Objective:This study aimed to assess the clinical application of subjective visual vertical（SVV） and subjective visual horizontal（SVH） tests at different head deflection angles in the diagnosis of vestibular neuritis（VN）, offering insights for a more precise evaluation of otolith dysfunction. Methods:A total of 40 patients with VN who were diagnosed at the Hearing Impairment and Vertigo Centre, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, between January and December 2024 were retrospectively analysed, and 31 healthy adults served as the control group. All participants underwent computer-assisted SVV/SVH tests at three head tilt angles: upright head position 0°（0°）, left head deflection 45°（L45°）, and right head deflection 45°（R45°）, and the deviation values were recorded and compared with those of the healthy control group for statistical analysis. Results:①Compared with normal controls, the difference in the rate of SVV/SVH abnormalities at 0°, L45° and R45° deflection angles was statistically significant in patients with VN（P<0.05）, with the highest rate of abnormality at 0°; ②The rate of abnormalities on the affected side of SVV and SVH was significantly higher in VN patients than on the healthy side（P<0.05）; ③Statistically significant differences were found in the comparison of the absolute values of different head deflection angles of SVV between VN patients and healthy controls（P<0.05）, and in the comparison of the absolute values of SVH in upright head position 0° and L45° between VN patients and healthy controls（P<0.05）, while the difference in the comparison of the absolute values of R45° was not statistically significant（P>0.05）. Conclusion:The SVV and SVH tests are important tests for assessing otolith dysfunction in patients with VN, with high sensitivity, and can quickly determine the side and degree of damage, of which the upright head position 0o is the most helpful for diagnosis, and is recommended as a routine examination head position, and this test can be an important method for the refined assessment of otolith dysfunction in patients with VN.

Early non-invasive correction of neonatal auricular deformities is highly dependent on timely and precise diagnosis. However, clinical practice is often compromised by the subjectivity of visual assessments and the lack of objective tracking metrics, which frequently leads to missed optimal treatment windows. To address these challenges, we developed an interpretable deep learning-based diagnostic system for the automated screening and fine-grained classification of these deformities. Methodologically, a large-scale, multi-source dataset (n = 4644) was curated to support model training. The system pairs an automated object detector (YOLOv11) for background-reduced region-of-interest isolation with a cascaded classification pipeline optimized via ConvNeXt-Tiny. Crucially, we introduced a supervised contrastive learning module to project high-dimensional morphological features into a continuous severity score, enabling quantitative longitudinal tracking of therapeutic efficacy. To evaluate generalization and robustness, the framework underwent rigorous evaluation across three independent real-world cohorts and one controlled synthetic stress test. The system achieved 88.2% accuracy (Area Under the Curve (AUC): 0.949) in binary screening and 87.4% accuracy (macro-AUC: 0.976) in multi-class subtyping on the internal baseline. To enhance interpretability and build clinical trust, Gradient-weighted Class Activation Mapping (Grad-CAM) was utilized to explore the spatial distribution of the model’s attention, which frequently aligned with key anatomical landmarks. Furthermore, the learned severity scores robustly quantified post-intervention improvements (p = 0.0004), effectively capturing subtle anatomical normalization. While validation for rare subtypes remains underpowered, and the severity score currently functions mainly as a learned morphological similarity index requiring future clinical calibration, this study ultimately provides an objective and standardized web-based tool to facilitate the early intervention and precision management of neonatal auricular anomalies.

Objective: This study aims to analyze the characteristics of vestibular evoked myogenic potentials (VEMPs) and evaluate specific vestibular nerve pathway impairments in children with Attention Deficit Hyperactivity Disorder (ADHD) compared to typically developing (TD) children. Methods: Forty-five children with ADHD and 34 TD children were recruited. All participants underwent comprehensive acoustic (ACS) and galvanic (GVS) VEMP examinations. To account for within-subject correlation, statistical analyses were performed at the subject level. Results: Children with ADHD exhibited prolonged P13 and N23 latencies in both ACS-cVEMP and GVS-cVEMP compared to TD children. For oVEMP, the N1 latency of ACS-oVEMP was significantly shorter in the ADHD group, and the interval was prolonged. Additionally, the absolute amplitude of ACS-cVEMP was significantly and markedly higher in children with ADHD. Conclusions: Children with ADHD exhibit functional abnormalities in both the saccule inferior vestibular nerve pathway (reflected by cVEMP) and the utricle superior vestibular nerve pathway (reflected by oVEMP). These impairments are primarily characterized by altered neural conduction latencies and hyperactive amplitude responses, providing valuable electrophysiological insights into vestibular dysfunction in ADHD.

