BACKGROUND:Triple Semicircular Canal Occlusion (TSCO) has been developed in recent years as a surgical method for treating Meniere's disease(MD). AIMS/OBJECTIVES:To explore the effectiveness of TSCO surgery in the treatment of patients with Tumarkin crisis associated with MD. MATERIALS AND METHODS:Clinical data of 7 patients with Tumarkin crisis secondary to unilateral MD were analyzed. All 7 patients with Tumarkin crisis were treated with TSCO surgery. Audiological and vestibular function assessment was performed. RESULTS:None of the 7 patients in the Tumarkin group experienced drop attacks after TSCO surgery. Regarding vertigo control, 6 out of 7 patients (85.7%) achieved grade A improvement while 1 patient (14.3%) achieved grade B. No statistically significant differences were found in disease duration, pure tone average, ACS-cVEMP, or ACS-oVEMP between the two groups (all p > 0.05). However, vHIT gain values in both the lateral and posterior semicircular canals were significantly higher in the Tumarkin group than in the control group (p = 0.03 and p = 0.01, respectively), but not in the superior semicircular canal (p = 0.29). CONCLUSIONS AND SIGNIFICANCE:TSCO surgery can probably serve as an alternative treatment for patients with Tumarkin crisis associated with MD before labyrinthectomy or vestibular neurectomy.

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.

BACKGROUND:There is no consensus regarding the optimal management of postradiation secretory otitis media (SOM) in patients with head and neck malignancies. OBJECTIVES:In this network meta-analysis, we compared the efficacy and complication profiles of tympanostomy tube insertion (TI), laser tympanostomy (LT), tympanocentesis (TC), intratympanic injection (ITI), and TI combined with injection (TI+I). METHODS:Sixteen studies (nine randomized controlled trials [RCTs] and seven semi-RCTs; 1464 participants) were analyzed using Stata 15.0. Primary outcomes included treatment efficacy based on the Surface Under the Cumulative Ranking Curve (SUCRA) and complication rates, specifically suppurative otitis media and tympanic membrane perforation. RESULTS:Efficacy rankings were as follows: ITI < TC < TI < TI+I < LT, with SUCRA values highest for LT (97.3%) and TI+I (71.3%). LT and TI+I showed greater symptom relief and hearing improvement than the other interventions. Complication rates were the lowest for LT (suppurative otitis: 13.2%; tympanic perforation: 14.2%) and the highest for ITI (77.3% and 70.4%, respectively). TI performed with preinsertion ambroxol or triamcinolone was associated with a reduced recurrence rate. CONCLUSIONS:Laser tympanostomy offers optimal efficacy and safety for postradiation SOM, with TI+I representing a feasible alternative. ITI and TC were associated with higher complication risks. Key limitations include short follow-up duration for LT and the predominance of unblinded study designs.

Sensorineural hearing loss (SNHL) is a prevalent global health issue, primarily caused by excessive generation of reactive oxygen species (ROS) due to acoustic trauma, aging, and ototoxic drugs. Natural antioxidant enzymes, such as catalase (CAT), possess remarkable ROS scavenging capabilities and hold significant potential for SNHL treatment. However, their clinical application is hindered by inefficient delivery and limited stability. Here, we introduce a novel peptide-oligosaccharide conjugate, sELP-ON, which forms coacervate microdroplets via liquid-liquid phase separation. These microdroplets efficiently encapsulate and stably carry CAT, releasing it in a glutathione-triggered, redox-responsive manner. The CAT-loaded sELP-ON (sELP-ON@CAT) enhanced cellular uptake through direct cytoplasmic internalization and demonstrates a more robust ROS scavenging activity than naked CAT treatment. Local administration of sELP-ON@CAT in an acoustic injury mouse model effectively rescues hearing loss by reducing cochlear ROS levels, thereby mitigating hair cell loss, ribbon synapse depletion, stria vascularis shrinkage and spiral ganglion neuron degeneration. In summary, our innovative coacervate microdroplet system enables targeted, redox-responsive cytoplasmic delivery of macromolecular antioxidants, offering a novel and effective strategy for treating SNHL. (c) 2026 Published by Elsevier B.V. on behalf of Chinese Chemical Society and Institute of Materia Medica, Chinese Academy of Medical Sciences.

