Assessment of the Hearing Threshold and Pattern of Tympanograms of Sickle Cell Disease Patients in Calabar, Nigeria.

Abstract

Background: Sickle cell disease patients often have high level of hearing threshold due to their susceptibility to pneumococcal infections, otitis media, and vaso-occlusive injury to the cochlea.

Aims: This study aimed to determine the associations between the hemoglobin variants and hearing thresholds, hearing loss (HL), and tympanometry distributions in patients with sickle cell disease (SCD).

Methods: This hospital-based study was conducted between September 2019 and September 2021. We recruited 110 confirmed SS and SC patients from adult and pediatric sickle cell clinics, Calabar sickle cell clubs, and 110 healthy controls (AA and AS). Structured questionnaires were used to interview the study population, and all of them underwent ear, nose, and throat examinations, tympanometry, and pure tone audiometry for those aged >5 years after obtaining informed consent and medical ethics committee approval. Data were analyzed using international business machine (IBM) corporation statistical product and service solution (SPSS) version 25 software. Descriptive analysis was performed using tables, graphs, and charts, whereas inferential statistics were obtained using the Chi-square test of independence or Fisher's exact test, t-test, or analysis of variance (ANOVA). Statistical significance was set at P value < 0.05.

Results: The median ages of the SCD patients and their controls were 18 and 23 years, respectively. SCD patients have higher hearing thresholds, with 8.9% conductive loss, 4.5% unilateral mild mixed hearing loss, and 3.3% sensorineural hearing loss (SNHL) (2.0% among the controls; P value of 0.669), and more commonly in the right ear. The overall HL prevalence was 16.7% SCD patients and 8.0% controls (double; P value of 0.067). SNHL is mostly mild and unilateral in nature and affects only adults. Type B tympanogram was only reported in children with SCD.

Conclusion: HbSS was the most prevalent genotype, with greater (double) HL than controls, affecting the right ear of males. HL patterns included mild conductive HL, mixed HL, and SNHL. SCD could be a risk factor for OME.