Abstract:Research indicates that children with sensorineural hearing loss(SNHL)exhibit significantly greater instability in balance function assessments such as the Romberg test,single-leg stance test,and Bruininks-Oseretsky Test of Motor Proficiency compared to their normal hearing peers,along with a higher incidence of vestibular dysfunction.Factors influencing balance function in children with SNHL include laterality of hearing loss(unilateral/bilateral),age and the degree of hearing impairment.The underlying mechanisms may involve multiple factors such as vestibular dysfunction,reduced auditory input,increased cognitive load and overprotection.Notably,the use of hearing assistive devices(e.g.,hearing aids or cochlear implants)may have a positive impact on balance function.Although current research primarily focuses on adult and elderly populations,preliminary evidence suggests that restoration of auditory input could contribute to improved balance performance.This article systematically reviews the performance characteristics of static balance,dynamic balance and vestibular function tests in children with SNHL,as well as the influencing factors and potential mechanisms,to provide clinicians and rehabilitation therapists with a theoretical foundation for optimizing balance function and rehabilitation intervention strategies in these children,thereby promoting their holistic development.

Abstract:Objective To investigate the role of DNA methylation and gene expression in the pathogenesis of sensorineural hearing loss(SNHL).Methods Summary data-based Mendelian Randomization(SMR)and co-localization analysis were used.Genomic data on DNA methylation and gene expression quantitative traits in European individuals were used as exposure variables,and genetic data on SNHL from the latest public release of the Finngen study,version R10,were used as outcome variables.SMR and co-localization analyses were performed to determine potential Associations.Results There was an association between DNMT3B and reduced risk of SNHL,and its methylation sites cg09149842,cg13788819,cg21235334,and cg22052056 were protective against SNHL by up-regulating DNMT3B gene expression.Conclusion DNMT3B is associated with a reduced risk of SNHL,and modulation of the cg09149842,cg13788819,cg21235334 and cg22052056 CpG sites of DNMT3B exerts a protective effect against SNHL.

Abstract:Objective To report clinical features,diagnosis and treatment of SSNHL caused by labyrinthorrhage.Methods Date from 65 patients with SSNHL who were admitted to Xuzhou Medical University Affiliated Hospital from 2021 to 2024 were reviewed,including general conditions,clinical manifestations,hematology tests,audiological tests,vestibular function tests,and prognosis.Patients with inner ear hemorrhage were identified by 3D FLAIR sequence of MRI and compared with those without inner ear hemorrhage.Results 3D FLAIR sequence examination showed abnormal high signal in different parts of the inner ear in 25 patients,diagnosed as inner ear hemorrhage.Compared with the other 40 cases without inner ear bleeding,the level of hearing loss,symptoms and vestibular function showed statistically significant differences(P<0.05),although no statistically significant difference in treatment outcomes(P>0.05).Conclusion SSNHL caused by inner ear hemorrhage tends to present with more serious clinical manifestations and poorer prognosis.3D FLAIR is an important way to diagnose inner ear hemorrhage,with T1WI and 3D FLAIR sequences showing abnormally high signals.Hemorheological therapy should be used with caution until MRI diagnosis.

Abstract:Auditory cochlear hair cells,as energy-consuming sensory cells,are extremely sensitive to hypoxic environment.The effects of hypoxia on hearing health have received increasing attention.Through reviewing the literature related to hypoxia and hearing loss,this paper systematically summarized the potential mechanisms,manifestations and intervention and treatments in hypoxia related hearing dysfunction,aiming present an overview on the current research status of this issue,and provide a solid theoretical basis for future research and clinical management.

Abstract:Objective To report the relationship between sleep and clinical presentation in patients with sudden sensorineural hearing loss(SSNHL).Methods A total of 101 patients with SSNHL(aged 18～65 years),who were admitted to the Division of Otology,Department of Otorhinolaryngology Head and Neck Surgery,Chinese People's Liberation Army General Hospital from May 2023 to January 2024,were surveyed using a general condition questionnaire,the Pittsburgh Sleep Quality Index(PSQI),Tinnitus Handicap Inventory(THI),Dizziness Handicap Inventory(DHI),visual analogue scale(VAS)for ear fullness,Hyperacusis Questionnaire(HQ),and Self-rated Anxiety Scale(SAS).Results The PSQI score was(7.53±4.45),with 45.6%of the patients showing poor sleep(PSQI>7).Gender(t=-2.389,P=0.019),presence of sound sensitivity(t=2.348,P=0.021)and/or migraine(t=2.792,P=0.006)were influencing factors for sleep.In patients with poor sleep,tinnitus(Z=3.267,P=0.001),ear fullness(Z=2.054,P=0.04),sound sensitivity(Z=2.091,P=0.037)and anxiety(Z=3.892,P<0.01)were more common and of greater severities,with no significant differences in the level or type of hearing loss as compared to those with no sleep difficulties(Z=0.778,P=0.436 and Z=0.092,P=0.927,respectively).Conclusion Nearly half of patients with SSNHL have sleep problems,who are more severely affected by the disease and require special attention to help them effectively cope with their disease,reduce the impact of their disease and improve their quality of life.

