A clinical study on association between hearing loss and inflammatory bowel disease in a population attending a hospital

Mymoona Akhter, Ayaz Rehman, Showkat Kadla, Sajad Hamid, Qazi Najeeb, Mohd Arif Makdoomi, Basharat Mughal


Background: Inflammatory bowel disease usually presents with gastrointestinal stigmata of weight loss, anaemia, and rectal bleeding, but may exhibit prominent extra-intestinal manifestations also such as joint symptoms, skin signs and some other auto-immune manifestations. During the last few years many authors have reported serious complications of IBD manifesting in the Ear-Nose-Throat (ENT) and influencing disease morbidity.

Methods: Twenty four patients with active ulcerative colitis (mean age 45 years) were recruited prospectively along with 24 healthy age- and sex-matched controls. Otoscopy, tympanometry and pure tone audiometry were performed. Otoscopy and tympanometry were normal in all patients and controls. Pure tone audiometry showed sensorineural hearing loss over all frequencies in patients with inflammatory bowel disease and compared with controls. The otologic data including age of onset, family history of otologic problems, exposure to noise and audiometric findings were also reviewed.

Results: Out of 48 patients with a history of IBD, 24 had documented SNHL, 17 of these patients had a diagnosis of ulcerative colitis and 7 had Crohn’s disease. 22 patients had bilateral SNHL, and 2 patients had unilateral SNHL. Tinnitis were the most common associated aural complaint.

Conclusion: Sensorineural hearing loss is very unusual finding, possibly of auto-immune aetiology. We recommend steroid or immunosuppressive therapy in such a patient. Evidence for an autoimmune basis for this condition is reviewed and the potential benefit of systemic corticosteroids emphasized.



Inflammatory bowel disease, Ear-nose-throat, Sensorineural hearing loss, Extraintestinal manifestations

Full Text:



McCabe B. Autoimmune hearing loss. Ann Otol Rhinol Laryngol. 1979;88:585.

Summers RW, Harker L. Ulcerative colitis and Sensorineural hearing loss.Is there a relationship? J Clin Gastroenterol. 1982;4:251.

Weber RS, Jenkins HA, Coker NJ. Sensorineural hearing loss associated with ulcerative colitis. Arch Otolaryngol. 1984;110:810-2.

Hollanders D. Sensorineural deafness-a new complication of ulcerative colitis. Postgrad Med J. 1986;62:753-5.

Herdman RC, Hirani M, Ramsden RT. Autoimmune inner ear disease and ulcerative colitis. J Laryngol Otol. 1991;105(4):330-1.

Kumar BN, Walsh RM, Wilson OS, Carlin WV. Sensorineural hearing loss and ulcerative colitis. J Laryngol Otol. 1997;111(3):277-8.

Renato P, Raul VRZ, Priscilla BR. Autoimmune hearing loss and ulcerative colitis. Rev Bras Otorhinolaryngol. 2006;72(4):572.

Garcia Callejo FJ, P. Laporta Marin P, Velert Vila MM, Orts Alborch MH, de Paula Vernetta C, Marco Algarra J. Hearing loss associated to ulcerative colitis. Acta Otorhinolaryngol Esp. 2005;56:68-73.

Kanzaki J, Ouchi T. Steroid-responsive bilateral sensorineural hearing loss and immune complexes. Arch Otorhinolaryngol. 1981;230:5-9.

Veldman JE, Roord JJ, O’ Connor AF, Shea JJ. Autoimmunity and inner ear disorders; an immune complex mediated sensorineural hearing loss. Laryngoscope. 1984;94:501-7.

Roitt I, Brostoff J, Male D. Immune reaction. In: Roitt I, Brostoff J, Male D, eds. Immunology. 2nd ed. New York: Gower Medical Publishing; 1989.

McCabe BF. Autoimmune sensorineural hearing loss. Ann Oto Rhinol Laryngol. 1979 Sep-Oct;88(5 Pt 1):585-9.

Hughes GB, Barna BP, Kinney SE, Calabrese LH, Nalepa NJ. Clinical diagnosis of immune inner ear disease. Laryngoscope. 1988;98:251-3.

Veldman JE. Immunology of hearing. Experiments of nature. Am J Otol. 1989;10:183-7.

Orchard TR, Jewel DP. Extraintestinal manifestations: skin, joints and mucocutaneous manifestations. In: Sartor RB, Sandborn WJ eds. Kirsner’s In-flammatory Bowel Disease. 6th ed. Philadelphia: Saunders; 2004: 658-672.

Kuczkowski J, Kozlowski J, Narozny W. Acute autoimmune sensorineural hearing loss in pregnant women with Lesniowski-Crohn disease. Otolaryngol Pol. 2006;60:583-5.

Akbayir N, Calis AB, Alkim C, Sokmen HM, Erdem L, Oz-bal A, et al. Sensorineural hearing loss in patients with inflammatory bowel disease: a subclinical extraintestinal manifestation. Dig Dis Sci. 2005;50:1938-41.

Kumar BN, Walsh RM, Wilson PS, Carlin WV. Sensori-neural hearing loss and ulcerative colitis. J Laryngol Otol. 1997;111:277-8.

Welling DB. Clinical evaluation and treatment of immune-mediated inner ear disease. Ear Nose Throat J. 1996;75:301-5.

Mathews J, Rao S, Kumar BN. Autoimmune sensorineural hearing loss: is it still a clinical diagnosis? J Laryngol Otol. 2003;117:212-4.

Bernstein JM. The immunology of autoimmune disease of the inner ear. In: Bernstein JM, Orga PL, eds. Immunology of the Ear. 1st ed. New York: Raven Press; 1987: 419-426.

Wakefield AJ, Sawyerr AM, Dhillon AP, Pittilo RM, Rowles PM, Lewis AA, et al. Pathogenesis of Chron’s disease: multifocal gastrointestinal infarction. Lancet. 1989;2:1057-62.

Staecker H, Lefebvre PP. Autoimmune sensorineural hearing loss improved by tumor necrosis factor-aplha blockade: a case report. Acta Otolaryngol. 2002;122:684-7.

Buge A, Chamouard JM, Michon C, Schadeck B, Baglin G, Vincent D, et al. Cogan’s syndrome: apropos of a case. Association with Crohn’s disease. Ann Med Interne (Paris). 1986;137:75-6.

Ilnyckyj A, Aldor TA, Warrington R, Bernstein CN. Crohn’s disease and the Melkersson-Rosenthal syndrome. Can J Gastroentrol. 1999;13:152-4.

McCallum DI, Gray WM. Metastatic Crohn’s disease. Br J Dermatol. 1976;95:551-4.

Pace-Balzan A, Timms MS. Intranasal squamous cell carcinoma in a renal transplant recipient on long term immunosuppression. Postgrad Med J. 1987;63:989-91.