Rheumatoid arthritis is an inflammatory autoimmune condition that can damage your inner ears in addition to your joints. Those with rheumatoid arthritis are at an increased risk of developing sensorineural hearing loss. This type of hearing loss is characterised by damage to the cochlea, which receives sound and transfers it to your brain for processing. Here's an overview of two ways rheumatoid arthritis can damage your inner ear and the treatment options:
Drug-Related Cell Damage
There are some drugs used to treat rheumatoid arthritis that can cause cell damage in the cochlea. These drugs are referred to as ototoxic and include salicylates and some anti-inflammatories. Each section of the cochlea is responsible for receiving and processing different sounds, so if the cells in the top section of your cochlea are damaged as a side effect of taking ototoxic drugs, low-frequency sounds won't be picked up by the cochlea, but you'll be able to hear high-frequency sounds. If there's severe cell damage to every section of the cochlea, you can experience complete loss of hearing.
Your rheumatologist will discuss the risks and benefits of taking ototoxic drugs to control the symptoms and stunt the progression of your arthritis. It may be there's not a suitable alternative for you at this time, but you should be aware these drugs can cause immediate or gradual damage to the cells of your cochlea.
Overactive Immune Response
When your immune system is overactive it can attack your body and an inflammatory response is triggered in the area that's affected in an attempt to counter the attack. Inflammation can damage your cochlea in the same way ototoxic drugs can, and this can lead to partial or complete hearing loss, depending on the extent of the damage. Inner ear inflammation can cause dizziness and ringing in your ears, so if you experience these symptoms, you should have your ears examined and hearing tested by an audiologist.
Treatment Options
Sensorineural hearing loss can't be reversed, so treatment aims to prevent further damage to your inner ears and improve your hearing, if possible. Corticosteroids can be used to reduce inflammation, and your rheumatologist will review your current dose of your prescribed immunosuppressant, which may need altered to further dampen down your immune system.
If only a small area of your cochlea is damaged, a hearing aid can be used to allow you to hear the sounds that aren't being picked up by the damaged area. Although hearing aids are often used to amplify sounds, they can also be used to alter the frequency of sounds as they enter your ear canal.
So, if you can no longer hear low-frequency sounds well, the hearing aid will convert these sounds to a higher frequency. Severe damage to the cochlea will require cochlear implant surgery to improve your hearing. The implant is placed on your temporal bone and uses an external microphone to pick up sound, so the inner ear is not involved in the hearing process at all.
Regular hearing tests can allow early signs of inner ear damage to be picked up and addressed before significant hearing loss occurs. If you're overdue a hearing test, or if you have any concerns about the health of your ears, schedule an appointment with an audiologist as soon as possible.
