Sjogren’s syndrome is an autoimmune disorder that affects the moisture-producing glands in the body. This includes the tear glands and salivary glands, leading to dry eyes and dry mouth. But Sjogren’s syndrome can also affect other parts of the body, including the ears. Here is a closer look at how Sjogren’s syndrome can impact the ears.
Overview of Sjogren’s Syndrome
Sjogren’s syndrome is an autoimmune disorder in which the body’s immune system mistakenly attacks its own healthy cells and tissues. In Sjogren’s syndrome, the attack targets the glands that produce moisture. This includes the tear glands (lacrimal glands) and salivary glands.
When the tear and salivary glands are damaged, they produce less moisture. This leads to the two hallmark symptoms of Sjogren’s syndrome:
- Dry eyes
- Dry mouth
But Sjogren’s syndrome is considered a systemic disease, meaning it can affect the entire body. Other areas that can be impacted include:
- Joints
- Lungs
- Kidneys
- Blood vessels
- Nervous system
- Digestive system
The ears are another part of the body that can be affected by Sjogren’s syndrome. Let’s take a closer look at the connection between Sjogren’s and the ears.
How Sjogren’s Syndrome Affects the Ears
There are a few different ways that Sjogren’s syndrome can impact the ears and hearing:
Dryness
Just like it causes dry eyes and dry mouth, Sjogren’s can also lead to dryness of the ears. This is because the ears need moisture to function properly. There are glands in the outer ear canal that produce earwax, which helps lubricate and protect the ear.
In Sjogren’s syndrome, the attack on moisture-producing glands can affect these ear glands. When the glands in the ear canal produce less wax, it can lead to dry, itchy ears.
Eustachian Tube Dysfunction
The Eustachian tube connects the middle ear to the back of the throat. It helps equalize pressure between the middle ear and the outside environment. When the Eustachian tube doesn’t open properly, it can lead to a feeling of fullness or pressure in the ears.
Research shows that up to 50% of people with Sjogren’s syndrome experience Eustachian tube dysfunction. The dryness caused by Sjogren’s is believed to cause the Eustachian tube to stick together, preventing it from opening properly.
Hearing Loss
Sensorineural hearing loss is one of the most common ear-related symptoms of Sjogren’s syndrome. Sensorineural hearing loss occurs when there is damage to the inner ear (cochlea) or auditory nerve. This type of hearing loss involves difficulty hearing soft sounds or distinguishing words.
One study found that sensorineural hearing loss affected 54% of patients with primary Sjogren’s syndrome. The hearing loss is believed to be caused by the immune system attack on the moisture-producing glands in the inner ear.
Tinnitus
Many people with Sjogren’s syndrome also experience tinnitus, which is ringing or other noises in the ear. Tinnitus can arise from problems with the hearing pathways in the inner ear or auditory nerve damage.
One study found tinnitus in 44% of Sjogren’s patients. Tinnitus linked to Sjogren’s often occurs along with sensorineural hearing loss.
Increased Infections
The ears rely on earwax and moisture to prevent infections. When Sjogren’s syndrome reduces ear lubrication, it can make the ears more prone to infections like swimmer’s ear or otitis externa.
Repeated ear infections can, in turn, lead to hearing loss and other complications. That’s why it’s important for Sjogren’s patients to monitor their ears for signs of infection and seek treatment promptly.
Other Ear Problems Linked to Sjogren’s
In addition to the main ear-related symptoms covered above, Sjogren’s syndrome has also been linked to some less common ear conditions including:
- Sudden sensorineural hearing loss (SSHL)
- Meniere’s disease
- Vestibular neuritis
- Bell’s palsy
Researchers are still investigating the connections between Sjogren’s syndrome and these conditions affecting the ears and balance system.
Who Gets Ear Problems with Sjogren’s?
Not every Sjogren’s patient will experience ear-related complications. But research shows:
- Women are more likely than men to have hearing loss with Sjogren’s.
- People with an earlier onset of Sjogren’s appear to have a higher rate of ear problems.
- Those with primary Sjogren’s (Sjogren’s alone) have more ear involvement than those with secondary Sjogren’s (Sjogren’s accompanied by another autoimmune disease like rheumatoid arthritis).
