Audiological and vestibular evaluations in vitiligo patients

Abstract

The aim of this paper was to investigate audiological abnormalities and potential vestibular injury in a sample of vitiligo subjects. Thirty-five patients with non-segmental vitiligo (NSV) were enrolled in the study. They underwent pure tonal audiometry (PTA), vestibular Fitzgerald-Hallpike caloric test, C-VEM, and O-VEMP testing. The χ2 test and multiple regression analysis were performed. At PTA, 69% of patients presented with bilateral hearing loss, 8% monaural hearing loss, and 23% normal values. Bilateral caloric stimulations were performed and demonstrated that 14% of patients had a monolateral and 9% had a bilateral pathological response. VEMPs analysis showed that 20% of patients had no O-VEMPs response and 3% had no C-VEMPs response. Comparison between the normal values of healthy subjects and NSV patients showed an alteration of VEMPs in 44%. Multiple regression showed no statistical differences. We propose a specific diagnostic protocol employing PTA, bithermal caloric tests, C-VEMP, and O-VEMP testing to evaluate audio-vestibular damage. Our data were concordant with the anatomic-physiological melanocytic distribution and their possible degeneration linked with NSV.

The Vestibulospinal Reflex in Vitiligo Patients

“…Similarly, Abd El Mageed et al [26] reported that 27 (42.9%) patients had delayed latency. In contrast, Manno et al [28] cVEMPs findings revealed abnormal latency of P13 in 5 patients: One of them with a unilateral absent response. Latency of n23 was affected in only 2 patients, 1 with an absent response.…”

“…While 4 patients (6.3%) showed unilateral absent waves. Manno et al [28] found that 1/35 (3%) had no cVEMPs response. In comparison, Koura et al [27] found that cVEMP was absent bilaterally in 8 of 30 (26.6%) and absent unilaterally in 6 of 30 (20%) in the left ear.…”

“…This could be due to the ability of the vestibular system to compensate for deficit. According to Manno et al [28] their findings demonstrated that hearing loss predominated over vestibular deficiency. The vestibular system's capacity to carry out a central compensation that enables patients to be asymptomatic even when there is a hidden vestibular loss forms the basis of a theory.…”

Is there a correlation between vitiligo and hearing loss? - review of the literature

“…Scientists suspect that hearing degeneration may be related to NSV. In addition, they recommend performing bithermal caloric testing, C-VEMP and O-VEMP, even in asymptomatic individuals, to assess vestibular damage [19].…”