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Audiovestibular symptoms in systemic sclerosis: a systematic review and meta-analysis
Craig D Salvador1, Brian A Keith1, Celine Ward1
1Medical University of South Carolina, 135 Rutledge Ave, Charleston, SC, 29425, USA.
Summary
Patients with systemic sclerosis (SSc) experience more tinnitus, vertigo, and hearing loss than controls. While statistically significant, these audiological and vestibular issues may not be clinically significant, warranting further assessment.
Area of Science:
- Otolaryngology
- Rheumatology
- Systemic Sclerosis Research
Background:
- Systemic sclerosis (SSc) is a complex autoimmune disease with potential multi-organ involvement.
- Audiovestibular pathologies are increasingly recognized as a complication in SSc patients.
- Understanding the prevalence and presentation of these symptoms is crucial for patient management.
Purpose of the Study:
- To determine if patients with systemic sclerosis (SSc) have a higher prevalence of audiovestibular pathology compared to non-SSc patients.
- To characterize the symptomatic and testing-based presentation of audiovestibular issues in SSc.
- To answer a PICO question regarding audiovestibular pathology in SSc.
Main Methods:
- A systematic review and meta-analysis of studies published up to November 27, 2023.
- Searched databases including PubMed, Scopus, CINAHL, and Cochrane Library.
- Included studies with SSc patients and audiovestibular symptoms; excluded studies without relevant outcomes or with fewer than four patients.
Main Results:
- Thirteen studies involving 414 SSc patients and 390 controls were analyzed.
- SSc patients reported significantly higher rates of tinnitus (34.1%), vertigo (32.4%), and subjective hearing loss (26.0%) compared to controls.
- Data on vestibular testing was insufficient for meta-analysis due to incomplete reporting.
Conclusions:
- Systemic sclerosis patients exhibit statistically significant, though not clinically significant, hearing impairment compared to controls.
- Increased subjective audiological and vestibular symptoms in SSc patients highlight the need for interdisciplinary care.
- Assessment for audiovestibular pathologies should be considered in SSc patients within an appropriate clinical context.
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