Abstract:Tympanic membrane perforation is a prevalent condition in otology,and patients frequently experience symptoms such as hearing loss and a sensation of fullness in the ear.Endoscopic tympanoplasty has increasingly become a routine treatment for this condition,offering clear visualization,reduced trauma,and decreased recovery time.In recent years,surgical techniques for tympanoplasty have seen new advancements.Various repair techniques have been developed,including the underlay,sandwich,temporalis myofascial four-point fixation,retroauricular approach underlay,and the retromeatal approach.Autologous materials and artificial composite materials are typically utilized for tympanic membrane repair.While autologous materials are commonly used in clinical settings,they present issues such as the risk of infection at the donor site and challenges in shaping.Artificial composite materials encompass cellulosic materials,gelatin,polycaprolactone,hydrogels,polymers,and other synthetic materials.3D-printed artificial composite materials are anticipated to mimic the multi-layered structure and complex functions of the tympanic membrane,thereby enhancing the mechanical properties and biological activity of the repair materials and aiding in achieving a higher success rate.The integration of endoscopic tympanoplasty,artificial composite materials,and 3D printing technology has heralded a new era in the treatment of tympanic membrane perforation.This article primarily reviews the progress of artificial composite materials in tympanoplasty,focusing on endoscopic tympanoplasty,the current application of autologous materials and artificial composites,and the potential of 3D printing technology in this field,aiming to provide a basis for their clinical adoption.

Abstract:Objective To investigate the effectiveness of a BOPPPS+flipped classroom-based blended teaching model in rehabilitation audiology.Methods A total of 34 undergraduate students majoring in audiology and speech rehabilitation from the class of 2019 at Chongqing Medical University were selected as the control group,and 35 undergraduate students from the class of 2020 were selected as the experimental group.The experimental group used the blended model,while the control group followed traditional teaching.Outcomes were assessed via end-of-semester grades and questionnaires.Results The experimental group had significantly higher final scores than the control group,the difference is statistically significant(P<0.05).The experimental group also showed higher satisfaction in overall evaluation,learning interest,teamwork,and self-learning ability,the difference is statistically significant(P<0.05),but no significant difference in innovation ability satisfaction,the difference was not statistically significant(P>0.05).Conclusion The BOPPPS+flipped classroom model enhances student engagement and interaction,improving teaching quality and effectiveness in rehabilitation audiology.

Abstract:Objective To report effects of 100 dB SPL 8～16 kHz octave band noise exposure on hearing,cochlear hair cells and synapses in adult CBA/CaJ mice.Methods CBA/CaJ mice with normal hearing at 16 weeks of age were grouped to be exposed to 8～16 kHz octave noise at 100 dB SPL for 7.5,15,30,60 or 120 min(n=5～7 in each group).Auditory brainstem response(ABR)and distortion product otoacoustic emission(DPOAE)thresholds were assessed at 1 day and 14 days after exposure.The cochlear basilar membrane was isolated for immunofluorescence staining,with hair cells and synapses quantified using the Amira software.Results At 1 d after noise exposure,ABR and DPOAE thresholds were significantly elevated in all groups,which would have basically recovered to normal levels at 14 days after noise exposure.Immunofluorescence showed no inner and outer hair cells loss,but significant inner hair cells synapses loss in a noise dose-dependent manner and more severe in those exposed for 60 or 120 min(about 50%in the 32～45 kHz region).Conclusion Exposure to 8～16 kHz octave noise at 100 dB SPL for 7.5 min may be sufficient to cause hidden hearing loss in mice,especially at high frequencies.For short exposure,synaptic loss precedes the loss of sensory hair cells and represents an early manifestation of noise damage.

