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Alopecia areata linked to hearing loss

Photo by Kevlaraz via Wikimedia Commons

A recent study found a link between alopecia areata (AA) and cochlear dysfunction leading to hearing loss. The authors of the paper, published in Cureus, say their findings suggest more comprehensive assessment and management of hearing capabilities in patients with AA may be needed.

According to a press release, this study represents the first documented evidence of hearing loss in AA using otoacoustic emission (DPOAE) measurements. The authors noted that the results will strengthen the relationship between sensorineural hearing loss and autoimmune conditions.

Researchers write that while AA primarily involves hair loss due to melanocyte overactivity, the precise role that AA melanocytes play in hearing loss is not fully clear. They suggest cochlear melanocyte inflammation may disrupt endolymph production, a key factor in sound signal transmission. Cochlear melanocytes also maintain potassium ion levels, which are also important for hearing. The study sought to clarify the association between AA and hearing loss using DPOAE measurements.

The researchers included 32 patients with AA—26 males and 6 females—and a control group of 29 healthy volunteers. Fifteen of the patients with AA were between the ages of 18 and 25 years, and the other 17 were 25 years or older.

To measure audiological and ontological response, the investigators conducted pure tone audiometry (PTA), speech discrimination test (SD), and DPOAE measurements at seven different frequencies (500 Hz, 1,000 Hz, 2,000 Hz, 4,000 Hz, 6,000 Hz, 8,000 Hz, and 10,000 Hz). They also used Kolmogorov-Smirnov and Shapiro-Wilk tests to assess differences between the right and left ears, gender, and age groups.

Investigators found no significant differences in audiological measurements between the AA and control groups for 1,000 Hz, 2,000 Hz, 4,000 Hz, and 8,000 Hz (p>0.05). However, they found statistically significant differences in the mean DPOAE values for 1,000 Hz signal-to-noise ratio (SNR; p=0.03) and 6,000 Hz SNR variables (p=0.027).

There were also gender-based differences in DPOAE values observed at 2,000 Hz SNR (p=0.041), with men having lower values than women.

Regarding otoacoustic emission values, the authors found patients older than 25 years had lower values for 4,000 Hz (p=0.049) and 1,000 Hz SNR (p=0.023). The Mann-Whitney U test revealed that the 500 Hz SNR demonstrated a significant difference across age groups at a 5% significance level. This was also found to be lower in patients older than 25 years of age.

The authors emphasized the importance of monitoring auditory and cochlear function in individuals with AA, saying that early detection and treatment of hearing loss can help prevent further damage and improve patient quality of life.

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