Auditory function in children with vitiligo

Abstract

Background Vitiligo is an acquired disorder of pigmentation affecting ∼0.1–2% of the world population and characterized by the development of well-defined white macules on the skin. Vitiligo is classified into two broad categories, segmental and nonsegmental (most common). Recent studies have suggested a direct relation between cochlear dysfunction and decreased amounts of melanin. Loss of melanocytes resulting in decreased melanin production (as occurring in vitiligo) could decrease cochlear health. Owing to the high importance of having normal hearing during the infancy and the childhood period, this study is designed to assess the cochlear function in pediatric patients with vitiligo. Materials and methods This study involved 30 children with vitiligo and 30 apparently healthy controls; both groups were matched in age and sex. All patients included were subjected to full history taking, otological examination, and audiological evaluation. Audiologic evaluation including pure tone audiometry, extended high-frequency audiometry, immittancemetry, and transient evoked otoacoustic emission was evaluated to detect signal to noise ratio (average) for the frequency bands 1000, 1500, 2000, 3000, and 4000 Hz. Results Children with vitiligo had high pure tone thresholds at all frequencies with a statistically significant difference on both sides in conventional and extended high-frequency audiometry. Transient evoked otoacoustic emission (TEOAEs) average signal to noise (S/N) ratio showed decreased emission in the patient group in both ears and the difference was statistically significant in comparison with the control group. The pure tone threshold in generalized and localized vitiligo is elevated, and the difference is statistically significant almost at all frequencies, but the hearing is affected more in generalized type especially at high frequencies. Moreover, there is elevation in the pure tone threshold in either positive or negative family history in vitiligo subgroups. Patients with skin type IV are more affected than other types. There is no variation in the prevalence of hearing affection regarding sex. Conclusion Vitiligo is associated with cochlear dysfunction. Hearing loss is more common in generalized type of vitiligo. Recommendation Hearing screening of pediatric patients with vitiligo should be done for early detection of hearing abnormalities to ensure maximum scholastic and academic performance to help them to achieve their best potentials.