Abstract:Auricle pseudocyst is an uncommon,non-inflammatory,asymptomatic,benign ear disease with unknown etiology.Various treatment methods have been reported,but there is no gold standard treatment.Improper treatment can easily lead to recurrence and permanent deformity of the ear,making it quite difficult to handle.At present,there is no guideline or consensus.This article provides a review of this disease to provide a reference for physicians.

Abstract:Objective To report mutations of deafness genes among newborns in Jincheng area,Shanxi Province,to provide a scientific basis for the prevention and control of genetic deafness in newborns.Methods Flow-through hybridization technology was used to test 13 common mutation sites of 4 deafness genes in 26,962 newborns born in Jincheng,Shanxi Province,from April 2021 to November 2024.Spatial distribution pattern was identified based on screening data on a percentage stacked bar chart.Results Among the 26,962 newborns,abnormal deafness gene mutations were detected in 1,302(4.83%),including heterozygous(n=594,2.20%)and homozygous(n=3,0.01%)mutations of the GJB2 gene,heterozygous(n=475,0.79%)and homozygous(n=2,0.01%)mutations of the SLC26A4 gene,homogeneous(n=74,0.27%)and heterogeneous(n=21,0.08%)mutations of mitochondrial DNA,and heterozygous(n=115,0.43%)and compound/double gene mutation(n=18,0.07%)mutations of the GJB3 gene.High-incidence areas were identified in spatial distribution.Conclusion GJB2 gene mutations are the most common deafness gene mutations among newborns in Jincheng area,with the highest rate of gene mutations found in Gaoping City.Screening should be focused on reducing occurrence of deafness in such high incidence areas.

Abstract:Intracochlear Electrocochleography(ECochG)is a technology used during cochlear implant surgery to provide real-time monitoring of cochlear function.By detecting electrophysiological responses during electrode insertion,ECochG helps reduce cochlear trauma and improve patient rehabilitation outcomes.Despite technical challenges and intraoperative response variability,recent studies have demonstrated significant advantages in intraoperative ECochG.Ongoing research and technological advancements are expected to further refine this technique,making it a reliable monitoring tool during cochlear implant surgeries.This review focuses on the principles of intraoperative ECochG,and examines its clinical and research applications in improving cochlear implant surgery outcomes.

Abstract:Objective To report outcomes of virtual reality technology(VR)based vestibular rehabilitation therapy(VRT)in patients with vestibular dysfunction,to help improve clinical practice.Methods The SinoMed,WanFang Data,CNKI,VIP,Web of Science,PubMed,Embase,Scopus,Ovid and Cochrane Library were searched for randomized controlled trial(RCT)studies on the effect of virtual reality vestibular rehabilitation in patients with vestibular dysfunction from inception to January 1st,2024.Two researchers conducted independent literature screening,data extraction and the Cochrane Risk of Bias Assessment Tool was used to evaluate the risk of bias of the included literatures,while the Physiotherapy Evidence Database(PEDro)scale was used to evaluate their quality.The collected data were quantitatively analyzed using the RevMan 5.4 software.Results Twelve studies were included(total 791 patients)with PEDro scores ranging from 4 to 8.Meta-analysis showed that,compared with conventional vestibular rehabilitation,virtual reality vestibular rehabilitation better improved balance ability(MOL:MD=-34.07[95%CI-37.90,-30.25],P<0.01;EA:MD=-192.34[95%CI-208.88,-175.80],P<0.01),with less vertigo disability(MD=-6.71[95%CI-9.31,-4.10],P<0.01)and better daily quality of life(MD=-1.47[95%CI-1.69,-1.24],P<0.01).Immersive virtual reality technology also improved gait balance and reduced fall risk(MD=5.04[95%CI 4.21,5.88],P<0.01).Other measures showed no statistically significant differences.Conclusion The application of virtual reality technology in vestibular rehabilitation therapy can improve patient balance ability and daily quality of life,although there lacks strong evidence in improving patient psychology and compliance,probably limited by the number and quality of the included studies.This conclusions needs to be verified with long-term,large-scale and high-quality studies.

Abstract:Tinnitus,a condition with multifactorial etiology,continues to challenge our understanding of its pathophysiological mechanisms.Current treatment modalities include sound therapy,biofeedback,electromagnetic stimulation,traditional Chinese medicine interventions,surgical procedures and specialized tinnitus software or devices.Neuromodulation technology,which uses chemical or physical means(sound waves,electrical currents,magnetic fields e.g.,)to deliver targeted stimulation,aims to modulate neural activity and enhance the functionality of organs,nerve circuits,or brain networks,offering promising therapeutic potentials for tinnitus management.In recent years,non-invasive transauricular vagus nerve stimulation(taVNS),which involves percutaneous auricular stimulation of the vagus nerve to functionally regulate the central nervous system,has garnered significant attention.This review provides an overview of the mechanisms,safety,and efficacy of taVNS in the treatment of tinnitus.

