Objective To analyze the characteristics of bone conduction (BC) threshold changes after stapedotomy in patients with otosclerosis, and to explore the clinical significance and implications for the evaluation of surgical outcomes. Methods It is a retrospective, single-center study. A total of 97 ears from patients with otosclerosis who underwent endoscopic stapedotomy (footplate fenestration with titanium piston implantation) between November 2015 and February 2025 were included. Pure tone audiometry (PTA) was performed preoperatively, and at 1 month and 6 months postoperatively. Air conduction (AC) thresholds were tested at 125–8000 Hz, and bone conduction (BC) thresholds at 250–4000 Hz. Pre- and postoperative changes in BC thresholds, AC thresholds, and air-bone gap (ABG) were documented, and the results were compared with findings from other studies. Results The average postoperative BC threshold across 250–4000 Hz showed significant improvement, with a mean gain of 7.5 dB (Z = -6.343, p<0.001). At individual frequencies, improvements were significant at 250, 500,1000, 2000 Hz, with the most notable gain at 250 Hz (10 dB), followed by 500 Hz, 1000 Hz, and 2000 Hz (5 dB gain each) (all p<0.001). No statistically significant improvement of BC threshold was observed at 4000 Hz (Z = -0.368, p = 0.713). AC thresholds also showed significant improvements across all tested frequencies (125–4000 Hz) (all p<0.001), with a mean gain of 19 dB; the greatest improvement was observed at 1000 Hz (30 dB). Although the average ABG narrowed by 13 dB, the degree of closure underestimates the actual hearing improvement, as it fails to account for concurrent BC enhancement. Compared with those of other studies, the study cohort demonstrated more pronounced BC improvements. Conclusion Stapedotomy not only effectively restores AC hearing but also significantly improves BC thresholds. This improvement in BC thresholds may be attributed to the restoration of bone conduction mechanisms following stapedotomy. Traditional evaluation methods for surgical outcomes that rely solely on ABG closure tend to underestimate overall surgical efficacy. For clinical implementation, we suggest a multidimensional framework can be applied by simultaneously evaluating postoperative air conduction gain, bone conduction gain, and air‑bone gap closure at each frequency, rather than relying on ABG closure alone.
The prevalence of neurodegenerative diseases is escalating globally.However,the conventional diagnostic framework fails to identify the pathology until substantial neuronal damage occurs.The evidence from the recent literature indicates that auditory dysfunction commonly precedes motor and cognitive symptoms across multiple neurodegenerative diseases.The pathophysiology involves both the peripheral and cortical auditory struc-tures,which produce distinctive patterns reflects systemic neurodegeneration.Hence,this suggests auditory assessment as a valuable tool for early identification of neural degeneration.This review synthesises the contemporary literature on auditory dysfunctions and underlying pathophysiology in Alzheimer's disease,Parkinson's disease,Frontotemporal dementia,Amyotrophic lateral sclerosis,etc.The analysis included the temporal trajectories of auditory impairment,subjective-objective measurements,and evaluated the importance of early identification and longitudinal tracking.Objective measures of central auditory processing,including Auditory Brainstem Responses,P300,Mismatch Negativity,and speech-in-noise testing,provide objective,non-invasive diagnostic tools and its sensitivity comparable to established biomarkers.Integration of standardised auditory assessment batteries into clinical protocols could enable the early identification of pathology,differential diagnosis and the development of novel therapeutic strategies for both auditory and cognitive deficits.Current review suggests that future longitudinal studies with neurodegenerative conditions should focus on the clinical utility of auditory,cognitive,and neuroimaging biomarkers and facilitate clinical translation of these findings.
