Assessment of hearing impairment in adult patients with euthyroid Hashimoto’s thyroiditis

Topaloğlu Ömercan; BayramŞahin

doi:10.1530/endoabs.73.AEP643

Introduction

Hearing loss may be associated with autoimmune diseases, but it was less studied in Hashimoto’s thyroiditis (HT). We aimed to evaluate hearing impairment by audiometric assessments in adults with euthyroid HT.

Materials and Methods

Adult patients with euthyroid HT (normal thyroid functions, positive AntiTPO/AntiTg and sonographic findings) were compared with controls. We excluded pregnant or older patients (>50-year-old), those with history of otological/audiological disease or surgery, otitis media, acoustic trauma, chronic illnesses, use of alcohol, cigarette, medications, rheumatoid factor, antinuclear, antimitochondrial, antiparietal, antineutrophil cytoplasmic, anti-smooth muscle, or antigliadin antibodies, abnormal biochemical or otological findings. Tympanometry which indicated tympanic peak pressure (TPP, daPa), acoustic reflex testing (ART), pure tone average (PTA), and transient evoked otoacoustic emission (TEOAE) were performed. We grouped the participants according to ART (positive/negative), TEOAE (normal/undetected), PTA (≤20/>20 dB).

Results

Air conduction thresholds on right ear at 500, 4000, 6000, 8000 Hz, PTA average, and left ear at 250, 4000, 6000, 8000 Hz were higher in euthyroid HT (n = 36) than in controls (n = 40) (P<0.05). We found less negative TPP and a higher ratio of negative ART in euthyroid HT (P<0.05). Euthyroid HT predicted undetected TEOAE and increased hearing threshold on right ear at 500 and 8000 Hz (P<0.001). TEOAE detected hearing impairment at a higher rate. AntiTPO level was positively correlated with TPP and air conduction thresholds except right ear at 8000 Hz.

**Table 1.** Logistic regression analysis showing the association between categorical parameters and HT.
Parameters	Univariate		Multivariate
Parameters	OR(95% CI)	P value	OR(95% CI)	P value
fT4(normal-high/ normal-low)	8.000(2.832–22.72)	<0.001	11.20(3.10–40.35)	<0.001
ART L ipsilateral(positive/negative)	2.250(1.738–2.913)	0.046
ART L contralateral(positive/negative)	2.250(1.738–2.913)	0.046
TEOAE(normal/ undetected)	2.666(1.941–3.663)	<0.001	NA	<0.001
Hearing threshold (≥20/>20 dB)
R PTA average	2.252(1.739–2.915)	0.030
R air 500 Hz	2.252(1.739–2.915)	0.030	NA	<0.001
R air 4000 Hz	2.288(1.757–2.985)	0.015
R air 6000 Hz	2.427(1.828–3.225)	0.002
R air 8000 Hz	2.597(1.912–3.533)	<0.001	NA	<0.001
L air 250 Hz	2.252(1.739–2.915)	0.030
L air 4000 Hz	2.252(1.739–2.915)	0.030
L air 6000 Hz	2.380(1.805–3.134)	0.003
L air 8000 Hz	2.427(1.828–3.225)	0.002
R:right L:left

Conclusions

Hearing may be impaired in euthyroid HT. We recommend close monitoring of hearing functions in these patients. TEOAE more specifically indicates hearing impairment.

Endocrine Abstracts

AEP643