Abstract:Objective To report clinical outcomes of sigmoid sinus wall reconstruction surgeries in patients with unilateral venous pulsating tinnitus.Methods From March 2017 to August 2021,49 patients diagnosed with unilateral venous pulsatile tinnitus secondary to sigmoid sinus defects or diverticulum were enrolled,including 48 females and 1 male aged from 23 to 65 years,with the lesion on the right side in 39 cases and on the left side in 10 cases.All patients underwent preoperative temporal bone CT and cerebral magnetic resonance imaging,including magnetic resonance angiography and venography.Tinnitus severity and body mass index(BMI)were recorded.The same surgeon performed sigmoid sinus wall reconstruction under general anesthesia.Postoperative outcomes were evaluated after a minimum follow-up period of 1 year.The influence of anatomical abnormalities and BMI on clinical outcomes was analyzed.Results Tinnitus completely resolved in 23 cases,significantly improved in 9 cases,somewhat improved in 6 cases,and remained unchanged in 11 cases after followed up for 15-68 months,yielding a total effectiveness rate of 77.55%.Imaging findings included high jugular bulb(14 cases),mastoid emissary vein enlargement(19 cases),empty sella turcica(18 cases)and transverse sinus stenosis(10 cases).Transverse sinus stenosis significantly impacted clinical outcomes(P=0.017),whereas other anatomical variants and BMI showed no statistically significant correlation(P>0.05).Conclusion Unilateral venous pulsatile tinnitus predominantly affects females and occurs more frequently on the right side,caused by multiple factors.Sigmoid sinus wall reconstruction demonstrates favorable therapeutic efficacy.Transverse sinus stenosis is a significant prognostic factor affecting postoperative outcomes.

Abstract:Objective To characterize metabolic profiles of potential biomarkers of sudden deafness by untargeted metabolomics.Methods Patients admitted to the Department of Otorhinolaryngology Head and Neck Surgery,the Second Affiliated Hospital of Army Medical University,between June 2022 and January 2023(n=30)were recruited,including 15 patients diagnosed with sudden sensorineural hearing loss(SSNHL)and 15 patients with simple deviated nasal septum and no hearing impairment.Venous blood samples were collected and subjected to untargeted metabolomics analysis using Liquid Chromatography-mass Spectrometry(LC-MS).Supervised Orthogonal Partial Least Squares Discriminant Analysis(OPLS-DA)was employed to identify significantly differential metabolites(variable importance in projection[VIP]>1,P<0.05),followed by pathway enrichment analysis.Results A total of 599 metabolites were identified in positive ion mode and 315 metabolites in negative ion mode.Quality control(QC)sample correlation analysis revealed R²values all approaching 1.OPLS-DA results indicated significant intergroup differences in metabolites.In positive ion mode,the OPLS-DA model demonstrated an R2Y of 0.974 and a Q2of 0.717,leading to the identification of 103 differential metabolites.In negative ion mode,the model showed an R2Y of 0.996 and a Q2of 0.571,with 65 differential metabolites identified.Enrichment analysis revealed significant clustering in 8 metabolic pathways.Pathway mapping analysis demonstrated elevated levels of phosphatidylcholine,O-acetylcholine,L-histidine,N-methylhistamine,phenylalanine,citric acid,and linoleic acid in the sudden deafness group compared to controls.Conversely,17α-hydroxyprogesterone,cortisol,androst-4-ene-3,17-dione,androgen,and 7-methylxanthine were found at lower concentrations in the sudden deafness group.Conclusion Lipid metabolism and amino acid metabolism may constitute principal underlying pathways involved in the metabolic dysregulation associated with SSNHL.The increase in the level of its metabolites may be one of the causes of sudden deafness.

