title: Is Hearing Impairment Associated with Rheumatoid Arthritis? A Review.
abstract: BACKGROUND
  Rheumatoid arthritis (RA) is a systemic, inflammatory disease that affects 1% of the population. The auditory system may be involved during the course of disease; however the association of RA and hearing impairment has not been clearly defined.
  
  
  OBJECTIVE
  The objective of this review is to evaluate published clinical reports related to hearing impairment in patients with RA. Furthermore, we discuss possible pathologies and associated factors as well as new treatment modalities.
  
  
  METHODS
  A thorough literature search was performed using available databases including Pubmed, Embase, Cochrane and ComDisDome to cover all relative reports. The following keywords were used: hearing loss, hearing difficulties, hearing disorders, hearing impairment, sensorineural hearing loss, conductive hearing loss, mixed hearing loss, autoimmune hearing loss, drug ototoxicity, drug-induced hearing loss, hearing test, audiometry, auditory dysfunction and rheumatoid arthritis.
  
  
  CONCLUSIONS
  Based on our review it can be postulated that 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. This review can aid to clarify this condition and is a guide for further evaluation. To the best of our knowledge, this is the first review of hearing impairment in RA.
authors.affiliation: Department of Rheumatology, Odense University Hospital, Svendborg Hospital, Denmark.
authors.forename: Amir
authors.initials: A
authors.lastname: Emamifar
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Odense University Hospital, Denmark.
authors.forename: Kristine
authors.initials: K
authors.lastname: Bjoerndal
authors.affiliation: Department of Rheumatology, Odense University Hospital, Svendborg Hospital, Denmark.
authors.forename: Inger M J
authors.initials: IM
authors.lastname: Hansen
keywords: Audiometry; Conductive hearing loss; Hearing impairment; Hearing loss; Mixed hearing loss; Rheumatoid Arthritis; Sensorineural hearing loss