Objective:To explore the cognitive function of sensory age-related hearing loss（ARHL） patients and compare it with healthy control group. Methods:Twenty-two patients with bilateral symmetrical sensory ARHL and 21 healthy elderly controls with normal hearing were recruited. All participants were evaluated for cognitive function using the Montreal Cognitive Assessment（MoCA） and the P300 objective electrophysiological test, respectively. P300 latency, amplitude, the total MoCA score, and scores of different dimensions of the MoCA scale were recorded and statistically analyzed. Results:①The healthy control group showed a significantly higher total MoCA score than the sensory ARHL group（P=0.038）. This difference was primarily driven by the visuospatial/executive function（P<0.001）, attention（P=0.003）, and abstraction（P<0.001） domains. ②A significant difference in P300 latency was observed between the healthy control group and the sensory ARHL group（P=0.006）. ③No significant correlation was found between P300 latency and each dimension of the MOCA scale in both groups. Conclusion:Patients with sensory ARHL exhibit cognitive decline, which is primarily manifested as impairments in visuospatial/executive function, attention, and abstraction. The P300 test, as an objective electrophysiological measure, can serve as a crucial complementary tool to the subjective MoCA questionnaire, with prolonged latency being a key indicative parameter.

Objective:To investigate the relationship between symptoms of vertigo and vestibular functions and short-term hearing outcomes in patients with flat descending sudden sensorineural hearing loss （SSNHL）. Methods:A retrospective review was conducted of the vestibular symptoms observed in 48 patients with unilateral flat-down sudden sensorineural hearing loss treated at the Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. Symptoms of vertigo and the results of cervical vestibular-evoked myogenic potentials （cVEMP）, ocular VEMP （oVEMP）, caloric test and video head-impulse test （vHIT） were collected to determine whether these factors could predict therapeutic efficacy. Results:The symptoms of vertigo was not correlated with prognosis （P>0.05） or with abnormal vestibular functions （P>0.05）. Patients with abnormal cVEMP, oVEMP, caloric test or vHIT showed significantly lower effective rates （32.0%, 44.0%, 32.0%, and 24.0%, respectively）; the greater the number of abnormal tests, the poorer the outcome. Patients with all four tests abnormal gained only （3.13±15.97） dB HL in hearing recovery, whereas those with normal cVEMP, oVEMP, caloric test or vHIT showed better chances of hearing improvements by （29.22±20.31）, （31.18±21.59）, （26.17±21.31）, and （26.38±24.05） dB HL, respectively. Conclusion:Vestibular function effectively predicts prognosis in flat descending SSNHL. Patients with abnormal vestibular tests, regardless of symptoms of vertigo, responded poorly to treatment, whereas those with normal cVEMP, oVEMP, caloric test and vHIT results achieved better hearing recovery. Abnormal vestibular function implies more extensive and severe inner-ear lesions in patients with SSNHL.

To address the current lack of standardized protocols for vestibular infant screening (VIS), this clinical consensus aims to establish a clinical consensus on VIS in infants aged 0–12 months. Given a frequent co-occurrence of vestibular dysfunction in children with sensorineural hearing loss (SNHL) and the significant impact of vestibular dysfunction on early development, early identification and management are critical. This clinical consensus was developed by a panel of 28 international experts in pediatric otolaryngology and vestibular disorders through a structured, multi-round Delphi process. Panelists were selected based on clinical and academic expertise, representing 26 institutions across Asia and Europe. A comprehensive literature review (2000–2024) informed the initial draft of consensus statements. The consensus was reached through three iterative rounds of anonymous rating and feedback, followed by virtual discussions. Statements achieving ≥ 80

