Abstract:Tinnitus is a common clinical disorder.Due to its complex pathogenesis and lack of effective treatment,patients with tinnitus suffer from this condition.Sleep disorders are common in tinnitus patients because of its physiological and psychological changes,which can further aggravate tinnitus,seriously impair patients'physical and mental health,and render a profound impact on their quality of life and prognosis.This paper intends to summarize the current information on the epidemiology,influencing factors,assessment methods as well as the hazards and intervention measures in tinnitus with comorbid sleep disorders.We hope to raise attention of clinicians on this problem,and to provide a theoretical basis for future studies on tinnitus and comorbid sleep disorders.

Abstract:Objective To study the correlation between thresholds of electrically evoked auditory brainstem responses(EABRs)and behavioral audiometry(T-values)in Chinese-made cochlear implants users,as related to the feasibility of objectively setting T-values through EABR testing for cochlear implant programming.Methods In users of domestically manufactured cochlear implants(25 ears),the minimum electrical stimulation intensities that could evoke EABRs and induce a behavioral response(T-value)were determined using electrodes No.1,7,13,19 or 24,respectively.The implant was programmed using either the behavioral response threshold(Program ①)or the EABR threshold(Program ②)as the T-value.Aided audiometry thresholds were measured using Programs ① and ②,respectively,and the correlations between the two aided audiometry thresholds and the two T-values were analyzed.Results The wave V latency was(3.30±0.33)ms,(3.41±0.30)ms,(3.52±0.33)ms,(3.59±0.27)ms and(3.54±0.46)ms for electrodes No.1,7,13,19 and 24,respectively,with the T-value set at(83.20±10.40)CL,(89.20±13.52)CL,(101.00±15.48)CL,(102.20±19.26)CL and(110.80±18.97)CL from EABRs,and(79.00±18.91)CL,(80.04±17.04)CL,(86.64±19.38)CL,(90.68±17.37)CL and(104.60±17.91)CL from behavioral responses,respectively;showing a significant correlation between the two sets of T-value(P<0.05),and between aided audiometry thresholds based on the two sets of T-value(P<0.01).Conclusions There is a significant correlation between the electrical stimulation thresholds measured by EABRs and behavioral responses for Chinese-made cochlear implants.EABR testing can be used to assist the programming of domestically manufactured cochlear implants.

Abstract:Sudden sensorineural hearing loss is a high-incidence emergency in otolaryngology.Its pathological mechanism has not been fully elucidated.Clinical observations have found that this disorder is often accompanied by abnormal function of the vestibular system.In recent years,research on vestibular function in patients with sudden sensorineural hearing loss has gradually increased.However,the association between the location and degree of vestibular dysfunction and hearing prognosis has not been fully clarified,and the traditional symptom-dependent assessment model is prone to missed diagnoses.By reviewing mechanisms of vestibular injury,clinical values of functional examination and evidence-based assessment of rehabilitation interventions,this paper aims to provide a theoretical basis for multi-dimensional diagnosis and treatment of sudden sensorineural hearing loss,and to promote standardized application of vestibular function assessment in prognosis prediction.

Abstract:The GATA2 and GATA3 genes play critical roles in inner ear development.Mutations in these genes result in a series of severe clinical symptoms,including deafness.Deafness is highly prevalent in diseases associated with GATA2 and GATA3 mutations,making it a primary focus in defect prevention and control in such conditions.This review discusses the significant roles of GATA2 and GATA3 in inner ear development,the pathogenesis and clinical characteristics of deafness related to their mutations,and targeted prevention and treatment strategies.

