A Link Between Hearing Loss and Rheumatoid Arthritis 

A Link Between Hearing Loss and Rheumatoid Arthritis 

In Ear Health, Hearing Health by Bary E. Williams Au.D.

The effects of rheumatoid arthritis are still being studied however due to the nature of the disorder, there are some noted effects it can have on a person’s hearing.

Rheumatoid arthritis, or RA, is an autoimmune disorder, meaning a person’s immune system attacks the body causing chronic inflammation. In the case of RA, the inflammation generally happens in the joints causing swelling and even sometimes deformities however it can occur in other parts of the body as well including some organs.

Types of Hearing Loss and the Causes related to RA

When looking at the potential impacts of RA it is important to first understand the three primary types of hearing loss. These include sensorineural hearing loss, conductive hearing loss, and mixed hearing loss.

Sensorineural hearing loss occurs in the inner ear and can have a number of causes including age-related, noise-related, diseases and disorders, trauma, and certain medications. How RA can lead to sensorineural hearing loss is described here:

  • Auditory neuropathy is likely due to vasculitis, or inflammation of blood vessels, around the auditory nerve which can interrupt the nerve pathway between the ears and the brain.
  • Damage to cochlear hair cells in the inner ear from immune complex deposition of RA can lead to hearing loss as well since the hair cells are responsible for the transduction of sound.
  • Medication-related hearing loss is a known side effect of some classes of medications.

Conductive hearing loss happens in the middle and outer ear and is often caused by an obstruction. RA specific causes can include:

  • The incudostapedial (IS) and incudomalleolar (IM) are joints located in the middle ear. Because they are joints, they may experience inflammation and swelling with RA leading to some hearing loss.
  • Rheumatoid nodules are a common symptom of RA. They often appear as a firm lump under the skin but can occur almost anywhere on the body. This includes along the ear, nose, and throat sites potentially leading to hearing loss.

Mixed hearing loss is a combination of both sensorineural and conductive hearing loss, therefore it is caused by multiple factors of both other types of hearing loss.

Environmental Causes

It is important to note that other environmental factors can lead to hearing loss with or without the complication of RA. In fact, some of these factors can increase the incidence of hearing loss with RA.

  • Alcohol consumption- Long-term use of alcohol has a known impact on the auditory system, however, there is no evidence to suggest that hearing loss risk is increased in those with RA.
  • Smoking- Smokers have a higher risk of developing hearing loss. Furthermore, a smoker with RA has an increased risk of developing vasculitis and rheumatoid nodules. As previously described, both of these RA symptoms can lead to hearing loss.
  • Noise-related hearing loss- Noise exposure either suddenly or over time can lead to hearing loss. There is no known increased risk for those with RA for noise-related hearing loss.

Treatment of Hearing Loss with RA

The treatment of hearing loss for those with RA might be unique or might include some similar treatments to those without RA. We will look into options for both however determining the cause of hearing loss will be a vital step in treating it.

  • There are several immunosuppressants and other types of medications used to help treat RA. These could reduce inflammation and therefore potential vasculitis or the development of rheumatoid nodules working to prevent those types of hearing loss.
  • On the other hand, there are types of medications that are considered ototoxic, meaning they can cause hearing impairment. Talk to your provider about the side effects of the RA medications prescribed to determine if this could be a cause of hearing loss.
  • Regarding environmental factors, smoking cessation is the best treatment to mitigate the negative impacts smoking is known to have on your body.
  • Hearing aids are commonly used to treat permanent hearing loss. Your hearing health provider will discuss past medical history as well as signs and symptoms you are experiencing to determine if hearing aids are right for you.

Ultimately the impact of RA on hearing loss is a multifactor issue that is still being studied. Speak with your hearing health provider to better understand the risks and help mitigate any potential problems.

Bary E. Williams Au.D.
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