The Effect of Very Early Onset Inflammatory Bowel Disease on Hearing System in Infants and Children Aged of Birth to 6 Years Old

Background: Very early onset inflammatory bowel disease (VEO-IBD) is a severe form of inflammatory bowel disease (IBD) diagnosed in children under six years of age. It is associated with genetic mutations leading to primary immunodeficiencies. The incidence of VEO-IBD is increasing and is often linked to significant growth and developmental complications. Objectives: This study aims to investigate the relationship between VEO-IBD and subclinical hearing loss in young children. Identifying any significant associations could contribute to early diagnosis and management of hearing impairments in these patients. Methods: This case-control study was conducted on infants and children aged from birth to six years who were referred to Mofid Hospital in Tehran with a diagnosis of VEO-IBD. Based on previous studies, the sample size consisted of 25 patients with VEO-IBD, while the control group included 30 healthy children. Following an otoscopic examination, the condition of the middle ear was assessed using tympanometry and acoustic reflex testing. Subsequently, in a soundproof room, electrophysiological evaluations, including otoacoustic emissions (OAE) and auditory brainstem responses (ABR), were performed. Results: Statistical analysis was performed to evaluate the relationship between VEO-IBD and hearing function, considering factors such as disease duration, type, and site of involvement. Subgroup analysis revealed no significant differences in hearing function based on disease phase (acute, chronic, or long-term), type [Crohn’s disease (CD) vs. ulcerative colitis (UC)], or gastrointestinal involvement (colon vs. ileum). Independent t-tests were conducted to compare hearing function between the VEO-IBD and control groups. No significant differences were observed in distortion product otoacoustic emissions (DPOAE) or ABR between the two groups (P ≥ 0.01). These findings suggest no clear association between VEO-IBD and subclinical hearing loss in the studied cohort. Conclusions: There have been reports of sudden sensorineural hearing loss (SNHL) associated with autoimmune mechanisms involved in IBD. However, the present study found no evidence that VEO-IBD leads to hearing loss in affected children.