Abstract:Objective Sensorineural hearing loss(SNHL)is a common auditory disorder worldwide and may be associated with multiple factors.Recent studies suggest that physical activity(PA)may have a protective effect against SNHL,but the causal relationship remains unclear.This study employs Mendelian randomization(MR)analysis to investigate the potential causal relationship between PA and SNHL.Methods A two-sample MR analysis was conducted based on summary statistics from published genome-wide association studies(GWAS).Data were obtained from the publicly available MRC IEU GWAS database.Single nucleotide polymorphisms(SNPs)significantly associated with PA and SNHL were selected as instrumental variables.Two PA phenotypes were included in the analysis:the number of days per week engaging in at least 10 minutes of moderate-intensity physical activity(MPA 10+min)(GWAS ID:ukb-a-508,sample size=321 309)and the number of days per week engaging in at least 10 minutes of vigorous-intensity physical activity(VPA 10+min)(GWAS ID:ukb-b-151,sample size=440 512).To avoid sample overlap between exposure and outcome groups,SNHL data were obtained from the FinnGen consortium(finn-b-H8_HL_SEN_NAS),comprising 15 952 cases and 196 592 controls.MR analyses were performed using the inverse-variance weighted(IVW)method,MR-Egger regression,and the weighted median(WM)approach.Horizontal pleiotropy was assessed using MR-Egger regression and MR-PRESSO,while heterogeneity was evaluated using Cochran's Q test.Additionally,leave-one-out sensitivity analysis was conducted to ensure the robustness and reliability of the results.Results The IVW analysis demonstrated a negative association between PA and the relative risk of SNHL("MPA 10+min":IVW:OR=0.689,P=0.013,95%CI=0.514～0.924;"VPA 10+min":OR=0.625,P=0.001,95%CI=0.468～0.835).The WM method yielded results consistent with those of the IVW method.Sensitivity analyses indicated no evidence of heterogeneity or horizontal pleiotropy.The leave-one-out analysis confirmed that the findings were robust and not influenced by any individual instrumental variable.Conclusions This MR study provides causal evidence suggesting that PA may reduce the risk of SNHL.These findings support the potential role of PA in hearing protection.However,further research is needed to validate these results and explore underlying biological mechanisms.

Abstract:Objective The purpose of this study is to investigate potential roles of saturated hydrogen saline in prevention of noise-induced hearing loss(NIHL).Methods Twenty-four 8-week-old specific pathogen free(SPF)grade C57BL/6J male mice with normal auditory brainstem response(ABR)thresholds were randomly divided into normal control(wild type,WT),noise exposure(NG),and saturated hydrogen saline prophylaxis before noise exposure(HS)groups(n=8 in each group).The control group received intraperitoneal saline solution(1 mL/100 g/day)for three days.The NG group received the same saline treatment followed by noise exposure,whereas the HS group received an equivalent dose of saturated hydrogen saline before noise exposure.ARB audiometry was performed prior to and at 1,3 and 7 days after noise exposure.At the conclusion of the study,the middle cochlear turn basilar membrane was harvested and examined by scanning electron microscopy with immunofluorescence staining.Results Hearing loss was observed in both the NG and HS groups,with better ABR thresholds,less severe cochlear outer hair cells damage and less outer hair cells loss in the HS group than in the NG group(P<0.05).The degree of damage to the cilia morphology of cochlear outer hair cellsin the HS group was milder than that in the NG group.Cochlear basilar membrane ribbon synapses decreased in both HS and NG groups,and less in the NG group than in the HS group(P>0.05).Conclusions Prophylactic daily intraperitoneal injection of saturated hydrogen saline has a protective effect on hearing in mice against exposure to steady-state noise.This knowledge may have certain value in understanding molecular mechanisms of hydrogen protection.

Abstract:Objective To investigate the value of nystagmus latency in determining the affected side In horizontal semicircular canal benign paroxysmal positional vertigo(BPPV).Methods Patients with horizontal semicircular canal BPPV(n=91)admitted to the Vertigo Clinic of the Department of Otolaryngology,Head and Neck Surgery,Peking University People's Hospital in Qingdao from January 2023 to September 2024 were subjected to bow and supine test(BST),followed by 180°roll test(RT),while observed for nystagmus.Repositioning therapies were performed based on RT results if the side to side ratio of nystagmus intensity was greater than 3:2,or based on BST results if RT failed to indicate the affected side.When the affected side could not be determined by either RT or BST,the longer latency of nystagmus(LON)in RT(at least 1 s)was used to determine the affected side.If failing verification after repositioning,the maneuvers were repeated in the opposite direction.The sensitivity and rate of correct side determination for BST,RT and LON were analyzed.Results Of the 91 patients,nystagmus was induced in 71(78%)by BST.Side determination was successful in 75(82.4%)cases by RT and in 62 cases(68.1%)by LON.The rate of correction side determination was 72.5%(66/91)for BST,78%(71/91)for RT,and 67%(61/91)for LON,respectively(P>0.05).ROC indicated high accuracy in determining the affected side for all three methods.Repositioned was successful in all 91 patients,including 5 whose initial repositioning was erroneous resulting in cupulotolithiasis in 3 patients and in whom repositioning in the opposite direction was successfully.Conclusions Observing nystagmus latency in the 180°RT can significantly improve the rate of success in identification of the affected side in horizontal semicircular canal BPPV without increasing the burden on the patient,and is worthy of clinical adoption.