Objective:To analyze the types, directions, and intensities of nystagmus occurring during each step (positions 2, 3, and 4) of the Epley maneuver in patients with posterior semicircular canal benign paroxysmal positional vertigo (BPPV), and to explore their relationship with a positive Dix-Hallpike test at 24-48 hours post-maneuver, indicating incomplete canalith clearance. Methods:Clinical data from 60 patients with unilateral posterior semicircular canal canalithiasis were retrospectively analyzed. All patients underwent a standard Epley maneuver under video nystagmography (VNG) monitoring. The direction and slow phase velocity (SPV) of nystagmus were recorded at each repositioning step. The need for a second repositioning was determined by repeat Dix-Hallpike test 24-48 hours after the maneuver. Univariate and multivariate logistic regression analyses were performed to identify associations between nystagmus characteristics at each step and the need for a second procedure. Sensitivity, specificity, and predictive values were calculated. Results:Among 60 patients, 19 (31.7%) required a second repositioning. Univariate analysis showed that reverse nystagmus at position 3, reverse nystagmus at position 4, reverse nystagmus at either position 3 or 4, SPV of reverse nystagmus at position 4 ≥10°/s, diagnostic vertical SPV ≥20°/s, and latency ≤2 s were significantly associated with the need for a second procedure (all P<0.01). Multivariate logistic regression identified reverse nystagmus at position 4 as the strongest independent predictor (OR=32.1, 95%CI 6.2-166.7). Reverse nystagmus at position 4 predicted the need for a second procedure with a sensitivity of 84.2%, specificity of 97.6%, positive predictive value of 94.1%, and negative predictive value of 93.0%. Although reverse nystagmus at position 3 was also associated with the need for a second procedure (OR=18.5), its sensitivity was low (47.4%). Orthotropic nystagmus at position 2 showed no correlation with outcome (P>0.05). All four patients who exhibited down-beating nystagmus did not require a second procedure. Conclusion:During the Epley maneuver, reverse nystagmus occurring at position 4 is the strongest predictor of the need for a second repositioning, with a positive predictive value exceeding 94%. Down-beating nystagmus indicates a favorable outcome and was associated with a lower probability of requiring a second repositioning. Real-time nystagmus feedback during the procedure allows early identification of high-risk patients and enables optimized, individualized follow-up strategies.
Objective:To determine the prevalence, severity, and audiometric characteristics of age-related hearing loss (ARHL) in older Chinese adults attending a tertiary otolaryngology clinic, with emphasis on age- and sex-specific patterns based on the updated World Health Organization (WHO 2020) criteria. Methods:In this cross-sectional study, 1,000 adults aged ≥60 years underwent otologic examination, tympanometry, and pure-tone audiometry at a tertiary medical center between March 2022 and January 2023. Individuals with abnormal tympanograms or evidence of middle ear disease were excluded. Pure-tone averages (0.5, 1, 2, and 4 kHz) from the better ear were used to define and grade ARHL. Age- and sex-related differences in hearing thresholds were assessed using chi-square tests, t-tests, and two-way ANOVA. Results:Within this tertiary-care outpatient cohort, the prevalence of hearing loss according to WHO 2020 criteria was 84.1%, rising from 78.3% in the 60s to 100% in those aged over 90 years. Hearing thresholds showed a consistent high-frequency-sloping configuration, with high-frequency (8,000 Hz) thresholds declining at nearly double the rate of low-to-mid frequencies (11.7 dB vs. 4.5-6.3 dB per decade). The steepest decadal deterioration occurred between the 70s and 80s, characterized by a transition from high-frequency sensory loss to generalized cochlear decline. A sex-dependent "crossover" was observed: females exhibited superior hearing in their 60s and 70s but experienced more rapid deterioration in late life, resulting in comparable or poorer thresholds than males by their 80s and 90s. Conclusion:In this tertiary-care outpatient cohort of older Chinese adults, ARHL demonstrated distinct age- and sex-specific trajectories,including disproportionate high-frequency vulnerability and a late-life sex crossover effect. Adoption of WHO 2020 criteria substantially increased hearing-loss identification, particularly among adults in their 60s and 70s.
Background:Self-reported hearing difficulty is a common hearing-related complaint and may reflect perceived auditory impairment, communication difficulties, or clinically relevant hearing loss. Observational studies have linked cardiometabolic traits to hearing-related outcomes, but these associations are difficult to interpret because of residual confounding and reverse causation. Methods:We performed a two-sample Mendelian randomization (MR) study to evaluate the potential associations of five genetically predicted cardiometabolic traits-body mass index (BMI), C-reactive protein (CRP), systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL-C), and liability to type 2 diabetes (T2D)-with self-reported hearing difficulty. The primary outcome was self-reported hearing difficulty in the UK Biobank (field 2247; OpenGWAS: ebi-a-GCST90013961). External replication was conducted using a large genome-wide association meta-analysis of hearing loss/difficulty in hearing (OpenGWAS: ebi-a-GCST90018857). The inverse-variance weighted (IVW) method was prespecified as the primary estimator, complemented by sensitivity analyses and multivariable MR (MVMR) to assess robustness and the independence of the observed association. Results:Genetically predicted higher BMI was associated with higher odds of hearing difficulty in the primary analysis (IVW OR 1.076, 95% CI 1.030-1.124; P = 0.0011), and a directionally concordant association was observed in the external replication dataset (OR 1.092, 95% CI 1.012-1.178; P = 0.0226). By contrast, IVW estimates for CRP, SBP, LDL-C, and T2D liability were close to the null and showed no consistent evidence of association across the two outcome datasets. In MVMR including BMI and CRP, the BMI estimate attenuated toward the null, whereas CRP showed no independent association. Conclusions:These findings provide suggestive genetic evidence that higher BMI is associated with increased liability to self-reported hearing difficulty, whereas the other cardiometabolic traits examined showed limited evidence of consistent associations. However, the BMI association should be interpreted cautiously given the heterogeneity, pleiotropy-related findings, and attenuation observed in MVMR.
