Usama Kamel MD, FRCSEd(Otol.), PGCPCE, MBBCh

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Hearing Loss in Sjögren’s syndrome: A cohort matched prospective observational study Usama Kamel MD, FRCSEd(Otol.), PGCPCE, MBBCh ENT Dept, Queen’s Medical Centre, Nottingham University Hospitals Nottingham England, UK 8 June 2015 3rd Congress of European Otolaryngology HNS, Prague

3rd Congress of European Otolaryngology HNS, Prague Sjögren’s syndrome SS is a multisystem autoimmune disease characterised by chronic inflammation of the exocrine glands ♀ : ♂ 9 : 1 0.6% – 2.1% It is the second most common autoimmune rheumatic disease after RA (Thomas et al 1998) American-European Consensus Sjögren’s Classification Criteria for SS has established a clearer diagnostic framework (Vitali et al 2002) 8 June 2015 3rd Congress of European Otolaryngology HNS, Prague

3rd Congress of European Otolaryngology HNS, Prague Previous studies Deafness: Yes: 16 – 46% HFSNHL, Cochlear No: Trott et al. 1996 (n=14), no controls Freeman et al. 2005 (n=137) retrospective Tumiati et al. 1997 (46%) n=30 (unclear SS Dx criteria) Ziavara et al. 2000 (22.5%) n=40 Boki et al. 2001(16%) n=48 Hatzopoulos et al. 2002 (36%) n=22, no controls Doig et al. 1971 (1:21SSp, 7:31SSs), no controls 8 June 2015 3rd Congress of European Otolaryngology HNS, Prague

3rd Congress of European Otolaryngology HNS, Prague Methods A cohort matched, prospective, cross sectional observational study. Ethical approval was granted. Patient and control subjects gave informed consent. 28 SS patients (F=25:M=3), mean age 59 years old (range 36–83) according to the American European Criteria for SS diagnosis . 34 controls (F=32:M=2) with mean age 56 years old (range 35–78) This study was part of a larger project 8 June 2015 3rd Congress of European Otolaryngology HNS, Prague

3rd Congress of European Otolaryngology HNS, Prague Pure Tone Audiometry PTA was performed@ 0.25, 0.5, 1, 2, 3,4, 6& 8 KHz. hearing threshold means for both groups were calculated at the above frequencies. SPSS statistical package was used to analyse data. 8 June 2015 3rd Congress of European Otolaryngology HNS, Prague

3rd Congress of European Otolaryngology HNS, Prague Results Hearing acuity is highly correlated with age (Pearson 0.707 p<0.001 (L), 0.684 p<0.001 (R). L & R ear results are very highly correlated (Pearson 0.948 p<0.001). Statistically, there were no significant differences between cases and controls for hearing loss. 8 June 2015 3rd Congress of European Otolaryngology HNS, Prague

3rd Congress of European Otolaryngology HNS, Prague Right ear SS group Control group 8 June 2015 3rd Congress of European Otolaryngology HNS, Prague

3rd Congress of European Otolaryngology HNS, Prague Left ear SS group Control group 8 June 2015 3rd Congress of European Otolaryngology HNS, Prague

3rd Congress of European Otolaryngology HNS, Prague 8 June 2015 3rd Congress of European Otolaryngology HNS, Prague

3rd Congress of European Otolaryngology HNS, Prague Discussion This controlled study is the third in literature about deafness in SS – Dx Freeman et al. 2005 (n=137) retrospective 8 June 2015 3rd Congress of European Otolaryngology HNS, Prague

3rd Congress of European Otolaryngology HNS, Prague Strength of the study ENT examination, other senses and QoL in SS were studied N=28 SS and 34 controls 8 June 2015 3rd Congress of European Otolaryngology HNS, Prague

3rd Congress of European Otolaryngology HNS, Prague Weakness of the study More patients More audio-vestibular assessment 8 June 2015 3rd Congress of European Otolaryngology HNS, Prague

3rd Congress of European Otolaryngology HNS, Prague Conclusion SS does not appear to be associated with SNHL. 8 June 2015 3rd Congress of European Otolaryngology HNS, Prague

3rd Congress of European Otolaryngology HNS, Prague Acknowledgements Co workers: Prof Peter Maddison, Consultant Rheumatologist Rhiannon Whitaker, Statistician, Bangor R & D dept for supporting this project Audiology Dept, YG Outpatient clinic staff nurses, YG Declaration: Grant of £4990 from North Wales Research & Development Department to conduct this study as part of a larger project 8 June 2015 3rd Congress of European Otolaryngology HNS, Prague

3rd Congress of European Otolaryngology HNS, Prague Thank you 8 June 2015 3rd Congress of European Otolaryngology HNS, Prague