Facial nerve crush injuries frequently lead to incomplete functional restoration owing to constrained regenerative approaches and suboptimal treatment methods. While hydrogel-based systems have emerged as viable alternatives among bioengineered scaffolds, their therapeutic potential remains compromised by inadequate biological activity and unfavorable inflammatory conditions. Our research engineered a photoactivated GelMA/HAMA composite hydrogel incorporating bone marrow mesenchymal stem cell-derived exosomes (BExos), with comprehensive characterization of its material attributes. We systematically assessed the biomaterial's regenerative capacity through in vitro experiments involving BMSCs and RAW264.7 macrophages, complemented by comprehensive in vivo evaluations in a rodent facial nerve injury model incorporating functional restoration metrics, neurophysiological testing, tissue analysis, and biomolecular profiling. The BExos-integrated hydrogel established a favorable niche promoting BMSCs transdifferentiation toward Schwann cell-mimetic lineages while demonstrating marked improvement in neuromuscular functional restoration. Compared to untreated cohorts, the composite hydrogel demonstrated enhanced axonal regrowth, improved remyelination processes, and notably reduced oxidative damage. The biomaterial effectively shifted macrophage differentiation from M1 pro-inflammatory states toward M2 anti-inflammatory phenotypes through modulation of PI3K/NF-κB/P38 signaling cascades, with Neuronatin emerging as a key regulatory element in this pathway. Mechanistic investigations demonstrated that the therapeutic benefits stemmed from synergistic structural reinforcement combined with exosome-mediated immune regulation, positioning this dual-action hydrogel as an innovative solution for facial nerve repair.

王秋菊: 随着人口老龄化进程的加快,老年性听力损失与认知障碍的共病现象逐渐引起临床与科研领域的高度重视.大量研究提示,听力下降不仅影响老年人沟通能力与生活质量,还可能与认知功能减退呈显著相关,甚至在一定程度上加速痴呆的发生与发展.

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

BACKGROUND:Patients with benign paroxysmal positional vertigo (BPPV) may be at increased risk for hypertension. OBJECTIVES:To examine the causal relationship between hypertensive disorders and benign paroxysmal vertigo (BPV). MATERIALS AND METHODS:A bidirectional two-sample Mendelian randomization (MR) study was conducted to assess the causal relationship between hypertension and BPV. Summary statistics for BPV and hypertension were obtained from the FinnGen biobank to support the primary MR analysis. Five complementary methods - inverse variance weighted, weighted median, MR-Egger, simple mode, and weighted mode - were applied to obtain MR estimates. Furthermore, a multivariable MR (MVMR) analysis was conducted to examine whether hypertension independently influences BPV. RESULTS:The MR analysis indicated a significant causal effect of hypertension on BPV, with an odds ratio (OR) of 1.11 (95% CI: 1.02-1.22, p = .019), indicating an increased risk of BPV associated with hypertension. MVMR analysis further indicated that the causal effect of hypertension on BPV remained significant even after adjusting for menopausal disorders and ischemic stroke (OR: 1.108, 95% CI: 1.003-1.225, p = .043). CONCLUSIONS AND SIGNIFICANCE:This MR study provided evidence supporting a causal effect of hypertension on BPV.

Objective This study aims to investigate the effect of camera positioning (left-sided vs right-sided) on the vestibulo-ocular reflex (VOR) gain values of normal subjects during the video head impulse test (vHIT), thereby providing valuable reference data for otology clinical practice. Methods Thirty healthy adults (60 ears) were recruited and examined by vHIT for the three pairs of semicircular canals (SCs). During the examination, we meticulously recorded and compared the VOR gain values in the six canal planes—right lateral (RL), left lateral (LL), right anterior-left posterior (RALP), and left anterior-right posterior (LARP)—with the camera positioned on the left side first, followed by repositioning on the right side. We evaluated instantaneous gain (40 ms, 60 ms, and 80 ms), 0–100 ms median gain, and regression gain in 0–100 ms for all SCs. Results For horizontal canals, higher VOR gain values were recorded when the camera was positioned on the same side as the canal being tested. The gain value in LARP was higher when the camera was on the left side than on the right side, while the gain value in RALP was higher when the camera was on the right side than on the left side. Conclusion This study underscores the importance of camera positioning on VOR gain values for both lateral and vertical canals during vHIT. To mitigate the effects of these variables, standardization of operational procedures and equipment settings is crucial.

