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Öğe Assessment of balance skills and falling risk in children with congenital bilateral profound sensorineural hearing loss(Elsevier Ireland Ltd, 2019) Soylemez, Emre; Ertugrul, Suha; Dogan, ErkanObjective: To evaluate the balance skills and falling risk in children with a congenital bilateral profound sensorineural hearing loss (CBPSNHL). Methods: 25 children with CBPSNHL and healthy 25 children with similar age and gender were included in the study. The flamingo balance test, the tandem stance test, and the one-leg standing test were performed to assess the patients' static balance skills. The pediatric balance scale (PBS) was used to evaluate the dynamic balance. Visual analog scale (VAS) was applied to the patients assess the frequency of falls. Results: The flamingo balance test, the tandem stance test, and the one-leg standing test in the children with CBPSNHL were all significantly worse than the control group. Although the scores of PBS in patients with CBPSNHL were significantly lower than the control group (p < 0.001), the results of both groups were consistent with a low risk of falls. There was no significant difference between the VAS scores indicating the frequency of falls among the groups (p = 0.552). Conclusion: Static and dynamic balance skills of the children with CBPSNHL are significantly impaired compared to their healthy peers. Children with CBPSNHL also have a lower risk of falling just like their healthy peers and there is no significant difference between their falling frequencies. Balance skills of children with CBPSNHL can be assessed quickly and effectively on a hard floor (eyes closed), with a tandem standing test or a one-leg standing test.Öğe Assessment of temporal auditory processing in individuals with misophonia(Wolters Kluwer Medknow Publications, 2023) Ila, Kadri; Soylemez, Emre; Yilmaz, Nihat; Ertugrul, Suha; Turudu, Soner; Karaboya, Engin; Adigul, CaglayanObjectiveMisophonia is characterised by abnormal reactions to certain sounds such as sounds of eating, breathing, nose sniffing. Misophonia can be seen in individuals with normal hearing or hearing loss. The aim of this study to evaluate central auditory processing in misophonia patients with temporal processing tests, such as the Frequency Pattern Test (FPT), Duration Pattern Test (DPT), and Gaps-in-Noise Test (GIN).MethodsThirty patients with misophonia and 30 healthy control subjects were included in this study. The pure tone audiometry test, tympanometry test, and acoustic reflex test were administered to all participants. The DPT, FPT, and GIN tests were conducted with all participants.ResultsThere was no significant difference in the DPT scores between the two groups for both ears (p > .05). There was no significant difference in the FPT scores between the two groups for both ears (p > .05), and there was no significant difference in the GIN scores and GIN threshold (p > .05).ConclusionsThere was no difference between the healthy individuals and the misophonia patients when the temporal process of central auditory processing was evaluated.Öğe Association Between Chronic Rhinosinusitis and The Vestibular System(Deomed Publ, Istanbul, 2019) Ila, Kadri; Soylemez, Emre; Yilmaz, Nihat; Eshraghi, Adrien A.Objective: Objective: Chronic rhinosinusitis (CRS) is inflammation of the nasal mucosa and paranasal sinuses. Subjective complaint of dizziness can be observed in patients with CRS. However, a review of the literature did not reveal any prospective studies that have used videonystagmography (VNG) to examine the vestibular system of patients with CRS. The goal of this study is the evaluation of the vestibular system of CRS patients. Methods: The study comprised 30 patients with CRS and 30 control subjects. The vestibular system was evaluated through VNG. The association with vestibular function was evaluated according to the Lund-Mackay score, the Sino-Nasal Outcome Test-22 (SNOT-22) score, and the existence of nasal polyps. Results: Abnormal caloric test results were observed in eight (26.6%) of the 30 CRS patients. The caloric test results were normal for the control group. The oculomotor test results with VNG were normal for the CRS and control groups. The abnormal caloric results were higher for the CRS with nasal polyp patients than for the CRS without nasal polyp patients. The VNG showed no correlation among the SNOT-22 scores and the Lund-Mackay scores in patients with CRS. Conclusion: Abnormal caloric responses can be observed in patients with CRS with nasal polyps.