Abstract:Objective To report post-treatment hearing in patients with unilateral sudden total deafness and factors affecting post-treatment hearing.Methods Patients with sudden total deafness(n=290)hospitalized from July 2008 to October 2022,aged 18～60 years and within 14 days of onset,were selected and grouped according to their post-treatment hearing,i.e.:complete recovery(CR),flat recovery(FR),high-frequency descending recovery(HFD),high-frequency ascending recovery(HFA)and No recovery(NR).Associations with age,sex,affected side,associated symptoms,predisposing factors,comorbidities,time of treatment onset,initial hearing threshold and laboratory test results were analyzed with the SPSS 26.0 software.Results In the 290 patients,post-treatment hearing was characterized as CR in 31(10.7%),FR in 69(23.8%),HFD in 157(54.1%),HFA in 1(0.3%)and NR in 32(11.0%),resulting in a total effective rate of 89.0%.Univariate analysis showed differences among the 289 patients whose post-treatment hearing was categorized as CR,FR,HFD or NR in vertigo,ear fullness,time of treatment onset,initial hearing threshold,activated partial thromboplastin time(APTT)and triglyceride(P<0.05).Pairwise comparison revealed differences in vertigo,time of treatment onset,initial hearing threshold and triglyceride between those with CR and FR(P<0.05);in vertigo,time of treatment onset,initial hearing threshold and APTT between those with CR and HFD(P<0.05);in vertigo,ear fullness,time of treatment onset and initial hearing threshold between those with CR and NR(P<0.05);in initial hearing threshold w between those with FR and NR(P<0.05);in ear fullness and APTT between those with FR and HFD(P<0.05);in ear fullness between those with HFD and NR(P<0.05);and not among other groups(P>0.05).Conclusions Although the rate of complete recovery is low in total sudden deafness(10.7%),total effective rate can be as high as 89.0%,with patients predominantly showing HFD recovery(54.1%).Post-treatment hearing recovery in patients with total sudden deafness is closely correlated with accompanying vertigo,ear fullness,initial hearing threshold,onset of treatment and coagulation dysfunction.

Abstract:Presbyacusis,also known as age-related hearing loss(ARHL),usually refers to hearing impairment in people over the age of 60.ARHL is the most common sensory disorder in the aging process,which can significantly reduce the quality of life with great economic impact.However,the biological mechanism of ARHL is complex and yet to be fully described.This article reviews research on oxidative stress,cellular senescence and other factors in ARHL.

Abstract:Objective Within the framework of extended planned behavior theory,a structural equation model was used to build a self-management factors model for patients with sudden deafness for analysis of relationship paths among influencing factors.Methods Patients with sudden deafness admitted to the Department of Otology,Chinese PLA General Hospital in Beijing,from August 2023 to June 2024(n=205)completed a general questionnaire,the planned behavior theory scale,sudden deafness patients self-management status assessment scale,and social support rating scale.The SPSS 26.0 software was used for descriptive and single factor analyses.The AMOS 24.0 software was used for constructing the structural equation model and analyzing relationship paths among the influencing factors.Results Of the 205 questionnaires collected,200(97.6%)were valid.The self-management score was at a moderate level(103.37±24.87).Univariate analysis showed that higher self-management scores were associated with female gender,marriage,unilateral disease,BMI indicating overweight,and absence of migraine.The structural equation model showed an explanatory degree of SMC(R2)at 75.2%.Behavioral attitudes and subjective norms indirectly and positively affected behaviors through the complete mediating effect of behavioral intention,while perceived behavioral controlled behaviors directly or indirectly via the partially mediating effect of behavioral intention,and behavioral intention also affected behaviors directly or indirectly via the partially mediating effect of social support.Conclusions The influence of social psychological factors should be fully considered in the study of self-management intervention for patients with sudden deafness,so as to formulate targeted and evidence based intervention programs.

Abstract:Objective To investigate damaging toxic effects of cisplatin on House Ear Institute-Organ of Corti 1(HEI-OC1)cells and potential mechanisms.Methods In this study,a model of HEI-OC1 cell injury by cisplatin was established.The Caspase-1 inhibitor VX-765 was used as intervention.The CCK-8 method was used to identify cell viability.Flow cytometry,LDH release assay,and AO/EB fluorescence staining were used to examine cellular membrane integrity.ELISA,Western-Blot,immunofluorescence and qRT-PCR were used to demonstrate expression of pyroptosis-related proteins and its mRNAs.Results Compared with the control,cisplatin treated cells demosntrated decreased survival,with some cells showing increased membrane permeability,swelling and deformation or cell membrane rupture.Expression of pyroptosis-related proteins and mRNAs was increased(P<0.05).Compared with cisplatin treatment only,cells treated with VX-765+cisplatin showed increased survival with decreased expression of pyroptosis-related proteins and mRNAs(P<0.05).Conclusions Cisplatin induced death of HEI-OC1 cells in a concentration-dependent manner.Caspase-1-mediated cellular pyroptosis plays an important role in cisplatin-induced ototoxicity,potentially by regulating the NLRP3/Caspase-1/GSDMD pathway.