Testing Hearing with Sjogren’s Syndrome
Due to the high rate of ear problems with Sjogren’s, it is recommended that Sjogren’s patients have their hearing tested periodically. This may include:
- Audiometry: This hearing test determines the faintest tones you can hear at different pitches and volumes. It can detect sensorineural hearing loss.
- Tympanometry: This test measures how the eardrum responds to air pressure changes. It can detect issues like Eustachian tube dysfunction.
- Acoustic reflex testing: This checks the reflexes that protect the inner ear. It provides information about the auditory nerve.
Hearing tests allow Sjogren’s-related hearing loss and other ear problems to be diagnosed early. The sooner treatment can begin, the better the outcome is likely to be.
Treating Ear Problems Caused by Sjogren’s
Treatment for ear-related symptoms of Sjogren’s syndrome may include:
- Ear lubricants and drops: Products like mineral oil can help moisturize dry ears.
- Prescription ear drops: Eardrops containing acetic acid or steroids can reduce ear inflammation and infection.
- Humidifiers: Adding moisture to the air can prevent ear dryness.
- Hearing aids: Amplification devices can improve hearing loss.
- Medications: Steroids, immunosuppressants, and disease-modifying antirheumatic drugs may help improve Sjogren’s-related ear problems.
Preventing and managing ear complications is an important part of caring for Sjogren’s syndrome. With proper treatment, many patients find their ear symptoms improve significantly.
The Bottom Line
In summary, Sjogren’s syndrome can impact the ears in the following ways:
- Dryness of the outer ear and ear canal
- Eustachian tube dysfunction leading to feelings of fullness
- Sensorineural hearing loss
- Tinnitus or ringing of the ears
- Increased ear infections
These complications arise from the immune system attack on moisture-producing glands. Other rarer ear conditions like Meniere’s disease are also more common in Sjogren’s.
Testing hearing regularly and pursuing treatment for ear problems can help prevent complications and improve quality of life for Sjogren’s patients.
While dryness is the hallmark of Sjogren’s syndrome, the effects can extend throughout the body – including the ears. Paying attention to ear symptoms and working closely with your doctor is key to managing this extraintestinal manifestation of Sjogren’s syndrome.
Frequently Asked Questions
Can Sjogren’s syndrome cause ear pain?
Yes, Sjogren’s can sometimes cause ear pain. Ear pain may arise from dryness and irritation of the outer and middle ear. Ear infections that occur more frequently with Sjogren’s can also cause ear pain.
Does Sjogren’s syndrome affect balance?
Sjogren’s syndrome can sometimes impact balance. This may occur if Sjogren’s causes problems with the inner ear or vestibular system involved in balance. Conditions like vestibular neuritis and Meniere’s disease are more common in people with Sjogren’s.
Can ear problems with Sjogren’s come and go?
In some cases, ear problems caused by Sjogren’s may come and go. For example, Eustachian tube dysfunction and ear fullness may flare up during Sjogren’s disease activity, then improve when the disease is less active. Occasional ear infections can cause symptoms that resolve with treatment. But other ear issues like sensorineural hearing loss are typically more permanent.
What specialist treats ear problems with Sjogren’s syndrome?
An otolaryngologist, also known as an ear, nose and throat (ENT) doctor, can treat most ear issues related to Sjogren’s. An audiologist can help diagnose and manage hearing loss. In some cases, a neurotologist who specializes in ear disorders may be recommended.
Should Sjogren’s patients get ear tubes placed?
Ear tube placement, also known as tympanostomy tubes, may be helpful for some Sjogren’s patients with chronic Eustachian tube dysfunction or recurrent ear infections. Tubes can drain fluid from the middle ear and improve hearing. Discuss the potential benefits and risks of ear tubes with your ENT doctor.
The Takeaway
In summary, the key points to understand are:
- Sjogren’s syndrome frequently affects the ears due to dryness and immune system dysfunction.
- Common ear manifestations include hearing loss, tinnitus, ear infections, and balance problems.
- Monitoring hearing and managing ear issues can greatly improve quality of life.
- Working with ENT and audiology specialists is recommended to treat ear complications of Sjogren’s.
While often overlooked, paying attention to ear health is an important part of managing Sjogren’s syndrome.