Tahir Emel, Kan Elif Kılıç, Uştu Esra Kavaz, Küçüköner Asuman
Department of Otolaryngology, School of Medicine, Ondokuz Mayıs University, Kurupelit Cove, Atakum, Samsun, Turkey.
Department of Endocrinology, School of Medicine, Ondokuz Mayıs University, Samsun, Turkey.
Eur Arch Otorhinolaryngol. 2025 Mar;282(3):1179-1188. doi: 10.1007/s00405-024-09009-w. Epub 2024 Oct 2.
Patients with acromegaly may have abnormalities in their hearing and balance as a result of modifications in body composition and involvement of the temporal bone. The objective of this study is to examine if there are any changes in the auditory and vestibular systems in individuals with acromegaly by using audiogram and vestibular function tests.
This prospective study included 33 healthy controls and 33 acromegaly patients who were matched for age and gender distribution. A pure-tone audiometry test was conducted, including frequencies ranging from 250 Hz to 8000 Hz. Videonystagmography (VNG) was employed to assess nystagmus, an essential parameter used for assessing vestibular functions. The Video Head Impulse Test (v-HIT) was used to assess the vestibulo-ocular reflex (VOR). The Dizziness Handicap Inventory (DHI) was applied to evaluate the subjective complaints of the participants.
The acromegaly patients had significantly elevated hearing thresholds at all frequencies (250, 500, 1000, 2000, 4000, and 6000 Hz) compared to the control group (p < 0.005). The VNG tests, including gaze horizontal, gaze vertical, saccade, spontaneous nystagmus, optokinetic, smooth pursuit, and positioning tests, did not show any statistically significant difference between the two groups (p values > 0.05). The patient group demonstrated reduced VOR gains compared to the control group in the anterior and posterior channels (p < 0.005). There was no statistically significant difference between the two groups for the occurrence of aberrant eye movements (p values > 0.05). The patient group had a total DHI score of 6.6 ± 3.2, while the control group had a score of 3.2 ± 2.6 (independent samples t-test; p < 0.001). Therefore, The patient group exhibited significantly greater subjective vestibular symptoms.
Patients with acromegaly experience impaired auditory function. The central vestibular system remains unaffected, while the gains of the vestibulo-ocular reflex (VOR) in the posterior and anterior semicircular canals are decreased. Additionally, these patients report experiencing subjective dizziness. Screening for hearing and balance in patients with acromegaly may improve the quality of life of patients and prevent problems related to balance disorders at an early stage.
肢端肥大症患者可能因身体成分改变和颞骨受累而出现听力和平衡异常。本研究的目的是通过听力图和前庭功能测试，检查肢端肥大症患者的听觉和前庭系统是否有任何变化。
这项前瞻性研究纳入了33名健康对照者和33名年龄和性别分布相匹配的肢端肥大症患者。进行了纯音听力测试，频率范围为250Hz至8000Hz。采用视频眼震图（VNG）评估眼震，这是评估前庭功能的一个重要参数。使用视频头脉冲试验（v-HIT）评估前庭眼反射（VOR）。应用头晕残障量表（DHI）评估参与者的主观症状。
与对照组相比，肢端肥大症患者在所有频率（250、500、1000、2000、4000和6000Hz）的听力阈值均显著升高（p<0.005）。VNG测试，包括水平凝视、垂直凝视、扫视、自发性眼震、视动、平稳跟踪和定位测试，两组之间未显示出任何统计学上的显著差异（p值>0.05）。与对照组相比，患者组在前庭和后庭通道的VOR增益降低（p<0.005）。两组之间异常眼动的发生率无统计学显著差异（p值>0.05）。患者组的DHI总评分为6.6±3.2，而对照组为3.2±2.6（独立样本t检验；p<0.001）。因此，患者组表现出明显更严重的主观前庭症状。
肢端肥大症患者存在听觉功能受损。中枢前庭系统未受影响，而后庭和前庭半规管的前庭眼反射（VOR）增益降低。此外，这些患者报告有主观头晕症状。对肢端肥大症患者进行听力和平衡筛查可能会改善患者的生活质量，并在早期预防与平衡障碍相关的问题。