Necrotizing external otitis (NEO) is a rare but serious disease of the skull base (osteomyelitis). Immunosuppressed, and elderly patients are most commonly affected. The most common pathogen is Pseudomonas aeruginosa. Early diagnosis is crucial for the prognosis. To establish the diagnosis, both positive imaging findings, and clinical criteria are required to be met. Imaging is used during follow-up to monitor a potential recurrence due to its high risk, even after successful treatment. The use of radiological or nuclear medicine methods (scintigraphy) in the management of NEO is not currently standardised. We report a series of 5 patients with necrotizing external otitis/otogenic skull base osteomyelitis over a period of 12 years (2012-2024). In all patients, 99mTc-HMPAO (hexa-methyl-propylene-amine-oxime) labelled autologous leukocyte scintigraphy was used to diagnose, to monitor therapy response and for a follow-up. The primary diagnosis of necrotizing otitis was confirmed by scintigraphy in all cases (positive predictive value of 100%). In monitoring of treatment response, true negative scintigraphic findings were observed in two cases, two findings were false-negative (negative predictive value of 50%), and one case was found to be a false-positive. In a follow-up, the recurrence of the disease was truly detected or ruled out by subsequent scintigraphy in all subjects. Technetium-99m-labelled leukocyte scintigraphy is a convenient and reliable method, especially for diagnosing, and follow-up of necrotizing external otitis/otogenic skull base osteomyelitis. In terms of monitoring treatment response, further studies could be suggested for improving the estimated low negative predictive value.
Objectives:This study assessed the connection between vertigo severity and OSA. Material and methods:111 patients (78 men and 33 women, 48.35 ± 9.24 years) patients with OSA accompanied by vertigo were included in the investigation. These patients underwent respiratory polygraphy, and completed self-reported questionnaires, including the Dizziness Handicap Inventory (DHI), Beck Depression Inventory (BDI), and the Symptom Checklist-90-Revised (SCL-90-R) questionnaires. Results:In the study, 25.2% of the patients did not have OSA, 40.5% presented with mild symptoms, 9.9% had moderate symptoms, and 24.3% exhibited severe OSA symptoms. Although the difference in DHI scores based on OSA severity was statistically insignificant (p=0.35, H=3.21, Kruskal-Wallis test), there was a noticeable trend indicating higher DHI values in patients with severe OSA. A logistic regression model observed depression (p=0.010*; OR= 190.252, 95% CI=3.587-10090.086) and BMI obese category (p=0.019*; OR=141.068, CI=2.290-8688.383) as significant predictors for vertigo in OSA. When analysing the correlations between psychiatric symptoms and vertigo in OSA, significant relationships were observed between BDI and total DHI (rho=0.332, p= 0.002*), and the SCL-90-R depression (rho=0.480, p=0.000*) and anxiety points (rho=0.480, p=0.000*) and the total DHI, respectively. Conclusions:Our analysis indicates a connection between the severity of vertigo symptoms and the severity of OSA. Additionally, the significant correlation between psychiatric symptoms and OSA severity emphasises the need to consider these factors when managing OSA patients in everyday practice.