OBJECTIVE:The objective of this study is to investigate the relationship between symptom duration of vestibular-related dizziness/vertigo and cognitive function in elderly patients, and to establish clinical guidance for assessing and intervening in vestibular-related cognitive impairments. METHODS:This study included 100 elderly patients with vestibular dysfunction presenting dizziness, vertigo, or balance disorders, categorized into short-duration (n = 64) and long-duration (n = 36) groups based on symptom duration. A control group of 21 healthy elderly individuals was included. Cognitive assessments comprised P300 event-related potentials (latency/amplitude) and Montreal Cognitive Assessment (MoCA) with domain-specific analysis. RESULTS:Significant between-group differences in P300 latency were observed (control vs short-duration vs long-duration: p < 0.001), whereas amplitude showed no difference (p  =  0.817). MoCA total scores differed significantly across groups (p  =  0.001), although abnormality rates were comparable (p  =  0.093). Domain analysis revealed significant differences in visuospatial (p < 0.001) and abstract abilities (p  =  0.005). Symptom duration correlated with: MoCA total (R 2  =  0.113), visuospatial ability (R 2  =  0.181), attention (R 2  =  0.068), and orientation (R 2  =  0.157). P300 latency correlated with: MoCA total (R 2  =  0.141), visuospatial ability (R 2  =  0.090), delayed recall (R 2  =  0.112), and orientation (R 2 = 0.082). CONCLUSION:Prolonged vestibular-related dizziness/vertigo in elderly patients is associated with cognitive deficits, particularly in visuospatial and executive functions. P300 latency demonstrates greater sensitivity than both P300 amplitude and MoCA screening, suggesting that combined electrophysiological and neuropsychological assessment enhances early detection of vestibular-related cognitive impairment. Highlights:Long-duration vestibular-related dizziness or balance disorders are associated with a higher risk of cognitive impairment in elderly patients.Among early assessment tools, P300 latency proves more sensitive than both P300 amplitude and the Montreal Cognitive Assessment (MoCA) questionnaire.A combined evaluation using P300 latency and MoCA provides a more effective measure of how dizziness affects cognitive function in this population.

Objective: To evaluate the feasibility of vestibular screening in infants and investigate age-related changes in the characteristics of air-conducted sound cervical vestibular evoked myogenic potential (ACS-cVEMP) and bone-conducted vibration cervical vestibular evoked myogenic potential (BCV-cVEMP) in infants and children with normal hearing, aiming to provide new insights into the developmental trajectory of vestibular function during early childhood. Methods: A total of 159 subjects aged 3 months to 17 years old were divided into seven age groups. Additionally, 20 adults aged 18-30 years were included as controls to explore developmental changes in the sacculocollic reflex pathway. Results: The response rates of BCV-cVEMP in 3-month-olds were significantly higher than that of ACS-cVEMP (p = 0.048), while no significant difference was observed in other age groups (p > 0.05). Age-related changes were found in both latencies and amplitudes of ACS-cVEMP and BCV-cVEMP. ACS-cVEMP latencies reached adult levels at 13-17 years, while BCV-cVEMP latencies normalized by 7-12 years. ACS-cVEMP amplitudes increased with age, stabilizing at 4 years, whereas BCV-cVEMP amplitudes peaked at 4-6 years before gradually decreasing. Conclusions: This study demonstrates that cVEMP is not only a viable tool for vestibular screening in infants but also reveals crucial age-related developmental changes in the vestibular system. These findings contribute new insights into the maturation of the vestibular reflex pathways and provide normative data that can be used to guide early vestibular screening practices.

BACKGROUND:Currently, Intratympanic steroid injection (ITSI) has been identified as a common method for delivering dexamethasone to the inner ear in idiopathic sudden sensorineural hearing loss (ISSNHL). OBJECTIVE:This study analyzed factors influencing dexamethasone effective dose in ITSI, aiming to optimize injection protocols and efficacy assessment. MATERIALS AND METHODS:A total of 251 ISSNHL patients received ITSI with 5 mg dexamethasone, and drug leakage from the external auditory canal was quantified. The effects of Eustachian tube function (assessed via taste method), injection speed (5 vs. 10 s), and injection site (anteroinferior, posteroinferior, anterosuperior tympanic membrane) on the effective dose were evaluated. The pretreatment and posttreatment audiological examination results were collected, and the relationship between the effective dosage and the efficacy was analyzed. RESULTS:Significantly higher median leakage (1.90 mg vs. 0.75 mg, p < 0.01) was showed in patients with bitter taste, indicating passive eustachian tube opening. However, injection speed and site had no significant impact on leakage (p > 0.05). No significant differences in hearing outcomes were observed between high (>3.5 mg) and low (≤3.5 mg) effective dose groups (p > 0.05). CONCLUSIONS AND SIGNIFICANCE:ITSI effective dose primarily depends on eustachian tube function, and low-dose dexamethasone (sufficient to fill the tympanic cavity) is equally efficacious, suggesting simplified clinical protocols.

