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斑秃患者听觉和耳蜗功能评估:探索与耳蜗黑素细胞损伤的关联

Assessing Auditory and Cochlear Function in Alopecia Areata Patients: Exploring the Link to Cochlear Melanocyte Damage.

作者信息

Aliyeva Aynur, Yagiz Agayarov Ozlem, Dogan Esra Inan

机构信息

Department of Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, USA.

Department of Otolaryngology-Head and Neck Surgery, Tepecik Training and Research Hospital, Health Sciences University, Izmir, TUR.

出版信息

Cureus. 2023 Sep 8;15(9):e44882. doi: 10.7759/cureus.44882. eCollection 2023 Sep.

Abstract

Introduction Alopecia areata (AA) is an autoimmune disorder causing hair loss, including eyebrows, eyelashes, and body hair, primarily due to melanocyte impact. Though the precise AA melanocyte hearing loss mechanisms are not fully clear, it's speculated that cochlear melanocyte inflammation could disrupt endolymph production, which is necessary for sound signal transmission. Cochlear melanocytes maintain crucial potassium ion levels, which are pivotal for hearing. The potential AA-melanocyte-hearing loss link underscores the need to monitor auditory and cochlear function and consider interventions for AA-related hearing challenges. The study aimed to assess auditory and cochlear function using OAE and audiometry measurements to correlate disease severity and duration with OAE outcomes. Materials and methods In this study, we included 32 patients diagnosed with AA; the control group consisted of 29 healthy volunteers. We collected data on the patient's age, gender, onset age, family history, and disease duration. Audiological and otological evaluations were conducted, including pure tone audiometry (PTA), speech discrimination test (SD), and otoacoustic emission (DPOAE) measurements at frequencies of 500, 1000, 2000, 4000, 6000, 8000, and 10000 Hz. The patients were divided into two groups based on age: 18-25 and over 25 years old, and all parameters were compared. To examine differences between the right and left ears, gender, and age groups, we initially tested the variables for normal distribution using the Kolmogorov-Smirnov and Shapiro-Wilk tests. An independent sample t-test was conducted to compare the means for normally distributed variables. Results There were statistical differences at the 5% significance level in the mean DPOAE values of the 1 KHz SNR and 6 KHz SNR variables. According to the Mann-Whitney U test results, a significant difference was found in the gender-based DPOAE value at 2 kHz SNR (p=0.041), which was lower in men than women. Although there were no significant differences in the audiological parameters based on age, significant differences were found in the otoacoustic emission values. Variables, including 4 kHz DP1 (p=0.049), 500 Hz SNR (p=0.045), and 1 kHz SNR (p=0.023), differed significantly between age groups, with these values being lower in patients over 25 years old. Conclusion Overall, our study contributes to the growing body of evidence supporting an association between AA and auditory dysfunction, emphasizing the need for comprehensive assessment and management of hearing-related issues in individuals with AA.

摘要

引言

斑秃(AA)是一种自身免疫性疾病,主要由于黑素细胞受到影响,导致包括眉毛、睫毛和身体毛发在内的脱发。虽然AA导致黑素细胞听力损失的确切机制尚不完全清楚,但据推测,耳蜗黑素细胞炎症可能会破坏内淋巴的产生,而内淋巴是声音信号传输所必需的。耳蜗黑素细胞维持着至关重要的钾离子水平,这对听力至关重要。AA与黑素细胞听力损失之间的潜在联系强调了监测听觉和耳蜗功能以及考虑针对与AA相关的听力挑战进行干预的必要性。本研究旨在使用耳声发射(OAE)和听力测定测量来评估听觉和耳蜗功能,以将疾病严重程度和持续时间与OAE结果相关联。

材料和方法

在本研究中,我们纳入了32例被诊断为AA的患者;对照组由29名健康志愿者组成。我们收集了患者的年龄、性别、发病年龄、家族史和疾病持续时间的数据。进行了听力学和耳科学评估,包括纯音听力测定(PTA)、言语辨别测试(SD)以及在500、1000、2000、4000、6000、8000和10000Hz频率下的畸变产物耳声发射(DPOAE)测量。患者根据年龄分为两组:18 - 25岁和25岁以上,对所有参数进行了比较。为了检查右耳和左耳、性别和年龄组之间的差异,我们首先使用Kolmogorov - Smirnov和Shapiro - Wilk检验测试变量是否呈正态分布。对呈正态分布的变量的均值进行独立样本t检验。

结果

在1kHz信噪比和6kHz信噪比变量的平均DPOAE值方面,在5%显著性水平上存在统计学差异。根据Mann - Whitney U检验结果,在2kHz信噪比时基于性别的DPOAE值存在显著差异(p = 0.041),男性低于女性。虽然基于年龄的听力学参数没有显著差异,但在耳声发射值方面发现了显著差异。包括4kHz DP1(p = 0.049)、500Hz信噪比(p = 0.045)和1kHz信噪比(p = 0.023)在内的变量在年龄组之间存在显著差异,25岁以上患者的这些值较低。

结论

总体而言,我们的研究为支持AA与听觉功能障碍之间关联的越来越多的证据做出了贡献,强调了对AA患者听力相关问题进行全面评估和管理的必要性。

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