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.

BACKGROUND:Vestibular dysfunction is prevalent in severe/profound unilateral idiopathic sudden sensorineural hearing loss (ISSNHL) and may influence hearing recovery. This study investigates associations between vestibular function (cVEMP/oVEMP, vHIT, caloric tests) and short-term auditory outcomes. AIMS:To evaluate whether vestibular test abnormalities predict treatment response in severe/profound ISSNHL and identify independent prognostic factors. MATERIAL AND METHODS:Retrospective analysis of 133 patients (mean age 53.58 ± 18.56 years) treated with steroids/hyperbaric oxygen. Vestibular tests (cVEMP, oVEMP, vHIT, caloric) were performed pre-treatment. Outcomes were categorized as effective (complete/marked recovery) or ineffective (mild/no recovery). RESULTS:The ineffective group had higher vertigo prevalence (65/93 vs 14/40, p < 0.001) and older age (55.98 ± 17.85 vs 48.00 ± 19.22 years, p = 0.022). Univariate analysis showed abnormal vestibular tests (oVEMP/cVEMP/vHIT/caloric) correlated with outcomes (p < 0.05). Multivariate analysis identified three independent predictors of poor outcome: vertigo (OR 0.367), abnormal caloric test (OR 0.339), and abnormal vHIT (OR 0.316). cVEMP/oVEMP abnormalities were not independently associated (p > 0.05). CONCLUSIONS:Vertigo, abnormal caloric/vHIT results predict poorer short-term hearing recovery in severe/profound ISSNHL. Vestibular assessment aids prognosis but should not be used alone. Larger studies are needed for validation.

Epithelial–mesenchymal transition (EMT) and mesenchymal–epithelial transition (MET) are evolutionarily conserved cellular processes defined by reversible conversions between epithelial and mesenchymal phenotypes. As dynamic regulatory programs, they contribute to cell fate determination, tissue remodeling, and functional maturation during embryogenesis. In the cochlea, emerging evidence suggests that EMT/MET are implicated in certain aspects of sensory epithelium development. This review systematically dissects the molecular mechanisms underlying EMT and MET during cochlear development, along with the regulatory networks that control cell fate and signaling pathways. We further explore the emerging functions of these processes in cochlear pathologies, integrating recent advances to clarify their physiological and pathological relevance. By providing a comprehensive synthesis, this work aims to establish a theoretical framework for developing therapeutic strategies against related disorders.

OBJECTIVE:To analyze the long-term effects of cochlear implantation (CI) on vestibular evoked myogenic potentials (VEMPs) in children. METHODS:CI surgery was performed in a unilateral ear of 31 patients in the department of otolaryngology, Second Affiliated Hospital of Xi'an Jiaotong University from 2011 to 2015. The group comprised 15 boys and 16 girls, with a mean age of 10.68±7.60 years old. All operations were performed by the same surgeon, and the round window approach was used for all. Both ocular VEMPs (oVEMPs) and cervical VEMPs (cVEMPs) were detected on bilateral ears before operation. These were tested again from 1 to 5 years after operation (with device ON and OFF). The ears with CI were analyzed as the study group, and the non-operated ears were used as a control. The response rate, threshold, p13 (15) and n10 (23) latencies, and amplitudes of the VEMPs were analyzed and compared between groups. RESULTS:Before CI, the response rates of the oVEMPs and cVEMPs in the implant ear were 58.06% and 61.29%, respectively. However, within 1 to 5 years after surgery, the oVEMP response rates decreased significantly to 16.13% (device ON, P <0.01) and 12.90% (device OFF, P <0.01). The response rates of the cVEMPs decreased to 22.58% (device ON, P <0.01) and 19.35% (device OFF, P <0.01). For those patients with elicited VEMPs, abnormal waveform parameters could be found in both the oVEMP and cVEMP, including elevated thresholds, decreased amplitudes, and changed p13 (15)/n10 (23) latencies. CONCLUSIONS:Cochlear implant surgery can affect vestibular function of the implanted ear, which can be detected by the oVEMP and cVEMP tests. These effects can last for years.

