The Link between Rheumatoid Arthritis and Hearing Loss

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The Link between Rheumatoid Arthritis and Hearing Loss

As if dealing with Rheumatoid Arthritis (RA) wasn't enough, researchers

agree that a link exists between RA and certain types of hearing loss

that can blunt the perception of differing tones or make all noises and

voices sound distant. Furthermore, they agree that hearing loss is an

articulation of the disease itself--rather than drug toxicity from

medications--but they still cannot entirely pinpoint how or where the

hearing loss occurs.

Consider a recent study's findings: Looking for physical changes in an

RA patient's middle ear and variations in their hearing capacity, the

study used 74 patients and 45 controls. Every subject went through the

same line of speech tests, acoustic reflex tests and standard and high

frequency tone tests. In every case, the RA patients' hearing threshold

was higher than the controls' hearing threshold. (All subjects--RA

patient and control--had normal pressure in their middle ear.) Worse,

the patients who had RA longer exhibited greater hearing loss; for

those with RA for one to five years, the hearing loss usually began at

10,000 Hertz (Hz) while those with RA for eleven years and on exhibited

hearing loss at all frequencies, low and high. Because the researchers

are using the Hertz measurement, what is at question in this study is

the tone of the sound, not the perceived volume or intensity of the

sound (that would be decibels); 50 to 60 Hz is a low bass tone and

+10,000 Hz is a high-pitched shrill--the normal range for a human is 20

Hz to 20,000.

Similar studies have been done before and have found the same trend: RA

somehow brings about hearing loss over time. A 2002 study, using 37 RA

patients, reported 35% having sensorineural hearing loss, 24% with

conductive hearing loss and an approximate 11% with both types of

hearing loss. Sensorineural hearing loss occurs when there is a change

in how the cochlea functions; the cochlea is the chamber converting

sound vibrations into nerve impulses. Conductive hearing loss occurs

when there is a physical defect or obstructions affecting the passage

of sound into the inner ear's cochlea. For people with RA (and also

without) sensorineural hearing loss is the more common form of hearing

loss.

Understandably, the studies point to a malfunction in the cochlea as

the location of sensorineural hearing loss but don't get very much

father than that--not yet at least. Another study argues that the

joints within the ear deteriorate just as the joints in the hand or the

hip would, altering the ear's hearing mechanics. Similarly, another

study indicates a slackening, or " laxity " in the middle ear's tranducer

mechanism.

It is worth considering that hearing loss comes in sensorineural and

conductive form--sometimes even simultaneously. If anything else, this

suggests there is no one source of hearing loss when it comes to RA,

but a complex, " multifocal involvement " as one study puts it. But it is

especially worth considering that however gloomy the numbers and head

scratching may seem, the same technological advances and commitment to

improved care that have allowed the researchers to first identify this

problematic link will one day allow them to fix it.

Article References

Ozturk A, Yalcin S, Kaygusuz I, Sahin S, Gok U, Karlidag T, Ardicoglu

O. High-frequency hearing loss and middle ear involvement in rheumatoid

arthritis. Am J Otolaryngol. 2004 Nov-Dec;25(6):411-7.

Ozcan M, Karakus MF, Gunduz OH, Tuncel U, Sahin H. Hearing loss and

middle ear involvement in rheumatoid arthritis. Rheumatol Int. 2002

May;22(1):16-9.

Colletti V, Fiorino FG, Bruni L, Biasi D. Middle ear mechanics in

subjects with rheumatoid arthritis. Audiology. 1997

May-Jun;36(3):136-46.

Raut VV, Cullen J, Cathers G. Hearing loss in rheumatoid arthritis. J

Otolaryngol. 2001 Oct;30(5):289-94.