Vitiligo and its association with hypoacusis: A case control study

Vitiligo is a pigmentary disorder with absence of functional melanocytes in the affected area. Melanocytes originate from neural crest and migrate to rest of the body in a cephalo-caudal manner in the embryonic life. Apart from epidermis and hair bulb in skin, they are also present in leptomeninges, inner ear, retina and uveal tract. In the inner ear melanocytes are present in endolymphatic sac, hair cells, vestibular organ and striavascularis. Vitiligo is not just skin deep and is also responsible for subclinical hypoacusis in majority of patients. Patients suffering from vitiligo affecting the head and neck region at the time of origin are more prone to the auditory dysfunction. Leucotrichia is another association with asymptomatic sensori-neural hypoacusis. This is due to the loss of melanocytes which have a protective role in inner ear. TEOAE and Pure tone audiometry can be used effectively for screening patients and these patients should be informed regarding the noise exposure and ototoxic drugs.