Clinical Study of Vitiligo with Otological Changes (original) (raw)
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Hearing status in patients with vitiligo
Clinical, Cosmetic and Investigational Dermatology, 2019
Background: Vitiligo is an acquired disorder characterized by depigmented macules and patches that result from a progressive loss of functional melanocytes. During embryogenesis, precursor cells of melanocytes (melanoblasts) migrate not only to the epidermis and hair follicles but also to the leptomeninges, uveal tract of the eye, and inner ear. Thus, it has been proposed that these organs may be involved in vitiligo, as well. Objective: This study was designed to evaluate the frequency and characteristics of hearing loss by means of audiometry and distortion product otoaucostic emission (DPOAE) in patients with vitiligo. Methods: Fifty-three patients with vitiligo and 52 age-and sex-matched healthy subjects were enrolled in this case-control study. After a complete otological examination, comprehensive audiological evaluations including pure tone audiometry (PTA) and DPOAE were performed for all participants and the results were compared between the two groups. Results: Neither PTA nor DPOAE showed significant difference between the two groups in any of the evaluated frequencies (0.75-8 KHz). Furthermore, in patient group, there was no association between PTA/DPOAE and age, gender, duration of the disease, presence of halo nevus, type of vitiligo, extent of involvement, and positive family history of vitiligo. Conclusion: Vitiligo patients have normal hearing status.
Audiological Manifestations in Vitiligo Patients
2012
The hallmark of vitiligo is the disappearance of melanocytes from the skin due to an as yet unidentified mechanism. The presence of melanocytes in the auditory apparatus suggests that this system could possibly be affected by vitiligo, which targets the melanocytes of the whole body and not just the skin. The purpose of this study was to assess the incidence of auditory alterations in patients with vitiligo
Audiological Profile of Vitiligo Patients
Vitiligo Is A Systemic Disorder Influencing The Whole Pigmentary System Including Melanocytes In The Inner Ear. The Loss Or Reduction Of Melanocytes In The Inner Ear May Have A Critical Effect On Hearing.; Most Vitiligo Patients Are Asymptomatic For Audiological Abnormalities. The Aim Of The Present Study Was To Evaluate The Auditory Function In Vitiligo Patients. The Study Group Included 15 Cases Of Various Types Of Vitiligo. Fifteen Age-And Sex-Matched Non Vitiligo Cases Were Included As Controls In The Study. A Thorough Audiological Examination Including Pure Tone Audiometry, Transient Evoked Otoacoustic Emission And Auditory Brain Stem Response Were Carried Out In All Patients And Controls. The Result Shows Decreased Hearing At High Frequencies Which May Indicate More Serious Damage At The Base Of The Cochlea. Transient Oto-Acoustic Emission Result Shows A Significant Decrease In Reproducibility Percent Of Emission In The Vitiligo Group. Auditory Brainstem Response Result Shows A Statistically Significant Decrease Of The Peak I Latency And Increase Of The I-III Interpeak Latency In The Patients As Compared To The Controls.
Audiological Profile of Patients with Vitiligo
Sohag Medical Journal
Introduction: Vitiligo is an acquired hypomelanotic disorder characterized by circumscribed depigmented macules or patches resulting from loss of functional melanocytes and of melanin from the epidermis. The affection of extracutaneous melanocytes in some vitiligo patients suggests that systemic immunological reactions directed at pigment cells might play a role in the development of the disease. Aim of the work: Evaluation of the cochlea and the auditory nerve in vitiligo patients. Patients and Methods: Cross sectional clinical study included total number of 60 subjects were examined. All subjects included were subjected to the following procedures: Full history taking, clinical examination, Basic audiologic evaluation, Transient Evoked otoacoustic emissions (TEOAEs), Distortion Product Otoacoustic Emission (DPOAE), Auditory Brainstem Response test (ABR). Results: The ABR finding concluded that melanin play a significant role in establishment and maintenance of structure and function of the auditory system and may modulate the transduction of auditory stimuli by the inner ear. Conclusion: TEOAE and DPOAE are sensitive tests for detecting cochlear dysfunction before symptoms become manifested as the TEOAE and DPOAE were impaired in 35% and 35%of the ears with normal hearing.
Materia Socio Medica
Introduction: Vitiligo is a common acquired depigmented systemic disorder influencing the entire pigmentary system including Cochlear melanocytes and vestibular system in the inner ear. Vitiligo can leads to social negative impact and poorer quality of life among these patients. This study was conducted to investigate the relationship between skin involvement severity and hearing loss severity among vitiligo patients. Methods: This cross-sectional study was performed on 98 patients with vitiligo referred to the dermatology clinic of Shahid Beheshti Hospital of Kashan during 2012-2014. Using Vitiligo Area Severity Index (VASI), the skin involvement was evaluated by a dermatologist. Then, patients referred to an otolaryngologist, and after otoscopic examination, they underwent audiometric testing including Audiometry, Tympanometry and Auditory Brainstem Response (ABR tests. Patients aged 10-50 years old without any other underlying diseases, and after rule out of other causes of depigmentation and leukoderm were included. Patients with congenital hearing impairment and patients with history of ototoxic drugs intake such as aminoglycosides, vancomycin and thiazide were excluded. Results: No significant association was found between severity of Vitiligo with conductive hearing loss. Vitiligo has not been correlated with sensory neural hearing loss. Also, there was no relationship between the duration of clinical manifestations of vitiligo with conductive and sensory neural hearing loss. Conclusions: Our finding showed that there was no relationship between skin involvement severity and hearing loss severity in vitiligo patients. In addition, no relationship was found between the conductive and sensory neural hearing losses with the incidence duration of clinical manifestation and extent of skin involvement of vitiligo.
