Some people with rheumatoid arthritis (RA) complain of hearing loss, a full feeling in their ears or fluid in their ear. Although hearing loss is not a common symptom of RA, it can be chronic for those who have RA. Studies seem to disagree about what causes the hearing loss and whether it is really related to RA.
There may be several reasons for the hearing loss. First, patients taking NSAIDS (non-steroidal anti-inflammatory drugs), as well as the DMARD (disease-modifying anti-rheumatic drug) Plaquenil can develop symptoms of tinnitus and decreased hearing.
Second, people who have Sjogren’s Syndrome, which can be a comorbidity of RA, may develop hearing loss, although severe hearing loss is unusual. Sjogren’s Syndrome is an autoimmune disorder in which inflammation can occur in many areas of the body, but especially the glands that produce tears and saliva lead to eye and mouth dryness. Sjogren’s Syndrome is also commonly associated with connective tissue disorders such as RA, lupus or scleroderma. People with RA seem to have an increased incidence of also developing Sjogren’s syndrome. Individuals who have Sjogren's Syndrome often complain of tinnitus (ringing in the ears), mild hearing loss or ear pain caused by inflammation in the nasal cavity blocking the Eustachian tube.
Finally, some studies in recent years have found that RA can lead to hearing loss because of changes in the inner ear and how it functions. This can produce either sensorineural hearing loss, which occurs when there is a change in how the cochlea functions (converting sound vibrations into nerve impulses), or conductive hearing loss when a physical defect or obstructions affects the passage of sound into the inner ear's cochlea. Sensorineural hearing loss is the more common form of hearing loss. Another study found that the joints within the ear deteriorate just like other joints more commonly affected by RA.
In 2006, Mayo Clinic researchers contradicted the previous study by finding that people with rheumatoid arthritis were no more likely to have hearing loss than other members of the general population. The study compared 29 patients ages 40 to 69 who’d had RA for more than five years with 30 participants of the same gender and age categories who did not have rheumatoid arthritis. All participants had comprehensive hearing tests and questionnaires to measure hearing loss and dizziness, as well as assess their overall health. Seventeen of 29 patients with rheumatoid arthritis had abnormal hearing for at least one sound frequency (a measure of pitch), as did 14 of 30 of those without rheumatoid arthritis.
The researchers noted that the findings do not mean that hearing loss is never related to rheumatoid arthritis, it just means that people with RA are not more likely to develop hearing loss than the general population. They also found that the study participants who had RA were more likely to perceive that they had hearing problems even though there was no comprehensive difference. Individuals with more severe RA who had disabilities due to the disease were the most likely to have this perception. The researchers hypothesized that this may be due to an overall feeling of helplessness and general disability.
Like previous studies, the Mayo Clinic study found that the most common type of hearing loss was due to nerve problems in the inner ear (sensorineural). The researchers stated that this may be due to factors such as noise exposure or may be related to an autoimmune system attacks on the inner ear. The researchers also noted the possible link mentioned above between the hearing loss and rheumatoid arthritis medications, as patients who took Plaquenil were somewhat more likely to have hearing problems than other study participants.
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Updated On: August 15, 2016
Published On: September 19, 2006