ObjectiveThe study aims to assess the high-frequency Vestibulo-Ocular Reflex (VOR) gain across three pairs of semicircular canals using the EyeSeeCam device and to determine normative values.MethodsA total of 105 volunteers, aged 19 to 69 years with no history of vestibular disorders, were enrolled. This cohort included 50 males (mean age 41.11 ± 15.98) and 55 females (mean age 35.52 ± 15.07), with no statistically significant age difference between the genders (P = 0.078). Participants were categorized into six age brackets: 11-20, 21-30, 31-40, 41-50, 51-60, and 61-70. For each test, the recording device was consistently positioned on the left side of the goggles, and the tests were conducted by a right-handed operator.ResultsThe average regression gain for left anterior-right posterior canals (LARP) was 1.44 ± 0.19, significantly surpassing that of right anterior-left posterior canals (RALP) at 1.09 ± 0.13 (p < 0.001) and horizontal semicircular canals (HSC) at 1.11 ± 0.07 (p < 0.001). No significant difference was observed between the VOR gains of RALP and HSC (p = 0.1077). Additionally, VOR gain values did not show significant variation across different age groups. In a gender-based analysis, a marginally higher HSC gain was observed in females (1.13 ± 0.07) compared to males (1.11 ± 0.07; p = 0.042), while no significant gender disparity was noted for RALP gains (females: 1.09 ± 0.11; males: 1.10 ± 0.14; p = 0.641). Females exhibited significantly higher LARP gain values (1.49 ± 0.18) than males (1.41 ± 0.20; p = 0.002).ConclusionThis study underscores the stability of high-frequency VOR gain values across ages. However, it also reveals a significant asymmetry in vertical canal gains (LARP vs RALP), suggesting a possible vertical canals monocular directional preponderance. This finding highlights that normative values can be highly specific to the recording and testing protocol. Thus, laboratories should develop their own normative values, customized to their equipment and testing protocols.

Objective To analyze the clinical significance of subjective visual vertical(SVV)tests at different head deflection angles in assessing utricle function in patients with benign paroxysmal positional vertigo(BPPV).Methods A total of 61 BPPV patients who were treated at the Hearing Impairment and Vertigo Diagnosis and Treatment Center of Otolaryngology Head and Neck Surgery,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine from August 2022 to May 2023 were retrospectively included,and 29 healthy adults were selected as controls.SVV tests were performed on all research subjects at different head deflection angles:upright head(0°),left head 45°(L45°),right head 45°(R45°).The test results between the two groups were compared.Results SVV absolute value at R45°in BPPV group was lower than that in the control group(P=0.003);there was no significant difference in SVV values at 0°and L45°between the two groups.There was no statistical difference in SVV values at different head deflection angles between the control group and the left BPPV group.SVV absolute value at R45°in right BPPV group was lower than that in the control group(P＜0.001);there was no statistical difference in SVV values at 0°and L45° between the two groups.Conclusions SVV test can provide subjective information about the utricle,and SVV tests at different head deflection angles can fine-tune evaluate the function of the utricle in BPPV patients.