Audiological abnormalities in patients with vitiligo
Clinical and Experimental Dermatology, 2006
Background. Accumulating evidence suggests that vitiligo is a systemic disease affecting the entire pigmentary system. Aim. To investigate the subclinical abnormalities of melanin-containing cellular elements of the auditory system in patients with vitiligo. Methods. We studied the conventional audiometric investigations and brainstem auditory evoked responses (BAERs) of 57 active patients with vitiligo and 50 healthy human subjects. The I, III and V latencies, and I-III, III-V and I-V interpeak latencies (IPL) between the groups were compared. Results. A mild degree of sensorineural hypoacusis was found in eight patients with vitiligo (14%), whereas no controls demonstrated abnormal audiological results (P ¼ 0.006). A statistically significant increase in both ears of the third peak latency (P ¼ 0.02, P ¼ 0.01, respectively) and IPL I-III (P ¼ 0.04, P ¼ 0.008, respectively), and a significant increase of the fifth peak latency in the right ear (P ¼ 0.04) were found, compared with controls, but no differences were found for other latencies and IPLs. Conclusions. Melanin may play a significant role in the establishment and ⁄ or maintenance of the structure and function of the auditory system and may modulate the transduction of the auditory stimuli by the inner ear.
Assessment of audiovestibular system in patients with vitiligo: a case–control study
The Egyptian Journal of Otolaryngology, 2018
Background Vitiligo is characterized by loss of epidermal melanocytes. Alterations in melanocytes in extracutaneous sites have been reported in vitiligo and sometimes implied for the inner ear along with an associated compromise in function. Aim The aim of this study was to map the auditory and vestibular functions in patients with vitiligo. Materials and methods A total of 30 patients with vitiligo vulgaris and 30 age-matched and sex-matched healthy controls were enrolled in this study. Pure tone audiometry and measurements of auditory brainstem responses, cervical vestibular-evoked myogenic potential (cVEMP), and videonystagmography (VNG) were carried out in all participants. Results Mean hearing thresholds of patients with vitiligo were highly statistically significantly lowered at 4 and 8 kHz than the controls. Analysis of brainstem auditory-evoked potentials (BAEP) revealed statistically significantly prolonged wave III, wave V, and interpeaks of I–III and I–V latencies in both...
Mucosa
Background Vitiligo is a common pigment disorder characterized by destruction of melanocytes in epidermis. The inner ear is also one of the remarkable sites of melanocytes. The mechanism destroying the melanocytes in vitiligo may also affect other melanocyctic organs. Several studies have been reported some hearing abnormalities in patients with vitiligo. Objective The purpose of the study is to evaluate the hearing functions with transient-evoked otoacoustic emission (TOAE) test according to the clinical types, disease activity, localization at onset, age at onset, and duration of the disease in the children with vitiligo. Methods Thirty-five patients with childhood vitiligo (18 females and 17 males, mean age 9.71 ± 3.75) and a healthy control group consisting 35 children (18 females and 17 males, mean age 9.23 ± 3.40) were consecutively enrolled to this prospective study. Clinical characteristics of the disease including types, activity, localization at onset, age at onset and duration were noted. Auditory functions of children with vitiligo and healthy controls were measured by TOAE test. Test results were compared between vitiligo and control group, and in subgroups of vitiligo patients according to disease characteristics. Results There were no statistically significant differences between the childhood vitiligo group and control group when TOAE test results compared (p>0.05). Children with disease onset at the head and neck had significantly higher TOAE test results including in the right ear at a frequency of 4 KHz and average frequency, while compared to the children with disease onset at other areas, respectively (p=0.012, p=0.034). There was no statistically significant differences, while TOAE results of subgroups compared according to clinical types, activity, and duration of the disease in the patients with vitiligo (p>0.05). Conclusions According to the our study, which is the first one measures the auditory functions by TOAE in children with vitiligo, TOAE test results did not differ from healthy controls. Although the melanocytes are present in the inner ear, our findings suggest that auditory functions of children with vitiligo are not affected.
Audiological and vestibular evaluations in vitiligo patients
Audiological and vestibular evaluations in vitiligo patients, 2021
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 ocular VEMP (O-VEMP) testing. The χ 2 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 cervical VEMPS (C-VEMPs) response. Comparison between the normal values of healthy subjects and NSV patients showed an alteration of VEMPs in 44%. Multiple regressions 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.
Audiological Abnormalities in Vitiligo Patients: A Hospital-Based Cross-Sectional Study
International Archives of Otorhinolaryngology, 2019
Introduction There are some discrepancies in the literature about the influence of vitiligo on auditory functions. According to some authors, vitiligo influences hearing, whereas others question such influence. Therefore, we conducted a study to evaluate audiological functions in vitiligo patients. Objectives To determine the effect of vitiligo on auditory functions. Methods A hospital-based observational study was done from January 2017 to July 2017. Clinically diagnosed cases of vitiligo were enrolled for the study. A complete otological examination was conducted in all patients. Results Fifty-two patients (male: female 28:24) were included in the study. Ten patients (19.2%) had sensorineural hearing loss (SNHL). Seven patients (13.5%) had bilateral and 3 (5.7%) had unilateral SNHL. High frequency loss was seen in 17 out of 20 ears (10 affected patients), 6 ears had both low and high-frequency hearing loss. Of 12 ears with speech frequency involvement, mild hearing loss was seen in 5 and moderate to severe in 1 ear. Most cases of SNHL were detected in the age group 41 to 60 years old (63.6%), which was statistically significant (p-value 0.00). Conclusion The results of this study suggest that vitiligo patients require routine monitoring for auditory functions for early identification of SNHL. Older subjects with vitiligo might be at a higher risk for audiological abnormalities. These patients should also be informed regarding the associated risk with noise and ototoxic drug exposure.