Objective:To characterize age-related changes in wideband absorbance (WBA) among normal-hearing children aged 0-6 years through combined statistical and machine learning analyses, and to establish developmental reference patterns supporting pediatric middle-ear diagnostics. Methods:A cross-sectional study was conducted on 579 children (1158 ears) categorized into five age groups. All participants passed age-appropriate hearing screenings. WBA was measured under both ambient pressure (AP) and tympanometric peak pressure (TPP) conditions across 16 frequencies (226-8000 Hz). Repeated-measures analysis of variance examined the effects of age, ear side, and gender, while Random Forest classifiers and principal component analysis (PCA) explored the discriminative structure and feature importance of WBA data. Results:Neither gender nor ear side had a significantly effect on WBA patterns (p > 0.05). In constrast, Age significantly influenced WBA patterns (p < 0.001). Younger infants (< 6 months) exhibited dual-peaked "M-shaped" curves, whereas older children (3-6 years) showed single-peaked, inverted "U-shaped" profiles centered near 1600 Hz, reflecting progressive middle-ear maturation. The Random Forest model achieved a mean accuracy of 0.73 (balanced accuracy = 0.58), with the top-ranked predictors (AP_1000, and AP_793) emphasizing low-to-mid frequency absorbance and pressure-compensation effects as key age indicators. PCA with k-means clustering further revealed partially distinct groupings aligned with chronological age, supporting the developmental encoding of WBA responses. Conclusion:WBA demonstrates distinct, age-dependent acoustic characteristics that correspond to physiological maturation of the middle ear. These findings provide a quantitative reference for pediatric wideband acoustic immittance and highlight the potential of machine learning in delineating developmental auditory patterns.
Background:Tympanostomy tube(TT)insertion is one of the most common pediatric otologic procedures.This study compares postoperative com-plications between two commonly used tympanostomy tubes:Reuter Bobbin titanium tubes and Sheehy Collar Button fluoroplastic tubes.Design:Retrospective cohort study.Methods:The medical records of children aged 6 months to 7 years who underwent TT insertion at a tertiary care center between July 2022 and June 2023 were reviewed.Patients were divided according to the inserted tube model:Reuter Bobbin titanium or Sheehy Collar Button fluoroplastic.The main outcomes were postoperative ear drainage and complications,including tube clogging,granulation tissue for-mation,premature extrusion,and tympanic membrane perforation,assessed across the first,second,and third follow-up visits.Results:A total of 138 patients who underwent TT insertion in 268 ears were included;181 ears received Sheehy Collar Button fluoroplastic tubes and 87 ears received Reuter Bobbin titanium tubes.At the third follow-up visit(7.46±2.93 months),the overall complication rate was higher in ears with Reuter Bobbin titanium tubes than in those with Sheehy Collar Button fluoroplastic tubes(44.4%vs.5.6%,p<0.001).Ear drainage was more frequent in the fluoroplastic tube group across follow-up visits(7.2%,18.4%,and 27.8%vs.1.1%,7.4%,and 0%,respectively;p=0.054,p=0.12,and p<0.001).Conclusion:In this retrospective cohort,Reuter Bobbin titanium tubes were associated with higher later complication rates,whereas Sheehy Collar Button fluoroplastic tubes were associated with higher postoperative drainage.
Background We present two rare cases where a metal splinter became lodged in the middle ear (hypotympanum) as a result of occupational accidents. Methods Retrospectiveanalysis of two patients underwent surgical procedures for the removal of a metallic foreign body from the middle ear was reported. A systematicliterature review was conducted using PubMed. Results The patients reported symptoms of hearing loss, otorrhea, and vertigo following the injury. Temporalbone CT scans confirmed the presence of a foreign body in the hypotympanum in both cases. In the first case, the patient sought medical attentionpromptly and underwent a single surgical procedure: exploration of the tympanic cavity allowed removal of the foreign body, followed bymyringo-plasty. In contrast, the second patient delayed seeking treatment for 11 days, resulting in severe inflammation. This patient required two surgicalinterventions, the second involving mastoidectomy, to extract the foreign body. This highlights the need for improved occupational health safetymeasures, particularly in professions at risk for such injuries, and emphasizes the importance of timely medical care for optimal outcomes. Conclusion Delayedt reatment can lead to complications, necessitating more complex surgical procedures and prolonged recovery. Early diagnosis and timely surgicalmanagement are essential to minimize complications and preserve auditory function.