Abstract:Objective To report concentration of oxygenated hemoglobin(HbO)in the cerebral cortex in patients with chronic subjective tinnitus and its potential value in predicting therapeutic outcomes with Multiple integrated sound(MIS)at 6 months.Methods Patients with chronic subjective tinnitus and normal pure tone hearing(n=90)who visited the Department of Otorhinolaryngology Head and Neck Surgery of the Affiliated Hospital of North Sichuan Medical College from January 2023 to September 2023 were included,with 90 healthy individuals without tinnitus during the same period serving as the control.HbO in the cerebral cortex was measured.Tinnitus patients received MIS treatment.Based their Tinnitus Handicap Inventory(THI)scores,their treatment was categorized as effective or ineffective,and their cerebral cortex HbO before treatment was compared.Logistic regression analysis was used to screen for independent factors influencing MIS therapeutic outcomes.The receiver operating characteristic(ROC)curve was plotted,and the area under the curve calculated.Results The overall effective rate of MIS treatment in this group of patients with chronic subjective tinnitus was 56.7%.OPFC-HbO and VMPFC-HbO in patients with tinnitus were increased compared with the control,while DPFC-HbO was decreased(P<0.05).In patients whose MIS was effective,DPFC HbO was higher than in the control group,while VMPFC HbO and OPFC HbO were both lower(P<0.05).The optimal prediction cut-off point for OPFC-HbO was 0.050.Conclusions In patients with chronic subjective tinnitus,HbO in the orbitofrontal cortex and the ventral prefrontal cortex increases,while its concentration in the dorsolateral prefrontal cortex decreases.MIS treatment is effective for chronic subjective tinnitus.HbO in the orbitofrontal cortex can predict the effectiveness of MIS in patients with chronic subjective tinnitus.

Abstract:Objective To report subjective visual vertical and subjective visual horizontal results in patients with sudden sensorineural hearing loss(SSNHL)and their potential correlation with SSNHL prognosis.Methods The rate of SVV and SVH abnormality and deviation angles were retrospectively analyzed in 123 patients with unilateral SSNHL who visited United Family Pudong Hospital,United Family Hospital of Integrative Medicine,United Family Women's and Children's Hospital,Shanghai United Family Hospital(Jing'An)and Shanghai Jiahui International Hospital from January 2020 to June 2024.and 40 healthy volunteers,as well evaluate their correlation with SSNHL prognosis.Results Before treatment,the rate of SVV and SVH abnormality in the SSNHL group was significantly higher than in the healthy control group,and significantly higher in those who with vertigo with greater SVV and SVH deviation angles as compared to patients without vertigo and the healthy controls(P<0.05).After treatment,SVV and SVH deviation angles in SSNHL patients significantly decreased.Hearing improvement was(27.54±19.14)dB HL in patients with normal SVV and(23.91±17.53)dB HL in patients with normal SVH,respectively,but only(8.91±13.67)dB HL in patients with abnormal SVV and(12.02±14.47)dB HL in those with abnormal SVH,respectively,(P<0.05).Conclusions SVV and SVH tests can effectively assess vestibular damage in patients with SSNHL.Patients with abnormal SVV and SVH have poorer hearing recovery,indicating that SVV and SVH can be used as prognostic indicators in SSNHL.

Abstract:Nontypeable Haemophilus influenzae(NTHi)is the main pathogen of acute otitis media and chronic otitis media in children.With the popularization of Haemophilus type B vaccine,the serotype substitution phenomenon has become significant and the rate of NTHi infection continues to increase.Although several vaccine candidates have entered clinical trials,an effective vaccine against NTHi awaits a breakthrough.In recent years,exploration of novel anti-biofilm strategies and alternative therapies(e.g.,phage therapy)has provided new directions for the treatment of NTHi-associated otitis media).Future studies need to further elucidate the host-pathogen interaction network and promote multidisciplinary translational research.In this paper,we systematically review the pathogenic mechanisms,epidemiological characteristics,evolution of resistance and biofilm-forming ability of NTHi,and discuss its interaction with host immune response.