Abstract:Objective This propensity score-matched(PSM)retrospective cohort study aimed to investigate the association between serum 25-hydroxyvitamin D[25(OH)D]and total calcium levels and benign paroxysmal positional vertigo(BPPV).Methods A total of 107 BPPV patients diagnosed at the Department of Otolaryngology-Head and Neck Surgery,Beijing Tsinghua Changgung Hospital from June 2023 to January 2025 were enrolled as the case group,and 199 subjects from the Health Management Center served as controls.After 1:1 PSM matching for sex and age,74 matched pairs were included.Receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive value of 25(OH)D for BPPV.Results Serum 25(OH)D levels were significantly lower in BPPV patients compared to controls[19.56(IQR 16.59,23.03)ng/mL vs 23.10(IQR 20.73,27.79)ng/mL,P=0.001],with a higher prevalence of vitamin D insufficiency(52.70%vs 14.86%,P<0.001).Female patients exhibited notably lower 25(OH)D levels than males[19.16(IQR 15.76,22.78)ng/mL vs 21.44(IQR 17.67,25.35)ng/mL].ROC analysis demonstrated that a 25(OH)D cutoff of<19.84 ng/mL predicted BPPV with 53%sensitivity and 87%specificity(AUC=0.700).Conclusion Low serum 25(OH)D levels are significantly associated with BPPV incidence,suggesting vitamin D deficiency may serve as a potential risk factor for BPPV.

Abstract:Objective To report before and after treatment changes of subjective visual vertical(SVV)in in patients with idiopathic sudden sensorineural hearing loss(ISSNHL)and concomitant benign paroxysmal positional vertigo,and their relationship with otolithotic function outcomes.Methods A retrospective analysis was performed on 100 cases of ISSNHL and BPPV admitted to the Department of Otology,the First Affiliated Hospital of Zhengzhou University,from June 2020 to July 2023.Hearing loss was categorized as low frequency sliding(n=12),high frequency sliding(n=18),all frequency sliding(n=32)or total deafness(n=38).SVV deviation from the median(0°)was categorized as low(n=15),medium(n=33)or high(n=52).Multiple variable analysis was conducted for potential effects of SVV deviation on hearing,and clinical data of cases with different levels of SVV deviation were compared.Multiple variable analysis was also conducted for relationship between SVV deviation and treatment outcomes,and correlations between hearing and SVV deviation as well as otolithol function outcomes.Results The SVV-0°,SVV-L30°,SVV-L45°,SVV-L90°,SVV-R30°,SVV-R45°,SVV-R90°,cVEMP and oVEMP results demonstrated statistically significant differences among the four types of hearing loss(P<0.05).SVV-0° results were an independent risk factor for increased severity in sudden hearing loss with concomitant BPPV.Otolith functional characteristics and clinical outcomes showed statistically significant differences among low,medium and high SVV deviation groups(P<0.05),with decreasing correlation as SVV deviation increased(P<0.05).Otolith function parameters also showed statistically significant differences in relation to different levels of SVV deviation(P<0.05).Restricted cubic spline model showed no nonlinear correlation between SVV deviation and disease severity in both genders.Conclusion SVV-0° deviation is a risk factor for severe ISSNHL with concomitant BPPV with a positive correlation.SVV test plays an important role in assessing otolith function and is of great clinical value.

Abstract:Vestibular schwannoma is a benign tumor originating from the Schwann cell of the eighth cranial nerve sheath,and its clinical treatment involves mainly surgical resection.This article reviews the progress in research on the pathogenesis of sporadic vestibular schwannoma and its related signaling pathways in order to help further research on its pathogenesis and clinical diagnosis and treatment.

Abstract:Middle ear cholesteatoma is a non-neoplastic tumor characterized by the abnormal proliferation of squamous epithelial cells in the middle ear,which invade the adjacent bone structures and cause extensive local tissue destruction.It can lead to various clinical manifestations such as ear discharge,hearing loss,tinnitus,peripheral facial paralysis,and vertigo.At present,the mechanism of its occurrence and development is yet to be fully elucidated.However,with continuous research and discoveries in microbiome,the relationship between pathogenesis and mechanism of local invasion in middle ear cholesteatoma and the microbiota has been gradually revealed.This is a review of this correlation.

Abstract:Sensorineural hearing loss(SNHL)is the most common type of hearing loss among all hearing loss,usually caused by damage to the cochlea,auditory nerve or central nervous system,and may sometimes be accompanied by vestibular symptoms such as dizziness,vomiting,nausea and postural instability.The embryonic development timing of the cochlear and vestibular organs is similar and their anatomical structures are next to each other,making concomitant vestibular dysfunction(VD)in SNHL possible.Similarly,vestibular organ lesion may also extend to the cochlea.This article summarizes the etiology,pathogenesis and clinical characteristics of concomitant SNHL and VD related diseases with a review of literatures published domestically and internationally,to provide a basis for standardized clinical diagnosis and treatment.