There is convincing evidence that vitiligo is a systemic disorder influencing the whole pigmentary system, including melanocytes in the inner ear. Cochlear melanocytes and also melanin-containing cellular elements of the auditory system may be affected in vitiligo and interfere with the conduction of action potentials. We conducted a prospective clinical trial to determine hearing status and auditory evoked potentials in 50 patients affected by vitiligo and compared the results with those of 50 healthy controls. I, III, V latencies and amplitudes and I-III, III-V, I-V interpeak latencies were compared with each group. Statistical evaluation was accomplished using the t-test. With the exception of two subjects, all patients demonstrated normal audiological results. No statistically significant difference was noted between the study group and controls in regard to latencies, interpeak latencies and amplitudes. We conclude that auditory investigations supported by postmortem histopathological studies of the inner ear and brainstem may provide more accurate knowledge in vitiligo patients.
The ideal patient for revision stapes surgery is one who benefits from the initial surgery but complained of conductive hearing loss. In the present study, improvement in pure-tone average was 13.2 dB, and the mean air-bone gap was 9.6 dB.
Objective: To investigate the effects of the mechanical trauma to the round window, a model electrode inserted into the scala tympani on the cochlear reserve, and the efficacy of topical steroids in preventing hearing loss. Materials and Methods: 21 male Wistar Albino rats were equally categorized into three groups. In all groups an initial mechanical injury to round window was created. Only subsequent dexamethasone injection was administrated into the cochlea in the subjects of group 2 while a multichannel cochlear implant guide inserted into the cochlea prior to dexamethasone administration for group 3. Distortion product otoacoustic emissions (DPOAEs) were obtained prior to and immediately after the surgical injury, eventually on postoperative seventh day (d 7). Mean signal/noise ratios (S/Ns) obtained at 2000, 3000, and 4000 Hz were calculated. Data sets were compared with non-parametric statistical tests. Results: The early intraoperative mean S/Ns were significantly less than preoperative measurements for group 1 and 2; however, preoperative and postoperative d 7 average S/Ns did not differ. There was statistically significant difference between preoperative, intraoperative and postoperative d 7 average S/Ns for group 3. Conclusion: We observed that hearing was restored approximately to the preoperative levels following early postoperative repair. However, an electrode insertion into the cochlea via round window subsequent to mechanical trauma seems to cause a progressive hearing loss. Therefore, a special care must be taken to avoid the injury to the round window membrane in the course of the placement of a cochlear implant electrode and surgery for the chronic otitis media.
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