Otolith function assessment in patients with systemic sclerosis

Introduction: Audiovestibular dysfunction has been reported in connective tissue disease patients. Evaluation of the otolith organ function as a part of the vestibular system of the inner ear in systemic sclerosis (SSc) patients is still greatly uncovered in the literature.Aim of work: To assess otolith function in SSc patients and to correlate the findings with the clinical characteristics and disease severity.Patients and methods: Thirty SSc patients and 30 matched controls were included in this work. All patients were subjected to full history taking, clinical examination, assessment disease severity by modified Rodnan skin score (mRss), relevant laboratory and radiological tests. All patients had otolith function assessment using Vestibular Evoked Myogenic Potentials (VEMP) and auditory assessment done using pure tone audiometry (PTA), speech audiometry and tympanometry.Results: Auditory assessment revealed bilateral sensorineural hearing loss (SNHL) in 11 (36.6%) patients an abnormal VEMP response was found in 24 (80%). The mean latencies of P13 and N23 were significantly prolonged than in the controls (p < 0.001). Sine scleroderma subtype was significantly more frequent in SSc patients with normal VEMP (p = 0.04). Skin thickening was significantly more frequent in those with abnormal VEMP (p = 0.04) and the mRss score was also significantly increased (p = 0.007). Those with hearing loss were significantly older in age (p = 0.03) and had a significantly longer disease duration (p = 0.01) and had a significantly increased frequency of digital pitting (p = 0.02) and ulcers (p = 0.03) compared to those with normal hearing.Conclusion: Our results showed an evidence of inner ear involvement in SSc causing audiovestibular abnormalities. (C) 2014 Production and hosting by Elsevier B.V. on behalf of Egyptian Society of Rheumatic Diseases.