Auditory and vestibular manifestations of Vogt-Koyanagi-Harada disease

Introduction and aims: Vogt-Koyanagi-Harada disease is a chronic disorder involving the eye and the central nervous, auditory, vestibular and integumentary systems. This study aimed to determine the auditory and vestibular manifestations of this disease. Methods: Twenty-four patients diagnosed with Vogt-Koyanagi-Harada disease were assessed for auditory and vestibular dysfunction. Results: Uveitis presents in all cases. Sensory hearing loss was present in 50 per cent of cases, tinnitus in 42 per cent, vertigo in 17 per cent and headache in 17 per cent. Nine patients received systemic steroids. Six patients who were treated early regained their hearing, but three patients whose treatment was delayed did not. One patient with bilateral profound hearing loss underwent cochlear implantation, and achieved excellent post-implantation hearing. Conclusion: There is a high incidence of cochlear and vestibular end-organ involvement in patients with Vogt-Koyanagi-Harada disease. The adequacy and timing of treatment has a significant effect on the disease outcome. Vogt-Koyanagi-Harada disease appears to affect the inner ear end-organ. Patients who develop bilateral profound sensory hearing loss are suitable candidates for cochlear implantation.