Background Following successful canalith repositioning procedures (CRPs), some patients with benign paroxysmal positional vertigo (BPPV) may experience residual symptoms. There is currently no consensus on whether these residual symptoms are related to the disease duration. Objective To examine the impact of BPPV duration on the persistence of residual symptoms following successful CRP. Methods A total of 102 idiopathic BPPV patients were enrolled and categorized into short-course and long-course groups based on the duration of the disease. The course of disease in the short-course group was less than or equal to 7 days. The long course of disease was longer than 7 days. All patients underwent swivel-chair-assisted CRP and were followed up 7–10 days after successful CRP. The Dizziness Handicap Inventory (DHI) questionnaire was administered to all patients before and after CRP. Results Before CRP, significant differences were observed between the two groups in total DHI score and its subdomains: Physical (DHI-P), Functional (DHI-F), and Emotional (DHI-E) ( p < 0.05), indicating that long disease duration significantly affected all patient aspects. After CRP, significant differences remained in total DHI, DHI-P, DHI-F, and DHI-E scores ( p < 0.05), with the long-course group consistently scoring higher. However, no significant differences were found in the changes in DHI scores across dimensions before and after CRP between the two groups. Conclusion The duration of BPPV did not influence CRP outcomes, but patients with a longer disease course were more likely to experience residual symptoms after successful CRP.

Objective:To establish the normal values of subjective visual vertical （SVV） in different head deflection angles and analyze its test and retest reliability, in order to provide a reference for the clinical application of SVV in the evaluation of vestibular disorders. Methods:Thirty-one healthy young people were selected to wear VR glasses, and the SVV data were tested in five different head-tilt, namely, 0° in the upright head position, 45°in the left head position, 45° in the right head position, 90° in the left head position, and 90° in the right head position, and were re-tested 2 weeks later. Results:①The mean values of SVV at 5 different head-tilt angles of 0°, left 45°, right 45°, left 90°, and right 90° were -0.07±1.71, 4.30±5.39, -6.51±5.58, -3.76±7.42, and 0.40±8.02, respectively, The 95% confidence limits of SVV at 0°, left 45°, right 45°, left 90°, right 90°, and right 90° were （-3.42, 3.28）, （-6.26, 14.86）, （-17.45, 4.43）, （-18.30, 10.78）, and（-15.32, 16.12）, respectively; ②The absolute values of SVV at 4 different head-tilt angles of left 45°, right 45°, left 90°, and right 90° were 5.62±3.96, 6.90±5.07, 6.82±4.70 and 6.48±4.68, respectively. The 95% confidence limits of SVV at left 45°, right 45°, left 90°, right 90°, and right 90° were（0，12.11）,（0，15.21）,（0，14.53）and（0，14.16）, respectively. The asymmetry ratio is 10% for the absolute value of the 45 ° deviation and 3% for the absolute value of the 90° deviation; ③Intra-class correlation coefficients（ICC） for 0°, left 45°, right 45°, left 90°, right 90°were 0.757, 0.673, 0.674, 0.815, and 0.856, respectively. Conclusion:SVV has good retest reliability and high stability, and the SVV normal value data of different head deviation angles established in the present study can be used as a reference for the diagnosis and evaluation of vestibular disorders.

目的 构建听力正常婴幼儿不同频率短纯音听性脑干反应(TB-ABR)波V强度-潜伏期函数曲线,为临床TB-ABR反应阈的判断提供参考.方法 选取40例(80耳)听力正常婴幼儿作为研究对象,月龄3～12月,平均7.2±2.8月.分别选取 70、60、50、40、30 dB nHL 5 个不同刺激强度进行 TB-500、TB-1 000、TB-2 000和 TB-4 000 Hz 4个频率的TB-ABR检测,记录不同强度下各频率的波V潜伏期,使用SPSS 26.0进行统计学分析,建立各频率不同强度下的强度-潜伏期函数模型.结果 ①同一强度不同频率下的波V潜伏期差异均有统计学意义(P＜0.05);②阈值强度下不同频率下的波V潜伏期差异均有统计学意义(P＜0.05);③同一频率不同强度波V潜伏期差异均有统计学意义(P＜0.05);④不同刺激频率下的强度-潜伏期函数模型分别为TB-500 Hz:y=-0.09x+16.59;TB-1 000 Hz:y=-0.07x+13.73;TB-2 000 Hz:y=-0.05x+10.61;TB-4 000 Hz:y=-0.04x+9.44.结论 TB-ABR的波V潜伏期随刺激声频率和/或强度的升高而逐渐缩短,本研究建立的不同频率不同强度下的TB-ABR强度-潜伏期函数模型可为本实验室临床提供参考.