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.

Objectives: Patients with severe to profound sudden sensorineural hearing loss (SSNHL) generally experience poorer hearing recovery; however, the associated risk factors have not been identified. This study synthesizes current evidence to explore prognostic risk factors in this patient group. Methods: Databases were systematically searched through PubMed, Embase, Web of Science, and the Cochrane Library, from their inception to 18 October 2025. Three researchers independently extracted and recorded patient information and relevant data from all selected studies. Any inconsistencies were clarified through discussion or by consulting a fourth researcher. Results: The study included 2632 patients from 15 articles published between 2002 and 2025 and evaluated 8 prognostic risk factors. The results showed that profound hearing loss (OR = 4.68; 95% CI: 3.57–6.13; p < 0.001) and vertigo (OR = 1.95; 95% CI: 1.28–2.98; p = 0.002) were correlated with poorer hearing recovery. Subgroup analyses based on different prognostic criteria confirmed the consistent impact of hearing loss severity on poor outcomes. The remaining 6 risk factors did not show statistically meaningful associations. Conclusions: Profound hearing loss and vertigo are significantly associated with poorer prognosis in patients with severe to profound SSNHL. These findings may help identify high-risk patients early and inform the design of personalized therapeutic approaches in clinical settings.

Microbial colonization in the nasopharynx and nasal cavity plays a defensive role in children. The coronavirus disease 2019 (COVID-19) pandemic may have an influence on the nasopharynx and nasal cavity microbiota. This study aimed to identify and compare the microbiota in the nasopharynx and nasal cavity before and during the COVID-19 pandemic in a healthy pediatric population. Separate mucosal swabs were collected from the nasopharynx and nasal cavity of healthy children before and during the COVID-19 pandemic. A 16S ribosomal RNA-based metagenomic approach was employed to characterize and analyze alterations in the nasopharyngeal and nasal microbiota to determine whether isolation measures, such as mask wearing, influence microbial ecology. The richness and diversity of the nasopharyngeal and nasal microbiota decreased during the COVID-19 pandemic compared with before the pandemic. Firmicutes and Proteobacteria were the most abundant phyla in the nasopharyngeal and nasal microbiota, respectively, both before and during the pandemic. Corynebacterium and Moraxella were the dominant genera in the nasopharyngeal and nasal microbiota during the COVID-19 pandemic, whereas Pseudomonas and Corynebacterium were dominant before the pandemic. Compared with pre-pandemic conditions, microbial colonization differed significantly for Cyanobacteria/Chloroplast and Bacteroidetes in the nasopharynx and for Planctomycetes in the nasal cavity during the COVID-19 pandemic. This study revealed a lower microbiota diversity during COVID-19, possibly accompanied by microbiota dysbiosis, increased risk of respiratory infections and inflammatory responses in healthy children. This study underscores the importance of reestablishing microbiota balance and highlights the need for personalized treatment and prophylactic strategies in routine public health practice.

Connexins, as key players in intercellular communication in the inner ear, are vital for maintaining normal hearing function. While numerous studies have explored their role in congenital hereditary hearing loss, the underlying mechanisms and therapeutic potential of connexins in acquired hearing loss remain to be fully elucidated. This review summarizes recent advances in connexin research in the context of acquired hearing loss, with a focus on presbycusis, noise-induced, and drug-induced hearing loss, and delves into their pathophysiological roles. Through the analysis and organization of these research findings, the article aims to provide a theoretical basis and research direction for future connexin-targeted therapies for acquired hearing loss.