Objective:This study aimed to compare video head impulse test (vHIT) metrics in relapsing-remitting multiple sclerosis (RRMS) versus controls, test differences by cerebellar MRI status within RRMS, and explore clinical/MRI correlates of corrective saccades. Methods:Single-center prospective study including 35 adults with RRMS and 35 age-/sex-matched controls. Disability was quantified by EDSS; a blinded neuroradiologist classified cerebellar involvement. The MS cohort was categorized into two subgroups according to the occurrence of cerebellar lesions. Each group participated in a vHIT to assess VOR gain. Results:RRMS participants had low disability (mean EDSS 0.95). Compared with controls, RRMS showed lower VOR gain in the right anterior/posterior, left posterior, and left lateral canals and higher asymmetry across RALP, LARP, and lateral planes (p=0.012, 0.024, <0.001). Corrective saccades differed between groups only in the left anterior canal (p=0.025). Within RRMS, cerebellar-positive versus cerebellar-negative subgroups did not differ for gain or asymmetry (all p>0.05); corrective-saccade prevalence was similar (33.3% vs 35.0%; chi-square p=0.918). In regression, cerebellar involvement, relapse count, EDSS, and disease duration were not associated with recurrent corrective saccades. Conclusion:vHIT reveals canal-selective gain reductions and elevated asymmetry in patients with mildly disabled RRMS, but these abnormalities do not differ by cerebellar MRI status.
Objectives:Although LOXHD1 mutations have been increasingly implicated in late-onset hereditary hearing loss, the genetic spectrum and underlying molecular mechanisms in the Chinese population remain inadequately characterized. This study aims to delineate the genetic landscape of LOXHD1 in Chinese families with non-syndromic hearing loss and to determine the pathogenic significance of the identified variants. Method:In this study, we conducted targeted whole-exome sequencing along with Sanger sequencing on 157 probands with non-syndromic hearing loss, as well as their family members. We identified novel variants in the LOXHD1 gene. Additionally, we employed bioinformatic analyses to investigate the potential molecular functions of these variants. Results:In this study, potential causal variants were identified in 95 (60.51%) affected individuals and variants in SLC26A4 and GJB2 were most frequent in this cohort. we identified ten different variants in the LOXHD1 gene from five patients in their families. Among them, five novel LOXHD1 gene variants linked to hearing loss were recognized: c.3734G>A, c.4952T>A, c.4486C>T, c.6375G>C, and c.5002del. The pathogenicity of these variants was evaluated through multiple bioinformatics analyses. Notably, two patients with severe bilateral sensorineural hearing loss associated with LOXHD1 mutations showed significant improvement after cochlear implantation, attaining receptive and expressive language skills appropriate for their chronological age. Conclusions:We have identified five novel variants of the LOXHD1 gene in Chinese family affected by nonsyndromic hearing loss. These findings enrich the current understanding of LOXHD1-related pathogenic variants and offer important implications for molecular diagnosis, genetic counseling, and prenatal screening in hereditary hearing loss.
Objective:To evaluate the clinical efficacy of an adaptive vestibular rehabilitation training system based on Virtual Reality (VR) technology for patients with semicircular canal injury. Methods:A randomized controlled trial was conducted with 60 patients diagnosed with peripheral vestibular vertigo. Participants were randomly assigned to either an Intervention Group (n=30), which received VR-based adaptive vestibular rehabilitation using the PICO 4 Pro system, or a Control Group (n=30), which underwent traditional vestibular rehabilitation. Both groups received training for four weeks. The primary outcome measure was the Dizziness Handicap Inventory (DHI). Secondary outcomes included balance performance assessed via the Activities-specific Balance Confidence (ABC) Scale and static posturography (Maximum Sway Path Length and Sway Area). Vestibular function was objectively evaluated using the Video Head Impulse Test (vHIT) and the Bithermal Caloric Test. Psychological status was assessed using the Hospital Anxiety and Depression Scale (HADS). Results:Post-intervention analysis revealed that the Intervention Group achieved significantly lower DHI scores compared to the Control Group. In terms of balance, the Intervention Group demonstrated significantly higher ABC Scale scores and reduced Maximum Sway Path Length and Sway Area compared to controls. Furthermore, the Intervention Group showed a significantly lower rate of abnormal findings in both vHIT and Bithermal Caloric Tests, indicating improved physiological function. Improvements in psychological well-being were also observed, with the Intervention Group exhibiting significantly lower HADS scores. Conclusion:VR-based adaptive vestibular rehabilitation is effective in alleviating vertigo symptoms, enhancing balance function, and improving psychological well-being. The intervention also promotes the physiological recovery of semicircular canal function, demonstrating superior clinical efficacy compared to traditional rehabilitation methods.
