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Assessing Ossicular Stiffness and Cochlear Dysfunction in Patients with Juvenile Idiopathic ArthritisJuvenile Idiopathic Arthritis Linked to Specific Hearing Issues

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Key Takeaway
JIA is associated with significantly higher rates of ossicular stiffness and high-frequency hearing loss.

This meta-analysis investigated the prevalence of middle ear and inner ear dysfunction in children diagnosed with juvenile idiopathic arthritis (JIA). By comparing 237 patients with JIA against 132 healthy controls, the study evaluated tympanometry, pure-tone thresholds, and otoacoustic emissions.

Results indicated a significantly higher prevalence of Type As tympanograms in the JIA cohort compared to controls (RR = 13.93). Additionally, patients with JIA demonstrated elevated pure-tone hearing thresholds at 16 kHz, suggesting measurable high-frequency hearing loss. These findings indicate a high likelihood of ossicular stiffness in these patients.

While otoacoustic emission amplitudes showed a downward trend, the results did not reach statistical significance due to high heterogeneity. However, distortion-product otoacoustic emissions (DPOAE) showed a marked reduction. These findings suggest that while some measures are inconsistent, others point toward significant cochlear involvement.

Clinicians may find that combining tympanometry with extended high-frequency audiometry provides a more comprehensive assessment of auditory involvement. These tools can help identify subclinical hearing issues in children with inflammatory joint conditions.

Researchers looked at how juvenile idiopathic arthritis (JIA) affects the ears and hearing of children. They compared 237 children with JIA to 132 healthy children to see if there were differences in how their ears processed sound.

The study found that children with JIA had a much higher rate of a specific ear measurement called Type As tympanograms. They also showed higher hearing thresholds at high frequencies. Additionally, there was a marked reduction in distortion-product otoacoustic emissions, which are signals related to the inner ear.

Because these findings are based on a meta-analysis, some results like the inner ear signals need more testing in larger groups to be fully confirmed. These findings suggest that extra tests, like high-frequency hearing tests, could help doctors find hidden hearing issues in children with JIA. You should talk to a specialist to see if these specific tests are right for your child.

What this means for you:
Children with JIA may have specific ear and hearing issues that require specialized testing to detect.

Common questions

What specific hearing issues were found in children with JIA?

The study found that children with juvenile idiopathic arthritis had a much higher prevalence of Type As tympanograms compared to healthy children. They also showed higher hearing thresholds at 16 kHz and a marked reduction in distortion-product otoacoustic emissions (DPOAE). These results suggest that the condition is linked to specific auditory burdens.

Are the results about inner ear signals confirmed?

The results regarding otoacoustic emission amplitudes and distortion-product otoacoustic emissions (DPOAE) showed a trend or reduction, but these specific findings come from a single study. Because of this, the researchers noted that these specific results require confirmation in larger, prospective studies before they can be fully confirmed.

How can doctors better check hearing in children with JIA?

The study suggests that using tympanometry and extended high-frequency audiometry can provide more information. These tests may help doctors find subclinical auditory involvement, which means hearing issues that are not easily caught by standard tests, in children with juvenile idiopathic arthritis.

Study Details

Study typeMeta analysis
Sample sizen = 237
EvidenceLevel 1
PublishedNov 2026
View Original Abstract ↓
OBJECTIVES: To determine the prevalence of ossicular stiffness and cochlear dysfunction in patients with juvenile idiopathic arthritis (JIA) compared with healthy controls. METHODS: We searched PubMed (1966-27 December 2025), Embase (1947-27 December 2025) and the Cochrane Central Register of Controlled Trials (1996-27 December 2025). Studies of patients diagnosed with JIA who underwent audiological examinations (cochlear and middle ear function) were selected for the review. Random-effects models were used to calculate pooled risk ratios (RRs) and standardized mean differences (SMD). RESULTS: Seven studies (237 patients with JIA; 132 healthy controls) were included; six were judged high methodological quality (Newcastle-Ottawa score ≥ 8). Children with JIA exhibited a markedly higher prevalence of type As tympanograms (RR = 13.93, 95% CI 5.83-33.27) and elevated pure-tone hearing thresholds, with the largest effect observed at the extended high frequency of 16 kHz (SMD = 1.52, 95% CI 1.04-1.99). Pooled otoacoustic emission amplitudes trended lower in JIA but did not reach statistical significance (SMD = -1.72, 95% CI -8.77-5.33; I2 = 96%), although the single study reporting distortion-product otoacoustic emissions (DPOAE) suggested a marked reduction. CONCLUSION: JIA is associated with a quantifiable dual-compartment audiological burden-a markedly elevated risk of mechanical middle-ear stiffness and a frequency-dependent sensorineural deficit most pronounced beyond the conventional audiometric range. Tympanometry and extended high-frequency audiometry may provide complementary information for detecting subclinical auditory involvement in JIA. The potential role of OAEs, including DPOAE, requires confirmation in larger prospective studies.
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