Objective: To investigate the associations between cognition, anxiety, depression, and residual dizziness after successful repositioning maneuvers in the elderly with benign paroxysmal positional vertigo (BPPV). Methods: We enrolled 40 elderly patients with BPPV in our outpatient department. We used the Dizziness Handicap Inventory (DHI), Visual Analog Scale (VAS), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder Questionnaire-7 (GAD-7) to assess the degree of dizziness, anxiety, and depression of participants before repositioning therapy, respectively. At the 1-week follow-up after BPPV treatment, each participant will be reassessed and divided into a group with residual dizziness (RD) and a group without residual dizziness (NRD) based on the follow-up DHI score. The Mini-Mental State Examination (MMSE) evaluated the cognitive function of the participants. Results: The age, gender, duration of BPPV, and involved semicircular canals in the two groups did not show a significant difference. The RD group scored significantly higher on the DHI (p = 0.006), GAD-7 (p < 0.001), and PHQ-9 (p = 0.002) before the repositioning treatment than the NRD group. The two groups had no significant difference in MMSE score (p = 0.381). Anxiety and depression scores before repositioning treatment significantly and positively correlated with follow-up DHI scores (r = 0.678 and 0.522, respectively), but the MMSE score did not significantly relate to it. The univariate linear regression showed that the DHI (p < 0.001), GAD-7 (p < 0.001), and PHQ-9 (p = 0.002) scores before treatment could predict residual dizziness. The multivariate linear regression showed that GAD-7 before treatment was the only significant predictor of residual dizziness (p < 0.001). Conclusion: The level of dizziness, anxiety, and depression before treatment can predict residual dizziness after successful repositioning maneuvers in the elderly with BPPV. Anxiety may be the strongest predictor of residual dizziness after successful repositioning treatment in elderly BPPV patients.

BackgroundDizziness in children, which could not be diagnosed at an early stage in the past, is becoming increasingly clear to a large extent. However, the recognition of the diagnosis and management remains discrepant and controversial due to their complicated and varied etiology. Central and peripheral vestibular disorders, psychogenic and systemic diseases, and genetic pathogeny constitute childhood etiological entities. Further understanding of the etiology and the prevalence of vertigo disorders is of crucial importance and benefit in the diagnosis and management of pediatric patients.MethodsThis systematic review and meta-analysis were conducted by systematically searching Embase, PubMed, the Cochrane Library, CNIK, the Chinese Wan-Fang database, CBM, the Chinese VIP database, and the Web of Science for literature on childhood vertigo disorders published up to May 2022. The literature was evaluated under strict screening and diagnostic criteria. Their quality was assessed using the Agency for Healthcare and Research Quality (AHRQ) standards. The test for homogeneity was conducted to determine the fixed effects model or random-effect model employed.ResultsTwenty-three retrospective cross-sectional studies involving 7,647 children with vertigo disorders were finally included, with an AHRQ score >4 (high or moderate quality). Our results demonstrated that peripheral vertigo (52.20%, 95% CI: 42.9–61.4%) was more common in children than central vertigo (28.7%, 95% CI: 20.8–37.4%), psychogenic vertigo (7.0%, 95% CI: 4.8–10.0%), and other systemic vertigo (4.7%, 95% CI: 2.6–8.2%). The five most common etiological diagnoses associated with peripheral vertigo included benign paroxysmal vertigo of childhood (BPVC) (19.50%, 95% CI: 13.5–28.3%), sinusitis-related diseases (10.7%, 95% CI: −11.2–32.6%), vestibular or semicircular canal dysfunction (9.20%, 95% CI: 5.7–15.0%), benign paroxysmal positional vertigo (BPPV)(7.20%, 95% CI: 3.9–11.5%), and orthostatic dysregulation (6.8%, 95% CI: 3.4–13.0%). Vestibular migraine (20.3%, 95% CI: 15.4–25.2%) was the most seen etiological diagnosis associated with central vertigo in children. In addition, we found the sex-based difference influenced the outcome of psychogenic vertigo and vestibular migraine, while there was no significant difference in other categories of the etiology. For the management of vertigo, symptomatical management is the first choice for most types of vertigo disorder in pediatrics.ConclusionComplex etiology and non-specific clinical manifestations of vertigo in pediatrics are challenging for their diagnoses. Reliable diagnosis and effective management depend on the close cooperation of multiple disciplines, combined with comprehensive consideration of the alternative characteristics of vertigo in children with growth and development.