Artificial intelligence (AI)-based conversational models such as ChatGPT are increasingly used in healthcare for patient education and counselling. However, their feasibility and acceptance in routine ENT outpatient practice remain unexplored. This pilot study evaluates the usefulness of a ChatGPT-generated counselling sheet for patients with Chronic Suppurative Otitis Media (CSOM). Twenty adult patients (>18 years) diagnosed with CSOM received standard doctor counselling followed by a structured ChatGPT-generated counselling sheet. A validated five-question comprehension questionnaire assessed their understanding before and after receiving the AI-generated sheet. Results demonstrated a statistically significant improvement in patient comprehension (p < 0.001). This preliminary study highlights the potential role of AI-based tools as adjuncts to patient counselling in ENT OPDs.
Purpose:Endogenous hydrogen sulfide (H2S) mediates several biological processes and is an important gaseous signal transmitter akin to carbon monoxide or nitric oxide (NO). The role of H2S on auditory signaling pathway remains unknown. We have determined whether ATP can induce generation of H2S in outer hair cells (OHCs) and examined whether H2S can affect the ATP-stimulated generation of NO in OHCs. Methods:Individual OHCs were isolated enzymatically from the guinea pig cochlea. Using H2S- and NO-sensitive dyes, 6-CdII and 4,5-diaminofluorescein diacetate respectively, we monitored the change in generation of H2S and NO in response to extracellular ATP in OHCs. Results:We observed a gradual increase in 6-CdII fluorescence induced by extracellular ATP, providing evidence for H2S production in OHCs. This ATP-induced H2S production was inhibited by suramin, an antagonist of the P2 receptor. ATP did not induce H2S production in a Ca2+-free medium. This suggests that ATP-induced H2S production was mediating by an influx of Ca2+ via activation of P2-purinergic receptors. The inhibitor of cystathionine β-synthase (CBS), amino-oxyacetic acid (AOAA), counteracted this increase in 6-CdII fluorescence, which however was unaffected by cystathionine γ-lyase inhibitors, β-cyanoalanine or D-L-propargylglycine. L-NG-nitroarginine methyl ester, a non-selective inhibitor of NO synthase, also failed to inhibit ATP-induced H2S production. In contrast, AOAA inhibited generation of NO in the presence of ATP in OHCs. Conclusion:The current study suggests that ATP-induced H2S production is mediating by an influx of Ca2+via activation of P2-purinergic receptors. These findings imply generation of H2S by CBS in response to exposure to ATP in OHCs. Regulatory cross-talk among ATP, H2S, and NO may also exist in the cellular signaling pathways in OHCs.
Background:Chronic subjective tinnitus affects 15-20% of adults globally, with 3-5% experiencing severe quality-of-life impairment. Sound therapy (ST) is a core intervention, but its neuromodulatory mechanisms remain incompletely characterized due to the lack of objective biomarkers. Methods:Following PRISMA guidelines, we systematically searched PubMed, Web of Science, Embase, and other databases (1977-2025) for randomized controlled trials (RCTs) investigating ST effects on EEG spectral power in tinnitus patients. Inclusion criteria required pre/post-ST EEG data in delta (0.5-4 Hz) and alpha (8-14 Hz) bands. Two independent reviewers extracted data and assessed bias using Cochrane tools. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were pooled via fixed/random-effects models. Results:Two RCTs (n=71 patients) met inclusion criteria. Post-ST, the intervention group showed non-significant trends toward increased delta (SMD=0.11, 95% CI: [-0.40, 0.62], P=0.67) and alpha (SMD=0.09, 95% CI: [-0.41, 0.60], P=0.72) power. Between-group analyses revealed greater alpha enhancement in customized ST versus controls (SMD=0.40, 95% CI: [-0.12, 0.91], P=0.13; I2=39%). Alpha changes demonstrated moderate consistency across studies (I2=39%, P=0.19). Conclusion:ST induces measurable delta/alpha power modulation, suggesting enhanced inhibitory neurotransmission and attentional regulation. While statistical significance was limited by sample size, these trends support EEG as a tool for objective treatment monitoring. We propose a "dual-band synergistic neuromodulation" framework: ST concurrently suppresses pathological hyperexcitability and potentiates slow-wave inhibition. Standardized EEG protocols and longitudinal validation are critical for advancing precision tinnitus therapeutics.
