Cochlear and vestibular functions in patients with alopecia areata

Purpose: Follicular melanocytes are known to be damaged in alopecia areata (AA). However, it is not clear whether melanocytes are the primary target of autoimmunity and whether melanocytes in the inner ear are affected. This study aimed to detect possible cochlear and/or vestibular melanocyte damage in AA patients. Methods: Thirty-two AA patients and 35 sex- and age-matched healthy volunteers were evaluated. The conventional pure tone audiometry test and distortion product otoacoustic emission test were performed to evaluate hearing. To evaluate the vestibular function, the following tests were performed: the vestibulospinal reflex tests (Romberg test, tandem stance test and tandem walking test); positional balance tests (Dix-Hallpike test, supine roll test and head hanging test); vestibulo-ocular reflex tests (caloric test, head shake test) and oculomotor tests (saccade, smooth pursuit and optokinetic). Results: There were no significant differences in the results of the hearing and balance tests between the groups. Furthermore, disease parameters were not associated with audiovestibular findings. Conclusion: AA patients did not exhibit hearing loss or balance abnormalities that would indicate cochlear and vestibular melanocyte damage. The lack of damage to the inner ear melanocytes in AA patients may indicate that follicular melanocytes are affected secondary to autoimmune damage in the hair bulb, and melanocytes are not the primary target in the pathogenesis of AA.