While Sjögren’s disease is most commonly associated with dry eyes and dry mouth, many patients are surprised to learn that the condition can also affect the ears and surrounding structures. Dryness, inflammation, and immune system activity can contribute to a range of auditory symptoms that may impact hearing, comfort, and quality of life. Recognizing these symptoms early can help patients seek appropriate treatment and prevent complications.
Ways Sjögren’s Can Affect the Ears
Patients with Sjögren’s may experience:
- Hearing loss (conductive or sensorineural)
- Tinnitus (ringing, buzzing, or other sounds in the ears)
- Ear pain (otalgia)
- Eustachian tube dysfunction
- Fluid buildup in the middle ear
- Recurrent middle ear infections
- Referred ear pain from throat dryness
- Relapsing polychondritis affecting the ear cartilage
Hearing Loss and Sjögren’s
Research has shown that people with Sjögren’s are at an increased risk of hearing loss. This may occur in two forms:
Conductive hearing loss occurs when sound cannot travel effectively through the outer or middle ear due to problems involving the ear canal, eardrum, Eustachian tube, or middle ear structures.
Sensorineural hearing loss results from damage to the inner ear or auditory nerves. In Sjögren’s, autoimmune activity may target components of the auditory system, leading to this type of hearing impairment.
Treatment for autoimmune-related hearing loss may include corticosteroids administered orally or directly into the ear, and in some cases antiviral medications or other immunosuppressive therapies. Early intervention is important, as prompt treatment may help restore some hearing and slow progression. Patients who notice changes in hearing should discuss these symptoms with their healthcare provider and consider a hearing assessment.
Tinnitus: Ringing in the Ears
Tinnitus, commonly described as ringing in the ears, occurs more frequently in people with Sjögren’s than in the general population. Although tinnitus often accompanies hearing loss, some individuals with normal hearing may also experience it.
The exact cause is not always clear, but tinnitus can be influenced by stress, anxiety, and depression. For some patients, addressing these factors can help reduce the severity of symptoms. Treatment options may include:
- Sound-masking devices or hearing aids
- Tinnitus retraining therapies
- Biofeedback
- Medications when appropriate
- Complementary approaches such as acupuncture
While many people learn to manage tinnitus successfully, those with severe symptoms should seek professional evaluation and support.
Ear Pain and Pressure
Ear pain, or otalgia, affects a significant number of Sjögren’s patients. One contributing factor may be dryness in the upper airway, which can affect the function of the Eustachian tube—the small passage that helps equalize pressure between the middle ear and the environment.
When the Eustachian tube becomes dry or dysfunctional, pressure can build within the middle ear, potentially leading to:
- Ear discomfort or pain
- A feeling of fullness in the ear
- Hearing changes
- Fluid accumulation
- Increased risk of middle ear infections
Treatment often focuses on addressing the underlying inflammation and dryness. Nasal steroid sprays and decongestants may help improve Eustachian tube function, while more severe cases involving recurrent fluid buildup may require additional medical intervention.
When Throat Dryness Causes Ear Symptoms
Many people do not realize that dryness in the throat and mouth can sometimes cause pain that feels as though it originates in the ears. This phenomenon, known as referred pain, occurs because the nerves supplying the throat and ears are closely connected.
If ear pain occurs without evidence of infection or other ear disease, healthcare providers may also evaluate the throat and upper airway as possible sources of discomfort.
Relapsing Polychondritis and Ear Inflammation
In rare cases, Sjögren’s may be associated with relapsing polychondritis, an autoimmune condition that causes inflammation of cartilage throughout the body, including the external ear. Symptoms may include:
- Ear pain
- Redness
- Swelling
- Tenderness of the ear cartilage
Because this condition can affect other cartilage-containing structures in the head, neck, and body, prompt medical evaluation is important. Treatment typically involves corticosteroids and other immunosuppressive medications.
Takeaway
Ear-related symptoms are an often-overlooked aspect of Sjögren’s disease. Hearing loss, tinnitus, ear pain, pressure changes, and recurrent infections can all occur as a result of dryness and autoimmune inflammation. Patients who experience persistent auditory symptoms should discuss them with their healthcare team, as early assessment and treatment can improve comfort, protect hearing, and enhance overall quality of life.
* summary courtesy of The Sjögren's Book, Fifth Edition, Daniel J. Wallace, MD