Öğe Auditory evoked brainstem responses and medial olivocochlear efferent system in migraine patients with phonophobia(Taylor and Francis, 2024-11-20) Soylemez, Emre; Apaydin, Aydın Sinan; Soylemez, Tugce Gurel; Farhoomand, Borna; Ceylan, DursunObjective: This study aims to investigate Auditory Evoked Brainstem Responses (ABR) and Distortion Product Otoacoustic Emission (DPOAE) suppression in migraine patients with and without phonophobia. Methods: Thirty-two migraine patients with normal hearing and 30 healthy individuals were included in the study. Migraine characteristics and phonophobia status of migraine patients were noted. The patients were divided into two groups according to their phonophobia status. All participants underwent ABR, DPOAE and DPOAE suppression. Results: Migraine patients had less DPOAE suppression (1481 and 2222 hz) and shorter ABR wave latencies compared to the control group (p < 0.05). Twelve (37.5%) of the migraine patients did not have phonophobia, and 20 (62.5%) had phonophobia. Phonophobia was not found to affect DPOAE suppression (p > 0.05). However, ABR wave I and V latencies in migraine patients with phonophobia were shorter than in healthy individuals (p < 0.05). Conclusion: There are changes in the auditory evoked brainstem responses and medial olivocochlear efferent system of migraine patients. While phonophobia in migraine patients does not affect the medial olivocochlear efferent system, it may affect auditory evoked brainstem responses.Öğe Chronic Noise Affects Middle Ear Resonance and Absorbance in Industrial Workers(Aves, 2022) Yilmaz, Nihat; Soylemez, Emre; Soylemez, Tugce; Sanuc, Merve Betul; Yilmaz, OrhanBACKGROUND: The effect of chronic noise on the middle ear is not fully known. This study aimed to evaluate the middle ear functions of metal workers exposed to chronic noise using wideband tympanometry. METHODS: In this study, 62 male workers exposed to chronic noise and 30 healthy men were included. Workers exposed to chronic noise were divided into 2 groups according to their pure tone averages. Totally 30 workers (60 ears) with pure tone average less than 20 dB were included in group I, and 32 workers (64 ears) with pure tone average more than 20 dB were included in group II. All individuals were subjected to wideband tympanometry. Tympanometric peak pressure, equivalent ear canal volume, static acoustic admittance, resonance frequency, and absorbance ratios at peak pressure and ambient pressure values were analyzed. RESULTS: There was no difference between the groups in terms of traditional tympanometric parameters such as tympanometric peak pressure, equivalent ear canal volume, and static acoustic admittance (P >.05). Resonance frequency of workers exposed to chronic noise (group I and group II) was lower than the control group (P <.05). The absorbance ratios of workers exposed to chronic noise at approximately 4 kHz were lower in both peak pressures and ambient pressures (P <.05). CONCLUSION: Chronic noise does not only damage the inner ear but also causes changes in the middle ear structures. Wideband tympanometry can be used to detect minor auditory damage due to noise that cannot be detected by audiogram early. In this way, necessary measures can be taken in the early period before noise-induced hearing loss occurs.Öğe Clinical Characteristics of Patients with Dizziness According to the Level of Dizziness-related Disability(Modestum Ltd, 2021) Soylemez, Emre; Ertugrul, SuhaObjective: This study aims to evaluate the clinical characteristics of patients with dizziness according to the level of dizziness-related disability. Methods: Vestibular system evaluation forms of the patients who applied to the otolaryngology outpatient clinic between June 2018 and January 2020 were reviewed retrospectively. Ninety patients with dizziness complaints were included in the study. These patients were divided into 3 groups as mild disability, middle disability and severe disability according to the Dizziness handicap inventory (DHI). Demographic characteristics, comorbidity, smoking and alcohol use, motion sickness, duration of dizziness, type of dizziness and vestibular test results (Fukuda test, tandem stance test, tandem walking test, positional tests, head impulse test (HIT), head shake test, caloric test, gaze test, oculomotor tests and spontaneous nystagmus test) were evaluated according to the level of dizziness-related disability. Results: Twenty-one of the patients were male (21.3%), 69 (78.7%) were female and the mean age was 40.54 +/- 12.91; (range 15-73). Patients with cervical disc herniation, motion scikness, abnormal HIT, abnormal tandem stance test and prolonged dizziness had more severe dizziness-related disability level (p<0.05). There was also a mild positive relationship between age and functional disability (p<0.05). Conclusion: Patients with motion sickness, cervical disc herniation, prolonged dizziness, abnormal tandem posture test and abnormal HIT have a more severe disability. These factors should be considered in dizziness therapies applied to decrease vestibular symptoms and improve quality of life.