulations (which are of synovial type), may suffer from that disease.
Methods. 23 subjects have been examined (12 males and 11 females), aged between 4 and 13, affected by juvenile chronic rheumatoid arthritis and 16 healthy subjects of a control group (9 males and 7 females) aged between 4 and 12. The patients performed tonal audiometry, tympanometry and research of stapedial reflex in the earlier phase as possible for diagnosis and therapy (salycilates or FANS with or without immunosuppressor such as azatioprin 1-2 mg/kg/die or metotrexate 0.5 mg/kg/weekly) and then 18 months later.
Results. All the subjects (either pathological or healthy) showed a normal audiometry during the follow-up performed either in the early phase of the disease (1st control) or 18 months later (2nd control). Both ipsi and contralateral stapedial reflexes were normal with a range values between 75 and 95 dB. Tympanometry was of “A” type during the first control (compliance between 0.5 and 1.5 cm3) in the 16 healthy patients of the control group and in 16 subjects out of 23 (69.6%) children affected by arthritis. In the other 7 children (30.4%) tympanometry was of “As” type (compliance <0.5 cm3). During the second control, tympanometry was of “A” type in the 16 healthy subjects of the checking group and in 20 diseased children out of 23. In the other 3 cases (who belonged to the group of 7 subjects who showed “As” type tympanometry at the first control), the tympanometry was unchanged.
Conclusions. The results obtained show the considerable incidence (30.4%) of “As” type tympanometry during the early phase of therapy: this finding might show an arthritic involvement of synovial articulations of the chain, with possible stifness, decrement of compliance, and minor elasticity to the passing of acoustic vibrations. Therapy would head to some results, and this would confirm the assumption about what just mentioned. This disease, in such cases, however would not provoke an evident transmissive deafness.

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