Conductive and sensorineural hearing impairment in juvenile idiopathic arthritis: a systematic review and meta-analysis
Shih-Huan Chen, Yung-Hsuan Lee, Ching-Yuan Wang, Tang-Chuan Wang, Fang-Wei Lin, Chia-Der Lin, Po-Chang WuAbstract
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 relative risks (RR) 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 to 5.33; I² = 96%), although the single study reporting 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.