Öğe COGNITIVE AND MOTOR PERFORMANCES IN DUAL TASKS IN OLDER ADULTS WITH CHRONIC NECK PAIN: A RANDOMIZED CONTROLLED CLINICAL TRIAL(Turkish Geriatrics Soc, 2023) Apaydin, Aydin Sinan; Soylemez, EmreAim: There is limited information on dual-task performance in older individuals with chronic neck pain. This study aims to investigate cognitive and motor performances during dual tasks in older adults with chronic neck pain. Methods: Thirty-five older adults with chronic neck pain and 35 older adults without neck pain were included in the study. The timed up and go test evaluated individuals' single-task performance. To assess the dual-task performances of the groups, the individuals were given motor and cognitive (forward and backward digit span) tasks simultaneously with the timed up and go test. During cognitive dual-task, the cognitive performances of individuals were evaluated and the duration of their timed up and go test was recorded. Results: There was no difference between the groups in terms of singletask timed up and go test (p >0.05). There was also no difference between the groups in terms of cognitive-forward and cognitive-backward (p >0.05). However, cognitive performance of the chronic neck pain group during dual-task was worse than that of the control group (p <0.05). Additionally, the motor dual-task of older adults in the chronic neck pain group was worse than the control group (p <0.05). Conclusion: Older adults with chronic neck pain struggle more in motor dual-task situations than asymptomatic older adults. Therefore, gait assessment with a motor dual task should be performed for older adults with chronic neck pain. In addition, during cognitive dual-task conditions, the cognitive performance of older adults should be evaluated in addition to their gait performance.Öğe The Effect of Repositioning Maneuver Applied with the TRV Chair on Residual Dizziness after Benign Paroxysmal Positional Vertigo(Lippincott Williams & Wilkins, 2023) Soylemez, Emre; Bolat, Kubra Binay; Karakoc, Kursad; Can, Mehmet; Basak, Hazan; Aydogan, Zehra; Tokgoz-Yilmaz, SunaObjectiveThis study aims to investigate the effect of TRV chair on residual dizziness (RD) after idiopathic posterior semicircular canal benign paroxysmal positional vertigo (BPPV) successfully treated with canalith repositioning maneuver (CRM).Study DesignProspective case-control study.SettingHospital.PatientsThirty-three patients with posterior canal BPPV were included in the study. These patients were divided into two identical groups. CRM was applied to the first group with a TRV chair (TRV group) and manually to the second group (manual group).InterventionsDizziness Handicap Inventory (DHI), Beck Anxiety Inventory (BAI), and video head impulse test were applied to the patients. Patients in both groups were asked to report the RD developed after successful CRM daily by visual analog scale (VAS).ResultsThe TRV group's first-day RD rate was 94.1% with VAS, and the RD duration was 2.47 & PLUSMN; 1.77 (0-7) days. The manual group's first-day RD rate was 100%, and the RD duration was 3.38 & PLUSMN; 1.70 (1-7) days. There was no difference between the groups in terms of RD duration (p > 0.05). Mean RD severity and severity in the first 3 days were lower in the TRV group compared with the manual group (p < 0.05). There was no difference between the groups on other days (p > 0.05). In addition, there was a positive correlation between RD and DHI and BPPV duration (p < 0.05).ConclusionRD is a multifactorial symptom associated with how the repositioning maneuver is performed, BPPV duration, and DHI. Performing the repositioning maneuver with the TRV chair can reduce the severity of RD.Öğe Effectiveness of hearing protection apparatus in preventing noise induced vestibular loss(Taylor & Francis Ltd, 2022) Ertugrul, Suha; Soylemez, Emre; Gurel, TugceHearing protection apparatus (HPAs) are frequently used to prevent the detrimental effect of noise on the hearing system. However, it is not known exactly whether wearing HPAs in workers protects the vestibular system. This study aims to investigate the effectiveness of wearing HPAs in preventing vestibular loss caused by noise. Eighty-one workers exposed to chronic noise were divided into three groups according to their HPAs wearing status. Pure-tone audiometry test was used to evaluate the hearing. Caloric test and visual analogue scale were used to evaluate their vestibular systems. The pure-tone average of the workers who constantly wore HPAs was better than that of the other groups (p< 0.05). There was no difference between the groups in the vestibular tests (p > 0.05). This study demonstrated that HPAs do not protect the vestibular system but protect the hearing system in the inner ear from the harmful effects of noiseÖğe Evaluation of audiovestibular system in psoriasis patients without joint involvement(Wiley, 2020) Ertugrul, Goksen; Ertugrul, Suha; Soylemez, EmreInner ear involvement may occur in systemic autoimmune diseases. Although there are studies evaluating hearing in psoriasis patients, its effect on the balance system is not clear. The aim of the present study was to evaluate the audiovestibular system in psoriasis patients without joint involvement. In this prospective study, the audiovestibular system of 32 psoriasis patients without joint involvement and 35 healthy volunteers were evaluated. The severity of the disease was determined by the psoriasis area severity index (PASI). There was no significant difference between the groups in terms of hearing test results, while the abnormal caloric test response was significantly higher in the psoriatic patients. PASI scores of psoriasis patients with abnormal caloric test results were higher than those with normal caloric test response. In psoriasis patients without joint involvement, the hearing was not affected, but the vestibular system was. The severity of the disease was associated with vestibular involvement. Particularly in patients with severe psoriasis, it must be considered that the vestibular system might be affected, and vestibular evaluations should be performed.Öğe Evaluation of vestibular system with vHIT in industrial workers with noise-induced hearing loss(Springer, 2018) Yilmaz, Nihat; Ila, Kadri; Soylemez, Emre; Ozdek, AliPurposeIndustrial workers are frequently exposed to noise and the noise can cause hearing loss. The relationship between vestibular abnormalities and long-term exposure to occupational noise has been reported. The aim of this study was to use vHIT (video head impulse test) to evaluate the semicircular canal's function in industrial workers with noise-induced hearing loss.MethodsIn the present study, we included 36 male patients (aged 28-55years, mean 44.46.1years) with hearing loss due to noise exposure from working in the steel and metal industry for at least 4years, and a control group of 30 healthy men (aged 34-50years, mean 41.14.5years) without hearing loss. The gain of the vestibulo-ocular reflex for all 6 semicircular canals was examined by vHIT in 66 patients.Results p id=Par3 Canal deficit was detected in 20 (55.5%) of 36 patients in the noise exposure hearing loss group and was detected in 2 (6.6%) of 30 participants in the control group. There was significant loss of capacity for VOR gain in patients with noise exposure hearing loss.Conclusions p id=Par4 In the present study we found that exposure to noise can cause vestibular dysfunction. And the vHIT is easily applicable, quick and practical and can individually evaluate all semicircular channels. Therefore, to evaluate vestibular function with vHIT is quick and practical.Öğe Excessive smartphone use increases self-reported auditory and vestibular symptoms(Springer Wien, 2024) Soylemez, Emre; Dag, Mehmet; Ilgaz, Abdulkadir; Korkmaz, Bekir; Topcuoglu, Umit; Koc, Ahmet Dueha; Ensari, SerdarBackground With widespread smartphone use, there is growing concern about their potential impact on human health. Objective The effects of smartphone use on self-reported hearing ability, tinnitus, balance, falls, and anxiety level were investigated in this study. Methods This study included 682 participants who were divided into 2 groups: a high smartphone use (HSU) group and a low smartphone use (LSU) group. Both groups were evaluated for hearing ability using the Amsterdam inventory for auditory disability and handicap; balance status using the vertigo, dizziness, imbalance symptom scale; anxiety status using the Beck anxiety index; and fall and tinnitus status using the visual analog scale. Results The HSU group showed significantly worse hearing ability, tinnitus, balance, falling, and anxiety status results than the LSU group (p < 0.001). There was a positive correlation between smartphone addiction severity and auditory impairment, tinnitus, risk of falling, and anxiety, as well as a negative correlation with balance score (p < 0.001). Conclusion The findings suggest that individuals with excessive smartphone use are more likely to experience hearing, tinnitus, balance, falling, and anxiety problems than those who use smartphones less frequently. Excessive smartphone use may be considered a potential risk factor for these problems.