Varying types of hearing loss have been reported in people with rheumatoid arthritis (RA). But while a new study found the auditory system may be involved during the course of RA, the association between disease and hearing impairment (HI) is not clearly defined.
Sensorineural hearing loss (SNHL) is the most usual type of hearing impairment in RA patients ranging from 25 percent to 72 percent. Conductive hearing loss (CHL) and mixed hearing loss (MHL) have also been reported, but less frequently.
To discuss recent findings on the pathology, associated factors and management of hearing impairment in RA, Amir Emamifar, Kristine Bjørndal and Inger Marie Jensen Hansen, from the Odense University Hospital in Denmark, conducted a review using available databases — including Pubmed, Embase, Cochrane and ComDisDome — to cover relevant reports. The study, “Is Hearing Impairment Associated with Rheumatoid Arthritis? A Review,” was published in the journal Bentham Open.
“Elderly patients and those with long disease duration, active disease, seropositivity, elevated acute phase reactants and rheumatoid nodules are more likely to have HI,” the authors said, according to a news release.
Researchers found that environmental factors such as noise, alcohol and smoking (passive and active) can worsen the condition. In patients with RA, long-term use of alcoholic beverages was also found to have an impact on hearing, specifically on the cochlear function.
Scores of pure tone audiometry revealed a high prevalence of HI at all frequencies. The Transiently Evoked Otoacoustic Emissions (TEOAEs) test, a tool commonly used to assess cochlear function, detected decreased cochlear function in patients during early stages of the disease.
According to the authors, treating HI in RA is pragmatic. One option could be more intense use of disease-modifying anti-rheumatic drugs or oral steroids. Also, anti-oxidants such as vitamin E may be protective for the inner ear. HI in RA can also be managed by the use of hearing aids and implantable devices.
The authors noted that patients with RA should be regularly monitored with TEOAEs and audiometric tests, and would benefit by drinking less alcohol intake and quitting smoking.
“Patients with RA are at higher risk of hearing impairment compared to healthy subjects in their course of the disease. The hearing impairment in RA seems to be a multifactorial condition; however the mechanisms of injury, as well as the relative risk factors, are not completely clear,” they concluded.