OBJECTIVE:Our aim was to determine the correlation between cognitive impairment and P300 event-related potential (ERP) in older adults with vertigo and imbalance, which further provides a reference for clinical diagnosis and patients' rehabilitation.METHODS:A total of 79 older adult patients with vertigo and imbalance in our outpatient department from January 2022 to December 2022 were selected and divided into the mild group (n = 20), moderate group (n = 39), and severe group (n = 20) according to the Dizziness Handicap Inventory (DHI). The auditory P300 component of event-related potentials (ERPs), Generalized Anxiety Disorder Questionnaire-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Mini-Mental State Examination (MMSE) were used to evaluate depression, anxiety, and cognitive function in these patients, respectively.RESULTS:The P300 latencies of the different severity groups were 292 ± 10 ms, 301 ± 8 ms, and 328 ± 5 ms, respectively, and the differences were statistically significant (p = 0.010). The P300 amplitudes of the different severity groups were 14.4 ± 2.6 μV, 3.9 ± 0.8 μV, and 5.1 ± 1.4 μV, respectively, and the differences were also statistically significant (p = 0.004). There was no statistically significant difference in the DHI evaluation or VAS visual simulation scoring between the two groups (p = 0.625, and 0.878, respectively). Compared with the short-course group, the long-course group showed prolonged P300 latency and decreased amplitude, higher scores in PHQ-9 and GAD-7, and lower scores in MMSE, and all the differences were statistically significant (p = 0.013, 0.021, 0.006, 0.004, and 0.018, respectively).CONCLUSION:Older patients with more severe symptoms of vertigo and imbalance are at higher risk of developing abnormal cognitive function. The P300 can be used as an objective neurophysiological test for the assessment of cognitive function relevant to elderly patients with vertigo and imbalance.

人工耳蜗植入(CI)是帮助重度-极重度感音神经性聋患者恢复听觉的重要手段. CI效果取决于存活的螺旋神经元细胞数和听神经纤维、听觉神经中枢的功能 ,术前可行听力学、影像学检查及耳聋基因检测等判断可否进行CI .

Background:Severe and profound idiopathic sudden sensorineural hearing loss (ISSNHL) generally leads to unfavorable prognosis, and has a considerable impact on patient quality of life. However, related prognostic factors remain controversial.Objective:To elaborate the relationship between vestibular function impairment and the prognosis of patients with severe and profound ISSNHL, and investigated the relevant factors affecting prognosis.Methods:Forty-nine patients with severe and profound ISSNHL were divided into good outcome group [GO group, pure tone average (PTA) improvement > 30 dB] and poor outcome group (PO group, PTA improvement ≤ 30 dB) according to hearing outcomes. The clinical characteristics and the proportion of abnormal vestibular function tests in these two groups were analyzed by univariate analysis, and multivariable logistic regression analysis was performed for parameters with significant differences.Results:Forty-six patients had abnormal vestibular function test results (46/49, 93.88%). The number of vestibular organ injuries was 1.82 ± 1.29 in all patients, with higher mean numbers in PO group (2.22 ± 1.37) than in GO group (1.32 ± 0.99). Univariate analysis revealed no statistical differences between the GO and PO groups in terms of gender, age, side of the affected ear, vestibular symptoms, delayed treatment, instantaneous gain value of horizontal semicircular canal, regression gain value of vertical semicircular canal, abnormal rates of oVEMP, cVEMP, caloric test and vHIT in anterior and horizontal semicircular canal, however, significant differences were found in the initial hearing loss and abnormal vHIT of posterior semicircular canal (PSC). Multivariable analysis revealed that only PSC injury was an independent risk factor for predicting the prognosis of patients with severe and profound ISSNHL. Patients with abnormal PSC function had worse initial hearing impairment and prognosis than patients with normal PSC function. The sensitivity of abnormal PSC function in predicting poor prognosis in patients with severe and profound ISSNHL was 66.67%, specificity was 95.45%, and positive and negative likelihood ratios were 14.65 and 0.35, respectively.Conclusion:Abnormal PSC function is an independent risk factor for poor prognosis in patients with severe and profound ISSNHL. Ischemia in the branches of the internal auditory artery supplying the cochlea and PSC may be the underlying mechanism.