Öğe Explosion in hearing aid demands after Covid-19 outbreak curfew(Springer, 2021) Ertugrul, Suha; Soylemez, Emre[No abstract available]Öğe Investigation of hearing and outer hair cell function of the cochlea in patients with vitiligo(Wiley, 2020) Ertugrul, Goksen; Ertugrul, Suha; Soylemez, EmreVitiligo is a systemic disease that affects not only the skin but also other areas that contain melanocytes, such as the inner ear. Studies of the effect of vitiligo on hearing loss have shown inconsistent results, and it is not clear which parameters related to the disease affect hearing. The aim of this study was to determine which disease-related parameters trigger damage to cochlear melanocytes in vitiligo patients and the effect of vitiligo on the outer hair cells and hearing. Thirty-one vitiligo patients and 40 sex- and age-matched healthy volunteers were evaluated. The conventional pure tone audiometry (C-PTA) test and the distortion product otoacoustic emission (DPOAE) test were performed. There was no significant difference between vitiligo patients and controls in C-PTA test results, but the DPOAE test results were abnormal in vitiligo patients. The duration of the disease was significantly related to hypoacusis. As the duration of the disease increases, cochlear dysfunction may increase. Especially in patients with longer disease duration, otoacoustic emission tests should be performed in addition to conventional audiometry tests for early detection of damage to the outer hair cells.Öğe Investigation Of The Factors Affecting The Success Of Vestibular Rehabilitation Therapy In Patients With Idiopathic Unilateral Vestibular Hypofunction And Idiopathic Bilateral Vestibular Hypofunction(Deomed Publ, Istanbul, 2019) Ertugrul, Suha; Soylemez, EmreObjective: The aim of this study was to determine the factors affecting the success of vestibular rehabilitation therapy (VRT) in patients with idiopathic unilateral vestibular hypofunction (UVH) and idiopathic bilateral vestibular hypofunction (BVH). Methods: 30 patients with idiopathic UVH and 30 patients with idiopathic BVH were included in this prospective study. Visual analog scale (VAS) was used to evaluate the severity of the patients' complaints of dizziness. The duration of the complaint of dizziness was recorded. All patients underwent the Dizziness Handicap Inventory (DHI) before and after VRT. The severity, duration, and localization (unilateral/bilateral) of the vestibular hypofunction were compared with the efficacy of VRT. Results: A significant decrease in DHI scores was observed after VRT for both, UVH and BVH patients, as compared to their pre-VRT scores (p<0.001). There was no significant difference in the efficacy of vestibular rehabilitation therapy in patients with UVH and BVH (p=0.09). As the VAS scores increased and the duration of the complaint lengthened, the efficacy of VRT decreased significantly (p<0.001/r=5.6, p=0.016/r=3.1, respectively). Conclusion: VRT is an effective treatment for the relief of symptoms in both UVH and BVH patients. Unilateral or bilateral vestibular hypofunction does not affect the efficacy of VRT, whereas prolonged or severe symptoms of dizziness affect the effectiveness of VRT negatively. In idiopathic vestibular hypofunction patients with long-standing and/or severe dizziness complaints, VRT should be initiated immediately and continued longer.Öğe Potential Risk of Benign Paroxysmal Positional Vertigo Due To Traumatic Effect of Osteotomy in Septorhinoplasty Patients(W B Saunders Co-Elsevier Inc, 2020) Ertugrul, Suha; Abaci, Malik; Soylemez, EmrePurpose: We investigated the effect of osteotomy on the vestibular system in septorhinoplasty patients and determined the potential risk of benign paroxysmal positional vertigo (BPPV) in these patients. Patients and Methods: In the present prospective study, 47 primary septorhinoplasty patients were evaluated as the study group and 50 septoplasty patients as the control group. Osteotomy was performed in all septorhinoplasty patients. No hammer and osteotomes were used in the control group. All patients underwent static balance tests (tandem stance test, 1-leg standing test, and Romberg test), dynamic balance tests (tandem walking test and Fukuda test), positional balance tests (Dix-Hallpike test and supine roll test), head impulse test, and the adult dizziness handicap inventory (ADHI) preoperatively and during the first postoperative week. Results: No significant differences were found between the 2 groups in terms of the static balance tests, dynamic balance tests, positional balance tests, or head impulse test results. The postoperative ADHI scores were significantly worse in the septorhinoplasty patient group than in the control group. Posterior semicircular canal BPPV was observed in 2 patients in the septorhinoplasty group but none