Purpose:To evaluate the clinical validity of Acoustic Change Complex (ACC) measurements for diagnosing temporal resolution deficits in individuals with sensorineural hearing loss (SNHL). Methods:This study included 100 participants, divided into two groups: 50 adults with normal peripheral hearing (NH), who served as the control group, and 50 adults with bilateral mild-to-moderate sensorineural hearing loss (SNHL). All participants completed both behavioral and electrophysiological Gap-in-Noise (GIN) assessments. Results:Both behavioral and electrophysiological Gap-in-Noise (GIN) assessments demonstrated significantly elevated thresholds in the SNHL group compared with the NH group. Furthermore, electrophysiological GIN thresholds were consistently lower (better) than behavioral GIN thresholds in both groups. A strong positive correlation was observed between behavioral and electrophysiological GIN thresholds. The electrophysiological GIN threshold demonstrated a sensitivity of 84% and a specificity of 90% for identifying temporal resolution deficits. Conclusion:These findings indicate that the electrophysiological Gap-in-Noise (GIN) test is a reliable objective measure for evaluating temporal resolution. Moreover, it may be particularly useful in clinical situations where behavioral assessment is not feasible.
OBJECTIVE:This study aimed to investigate the long-term auditory and speech outcomes of sequential bilateral cochlear implantation (BiCI) in children with cochlear nerve deficiency (CND). METHODS:Sixteen CND children who underwent sequential BiCI were retrospectively reviewed. Auditory and speech abilities were evaluated using questionnaire-based rating scales, including the Categories of Auditory Performance (CAP), the Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS), and the Speech Intelligibility Rating (SIR). Closed-set and open-set speech recognition abilities were also measured. RESULTS:The first cochlear implantation (CI) was performed at a median age of 12 months. The mean age at contralateral CI was 43 months, and the mean inter-implant interval time was 26 months. All patients showed continuous auditory and speech improvement over time. Of the sixteen patients, nine completed closed-set and/or open-set speech recognition assessments. After contralateral CI, all nine patients showed improved closed-set speech recognition scores. Four patients achieved closed-set test scores of more than 90% and open-set disyllable recognition scores ranging from 44 to 85%. In addition, two patients demonstrated better performance with bilateral CI than with unilateral CI. CONCLUSIONS:CND children showed favorable long-term auditory and speech outcomes after sequential BiCI, and some demonstrated bilateral benefit in speech perception. These findings suggest that BiCI may be a viable option for selected CND children.
1 Introduction A 25-year-old woman presented with a 3-month history of otalgia and aural fullness in the left ear,without associated otological or systemic symptoms.Her medical history was unremarkable,and she denied any history of hepatitis,hypertension,diabetes,cardiovascular disease,or other significant conditions.The patient was diagnosed with external auditory canal cholesteatoma and subsequently underwent canalplasty under general anesthesia.Routine anesthetic drugs,including 2％lidocaine,dexamethasone,propofol,sufentanil,rocuronium bromide,ondansetron,flur-biprofen axetil,neostigmine,and atropine,were used during surgery and anesthesia recovery.No significant events were noted,and the patient experienced only a blood loss of 10 mL.
Background Brucellosis is a zoonotic infection common in Mediterranean countries and the Middle East. Neurological involvement, although rare, can lead to severe complications, including sensorineural hearing loss (SNHL). This case is particularly noteworthy as it highlights irreversible auditory nerve damage in brucellosis, emphasizing the importance of early diagnosis and treatment to prevent permanent neurological consequences. The novelty of this case lies in the severity of auditory involvement despite timely treatment.Case Presentation A 43-year-old male farmer of Maghrebi origin presented with neurobrucellosis complicated by severe, irreversible bilateral sensorineural hearing loss. The patient initially reported symptoms of hearing loss and dizziness, which were confirmed to be associated with auditory nerve involvement. Wright's serology and polymerase chain reaction (PCR) testing confirmed brucellosis. Despite appropriate and prolonged antibiotic therapy, including drugs that penetrate the meningeal barrier and act intracellularly, the patient's auditory impairment remained permanent. The patient is currently a candidate for cochlear implantation to manage his severe hearing loss. Neurological symptoms did not improve with treatment, but cochlear implantation may offer a potential solution to his hearing deficit.Conclusions This case highlights the importance of early recognition and intervention in brucellosis cases, particularly those with neurological involvement. Delayed diagnosis and treatment can result in irreversible neurological damage. It also underscores the potential for cochlear implantation in patients with severe, irreversible sensorineural hearing loss caused by neurobrucellosis. Cochlear implantation offers an important solution for patients with brucellosis-related hearing deficits, improving their quality of life despite the neurological damage caused by the infection.