Abstract:Objective This study aims to evaluate the effect of manipulating the number of active channels on speech perception in modern cochlear implant recipients.Methods Ten postlingually deafened adult patients with unilateral Nurotron cochlear implants who presented to the Department of Otolaryngology,Henan Provincial People's Hospital from November 2020 to November 2023 were enrolled.Their speech outcomes were assessed by measuring speech perception performance with 8,12,16,22 or 24 channels activated and under both quiet and+5 dB signal-to-noise ratio conditions.The assessments included the Mandarin Speech Perception(MSP)sentence recognition test,as well as subjective ratings of sound clarity and sound quality.Results As the number of active channels increased,there was a significant overall improvement in MSP sentence recognition,sound clarity,and sound quality ratings in quiet(P<0.05).In contrast,significant difference was observed only in MSP sentence recognition scores between 12 and 24 channels in noise(P=0.019).Conclusions Speech perception in quiet improves with an increasing number of active channels up to 24 in modern cochlear implant recipients.However,the relationship between the number of active channels and speech perception in noise warrants further examination.

Abstract:The vestibular system is the key to maintain balance and spatial orientation.Unilateral peripheral vestibule damage will cause a series of vestibular symptoms,which can gradually improve over a few days to a few weeks,a phenomenon known as"vestibular compensation".Vestibular compensation can be categorized as static or dynamic.Static compensation is mainly a localized phenomenon occurring within the vestibular nucleus,whereas dynamic compensation is the result of multiple aspects,and often involves global adjustments in the central nervous system.In this paper,we briefly review the current status of basic research on the central vestibular system participating in compensation in recent years,and potential directions of future research on vestibular compensation.

Abstract:Preauricular fistula is a common congenital disorder of the outer ear characterized by a inconspicuous opening in the skin anterior to the ascending helix.There lacks a relevant review that comprehensively summaries the genetic basis of preauricular fistula and its associated disorders.In this article,we review the clinical manifestations,histoembryology,genetics,investigation,treatment and genetic basis of preauricular fistula and its associated disorders,with the aim of facilitating comprehensive clinical diagnosis and treatment.

Abstract:Tinnitus,often linked to hearing loss and central nervous system plasticity changes,is a common symptom.Brain-derived neurotrophic factor(BDNF),a key neurotrophic factor,plays an important role in the development,function maintenance,and injury repair of the auditory system.It activates downstream signaling pathways by binding to the TrkB receptor,influencing auditory signal transmission and processing.BDNF may cause an imbalance in excitatory and inhibitory transmission in the auditory system through synaptic regulation and inflammatory responses,promoting tinnitus generation and maintenance.Moreover,BDNF genetic polymorphisms,especially variations at the Val66Met locus,may be associated with tinnitus susceptibility.Modulating BDNF levels via pharmacological treatments and non-pharmacological approaches like repetitive transcranial magnetic stimulation,transcranial direct current stimulation,cognitive behavioral therapy,and acupuncture,offer new avenues for tinnitus treatment.This article reviews mechanisms by which BDNF plays a role in tinnitus pathogenesis,and explores new therapeutic targets and approaches for tinnitus management.

Abstract:Objective To report the results of neonatal hearing screening and follow-up outcomes in 2286 cases.Methods Initial screening was conducted using distortion product otoacoustic emission(DPOAE).Infants who failed the initial screening underwent rescreening at 42 days postnatal using a combination of DPOAE and automated auditory brainstem response(AABR).Telephone follow-ups were conducted in 77 newborns who missed the initial screening and in 30 cases that failed the initial screening but did not undergo timely rescreening.Screening and follow-up results were analyzed.Results The initial screening rate was 97.5%,with a pass rate of 94.8%.The rate of rescreening was 89.2%,with a rescreening pass rate of 70.1%.The initial pass rate for the right ear(96.7%)was higher than that for the left ear(95.2%).Female infants had a higher initial pass rate(96.1%)compared to males(93.5%).Among the 107 cases rescreened using the DPOAE combined with AABR method(214 ears),the failure rate(19.6%)was higher than that using DPOAEs or AABRs alone(7.5%).From 2019 to 2023,the rate of telephone follow-up in newborns who missed the initial screening was 87.0%,and 96.7%in infants who failed initial screening and did not undergo timely rescreening.Conclusions This center met guideline requirements for the rates of initial screening,screening pass,and rescreening compliance.Gender and ear laterality influenced initial screening outcomes.The DPOAE combined with AABR method improved rescreening sensitivity,supporting its use to reduce missed diagnoses.The below 100%follow-up rates highlight the need for enhanced tracking systems and targeted education to optimize neonatal hearing care and minimize risks of delayed intervention.