in the control group. Conclusions: BPPV is one of the possible early postoperative complications of rhinoplasty. In patients with vertigo after rhinoplasty, surgeons should evaluate the semicircular canals using the Dix-Hallpike and supine roll tests. To avoid the traumatic effect of osteotomy reflected on the inner ear, attention should be given to the applied force, and sharp osteotomes should be used. (C) 2019 American Association of Oral and Maxillofacial SurgeonsÖğe Quality of life and self-reported symptoms in workers exposed to excessive noise(2024) Soylemez, Emre; Karakaya, Cihangir; Yılmaz, NihatObjective: Noise can cause physiological and psychological changes by affecting human health. This study aims to investigate the quality of life and self-report symptoms of tinnitus, hearing loss, dizziness, sleep, attention, anxiety and fatigue in workers exposed to excessive noise. Material and Methods: The study included 111 workers working in noisy environments and 74 individuals not working in noisy environments (control group). The Short Form (SF)-36 scale was used to evaluate the participants' quality of life, and the visual analogue scale (VAS) was used to assess the self-report symptoms. Result: Self-report tinnitus, hearing loss, dizziness, sleep, attention and anxiety scores of the workers were worse than the control group (p<0.05). In addition, the physical function, physical role restriction, social functionality, pain and general health scores of the workers, which are the sub-dimensions of SF-36, were worse than the control group (p<0.05). However, there was no difference between the groups in terms of emotional role, mental health, and energy/vitality scores (p>0.05). Conclusion: Noise increases workers' self-report symptoms and reduces their quality of life. By taking more precautions against workplace noise, workers' health and working performance can be protected.Öğe Severity of dizziness increased in dizzy patients during Covid-19 process(Routledge Journals, Taylor & Francis Ltd, 2021) Soylemez, Emre; Ertugrul, Suha[No abstract available]Öğe Sound energy absorbance changes in the elderly with presbycusis with normal outer and middle ear(Springer, 2023) Yilmaz, Nihat; Soylemez, Emre; Sanuc, Merve Betul; Bayrak, Muhammed Harun; Sener, VeyisObjective This study aimed to investigate the wideband tympanometry (WBT) findings in the elderly with presbycusis who have normal outer and middle ears according to otoscopic examination and traditional tympanometry, and to determine whether there is a relationship between the middle ear wideband absorbance value and the pure tone air-bone gap (ABG) observed especially at mid-high frequencies in the elderly. Methods The study included 30 elderly with presbycusis (> 65 years old, presbycusis group) and 30 healthy individuals (control group) between the ages of 18 and 55. Pure tone air conduction and bone conduction thresholds of all participants were determined and WBT was applied to all participants. Resonance frequency (RF), absorbance ratios at peak pressure (PPAR) and ambient pressure (APAR) values were analyzed. Results The RF value of the presbycusis group was lower than the control group (p < 0.05). APAR and PPAR values at 2000 and 4000 Hz and mean absorbance values of the presbycusis group were lower than the control group (p < 0.05). APAR was higher at 500 Hz in males than females (p < 0.05), but there was no difference between genders in RFs (p > 0.05). A moderate negative correlation was observed between ABG and both PPAR and APAR at 4000 Hz in presbycusis group (p < 0.05). Conclusion it was determined that there was a decrease in RF and absorbances at 2000 and 4000 Hz in the elderly with presbycusis. Aging affects not only the inner ear but also the conduction mechanism of the middle ear. Our findings may be effective in a more accurate and reliable interpretation of WBT in the elderly with presbycusis.Öğe There is no evidence of cochlear and vestibular melanocyte damage in patients with alopecia areata(Wiley-Hindawi, 2021) Ertugrul, Goksen; Ertugrul, Suha; Soylemez, EmrePurpose 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 between November 2018 and March 2020 at the Karabuk University Training and Research Hospital. 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 The mean age of AA patients was 31.94 +/- 11.86 years (range, 15-67 years). There were no significant differences in the results of the hearing and balance tests between the groups. Furthermore, disease parameters (duration of the last attack, recurrence, positive family history, positive pull test, the severity of the disease, etc) were not associated with hearing loss and vestibular damage. 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.
