02380caa a2200193   4500008004100000022001400041100002300055245011400078260001900192270008700211300001100298490001500309520170700324700002302031700001802054700002002072773004802092856004602140210629s9999    xx            000 0 und d  a0937-4477  aNiraj Kumar Singh  0aAltered auditory and vestibular functioning in individuals with low bone mineral density: a systematic review  bSpringerc2017  aAll India Institute of Speech and Hearing, Manasagangothri, Mysuru, 570 006, India  a1–10  vVolume 270  aAlteration in the process of bone remodelling is associated with falls and fractures due to increased bone fragility and altered calcium functioning. The auditory system consists of skeletal structures and is, therefore, prone to getting affected by altered bone remodelling. In addition, the vestibule consists of huge volumes of calcium (CaCO3) in the form of otoconia crystals and alteration in functioning calcium levels could, therefore, result in vestibular symptoms. Thus, the present study aimed at compiling information from various studies on assessment of auditory or vestibular systems in individuals with reduced bone mineral density (BMD). A total of 1977 articles were searched using various databases and 19 full-length articles which reported auditory and vestibular outcomes in persons with low BMD were reviewed. An intricate relationship between altered BMD and audio-vestibular function was evident from the studies; nonetheless, how one aspect of hearing or balance affects the other is not clear. Significant effect of reduced bone mineral density could probably be due to the metabolic changes at the level of cochlea, secondary to alterations in BMD. One could also conclude that sympathetic remodelling is associated with vestibular problems in individual; however, whether vestibular problems lead to altered BMD cannot be ascertained with confidence. The studies reviewed in the article provide an evidence of possible involvement of hearing and vestibular system abnormalities in individuals with reduced bone mineral density. Hence, the assessment protocol for these individuals must include hearing and balance evaluation as mandatory for planning appropriate management.  aAditi Gargeshwari   aPrawin Kumar   aRaghav Hira Jha  aEuropean archives of oto-rhino-laryngology   uhttps://doi.org/10.1007/s00405-017-4768-4