Assessment of auditory and vestibular functions in vitiligo patients

Abstract

ObjectivesTo evaluate audiological and vestibular functions via basic audiological evaluation, otoacoustic emissions and videonystagmography (VNG) in vitiligo patients.Material and methods30 vitiligo patients (8 acrofacial and 22 mixed types) as the study group and 30 normal healthy adults as the control group were included in the study. All participants were submitted to basic audiological evaluation, transient and distortion product otoacoustic emmisions (TEOAEs and DPOAEs), vestibular assessment including history taking, office tests and videonystagmography (VNG) and dermatological assessment to determine type, percent of body surface area involvement and duration of vitiligo.ResultsThis study showed statistically significant difference between control and study groups in pure tone audiometry (PTA) and otoacoustic emissions results. Fifty percent of vitiligo patients had peripheral vestibular disorders (10 vestibular neuritis and 5 posterior canal benign paroxysmal positional vertigo.ConclusionThe results in this study showed that 50% of vitiligo patients suffered from peripheral vestibular disorders in addition to auditory affection. Vitiligo patients require routine monitoring for auditory and vestibular functions for early identification and monitoring of changes as the disease progress.

Review of the pathology underlying benign paroxysmal positional vertigo

“…75 Vitiligo-associated auditory problems may be related to a degenerative process. 76 Dawoud et al 77 reviewed 30 patients with vitiligo and reported that 17% had BPPV. However, it is difficult to conclude that pigmentation disorders are a cause of BPPV because of the lack of sufficient data.…”

Investigation of hearing and outer hair cell function of the cochlea in patients with vitiligo

“…However, Prabha et al 16 reported that elderly patients with vitiligo had a higher risk of audiometric abnormalities. There are also studies reporting that vitiligo was associated with hearing loss in the C‐PTA test 5,17 . Although the vitiligo patients in the study by Fleissig et al 9 did not have a history of high noise exposure, the authors reported that they detected notch curve audiograms at high frequencies.…”

“…Studies of the effect of vitiligo on hearing loss have shown inconsistent results. Some studies have reported that hearing is negatively affected in vitiligo patients, 5,8,9 whereas other studies 10,11 indicate that hearing is not affected. It is not clear exactly which disease parameters are responsible for melanocyte damage in the inner ear in vitiligo patients.…”

“…The melanocytes in the cochlea are located mainly in the vascular stria, modiolus, osseous spiral lamina, and Reissner's membrane 3 . Although the exact function of the melanocytes in the inner ear is unknown, they are believed to be of great importance for cochlear function 4,5 . Indeed, hearing loss in hypopigmentary disorders such as Vogt‐Koyanagi Harada syndrome, Waardenburg syndrome, and Alezzandrini syndrome accompanies other disease‐related findings 6,7 .…”

“…3 Although the exact function of the melanocytes in the inner ear is unknown, they are believed to be of great importance for cochlear function. 4,5 Indeed, hearing loss in hypopigmentary disorders such as Vogt-Koyanagi Harada syndrome, Waardenburg syndrome, and Alezzandrini syndrome accompanies other disease-related findings. 6,7 Although the effect of melanocyte damage on the skin is directly visible, considering the presence of melanocytes in other body areas, it would be better to see vitiligo as a systemic disease, not a skin disease.…”