摘要：Objectives:Sea sickness,a form of motion sickness,is a common condition among sailors on various sailing vessels,primarily due to their roll and pitch movements.While the exact neurobiological mechanisms remain unclear,the most widely accepted explanation is the sensory conflict theory,which identifies two main sources of conflict:discrepancies between visual and vestibular inputs and conflicts within the vestibular system itself.This study aims to evaluate otolith-mediated verticality perception in first-time seafarers on board a naval frigate ship using the Subjective Visual Vertical(SVV)test.Methods:This observational study was conducted on board a naval frigate and involved two groups.The case group consisted of 50 newly recruited sailors experiencing their first sea voyage.The SVV test was conducted at three time points:prior to embarkation,during an active episode of sea sickness,and after disembarkation.A control group of 50 healthy,experienced sailors-regular seafarers with no history of vestibular symptoms underwent the same SVV testing at corresponding intervals.The results from both groups were collected and analyzed to assess changes in verticality perception related to sea exposure and sea sickness.Results:Analysis of the SVV test data from the 50 newly recruited sailors(case group)demonstrated a statistically significant difference compared to the control group of experienced sailors.During an active episode of sea sickness,the case group exhibited a notable tilt and deviation in SVV angles,indicating altered verticality perception.These deviations reduced significantly 24 hours post-disembarkation,suggesting an improvement in verticality perception once the motion stimulus was removed.Conclusion:This distinctive study assessed otolith-mediated verticality perception using the SVV test in first-time seafarers experiencing sea sickness aboard a naval frigate.Our findings emphasize the functional importance of the otolith organs in maintaining spatial orientation during maritime motion exposure.The observed SVV deviations support the subjective vertical conflict theory,highlighting the role of vestibular-visual mismatch in the development of sea sickness.However,our findings more likely reflect transient functional disturbance or overstimulation rather than a pre-existing utricular asymmetry alone.Based on the pattern of SVV deviation and recovery,we propose that the utricle may play a more significant role than the saccule in inducing sea sickness.

摘要：Objective:To present a rare case of glial heterotopia in the middle ear occurring in association with cholesteatoma.Patient and Intervention:A 56-year-old female presented with right-sided hearing loss and otorrhea.ENT examination and CT imaging revealed middle ear cholesteatoma.Right canal wall down mastoidectomy with type III tympanoplasty revealed a well-demarcated,soft,pinkish mass in the right middle ear without tegmen tympani dehiscence.Histopathological analysis confirmed glial heterotopia.Main Outcome Measures:Complete cholesteatoma resection,resolution of otorrhea,absence of neurological complications,and right-sided hearing improvement.Results:The patient demonstrated an uneventful postoperative recovery.At the five-month follow-up,tympanoplasty outcomes remained stable.Repeat imaging confirmed absence of skull base defects,with clinical resolution of otorrhea.No postoperative neurological complications(including cerebrospinal fluid leakage)were observed.Conclusions:Middle ear glial heterotopia is a rare entity that may be discovered incidentally or in association with infection/cholesteatoma.Definitive management requires surgical excision of the heterotopic tissue and concurrent repair of skull base bone defects when identified.Preoperative imaging evaluation with CT or MRI can be valuable to delineate anatomical relationships and exclude intracranial connections.

摘要：Purpose:The purpose of the study was to investigate the effect of bimodal beamforming on speech recognition and comfort for cochlear implant(CI)users with the bimodal hearing solution made up by linking a hearing aid to the CI sound processor.Methods:19 subjects participated in this study.Speech tests were conducted in quiet and in noisy environments,with the target speech presented from 0° and the noise signal from 45°.Speech recognition thresholds(SRTs)were compared among the previously used bimodal hearing configuration(baseline,any CI sound processor plus any hearing aid),the Naída Bimodal Hearing Solution with omnidirectional microphone,and with directional microphone(so called Stereo-Zoom)switched on.In addition,the study participants provided subjective feedback on their hearing impressions.Results:The SRT results showed no significant difference among the three hearing conditions in the quiet environment.No significant improvement was reported when using Naída bimodal system with omnidirectional microphone in noise compared to the baseline(p=0.27).When applying StereoZoom,SRT in noise showed significant improvements compared to omnidirectional settings(p＜0.05).Subjective feedback showed that 13 participants were satisfied with Naída Bimodal Hearing Solution,and wanted to continue using it after the trial.Conclusion:The Naída Bimodal Hearing Solution with the same pre-processing algorithm can provide satisfying hearing performance.Beamforming technology can further improve speech perception in noisy environ-ments.

摘要：Background:Vestibular assessments,such as the video ocular counter roll(vOCR)test,offer valuable insights into the interactions between age,otolith function,and vestibular performance.Objective:To analyze the relation between age and vOCR gains as a potential marker of age-related otolith degeneration.Methods:A total of 107 participants underwent vOCR testing.Descriptive statistics and simple linear regression analyses were conducted to explore the association between age and vOCR gains.Results were presented using regression coefficients,95％confidence intervals,p-values,and R-squared values.Results:In the overall sample,statistically significant associations were observed between age and vOCR gains in both ears.For the right ear,vOCR gains decreased with increasing age(coefficient:-0.03;95％CI:-0.05 to-0.01;p＜0.001;R2=0.08),while the left ear showed a slightly stronger association(coefficient:-0.04;95％CI:-0.07 to-0.02;p＜0.001;R2=0.12).These findings indicate a moderate age-related decline in otolith-mediated vestibular responses.Conclusion:vOCR gains appear to decline with age,reflecting potential age-related otolith degeneration.These results support the clinical value of vOCR as a non-invasive method to assess vestibular function and its changes across the lifespan.

摘要：This study aims to investigate the impact of middle ear effusion(MEE)on sound transmission in the human ear and its potential diagnostic signifi-cance.Firstly,the material properties of specific structures were adjusted based on the existing human ear finite element(FE)model,and the accuracy of the model was validated using experimental data.Secondly,six FE models were developed to simulate varying degrees of MEE by systematically altering the material properties of the middle ear cavity(MEC)at different anatomical locations.Finally,the effects of these six FE models,representing varying degrees of MEE,on sound transmission characteristics and energy absorption(EA)rate in the human ear were systematically analyzed.When the degree of MEE is less than 50％of the MEC volume,its impact on the sound transmission characteristics of the human ear remains mini-mal,resulting in an estimated hearing loss of approximately 3 dB,with EA rate remaining close to normal levels.Once the effusion exceeds 50％of the MEC volume,a significant deterioration in acoustic transmission is observed,accompanied by a flattening of the EA curve and a drop in EA rates to below 20％.When the effusion completely fills the MEC,the maximum hearing loss reaches 46.47 dB,and the EA rate approaches zero across the entire frequency range.These findings provide theoretical insights into the biomechanical effects of MEE on human auditory transmission and offer a reference for clinical diagnosis and evaluation.

摘要：Objective:To develop a sustained-release codelivery system for intratympanic administration of dexamethasone(DEX)and lipoic acid(LA).Methods:DEX microcrystals(MCs)were prepared via precipitation,while LA-loaded porous PLGA microspheres(LPMPs)were fabricated using a double emulsion-solvent evaporation method.DEX MCs were physically perfused into LPMPs via negative pressure to form a combined system(DEX MCs+LPMPs).Physicochemical properties,in vitro drug release,pharmacokinetics,and biocompatibility were evaluated.Guinea pigs were used for intratympanic injections of DEX MCs,LPMPs,or DEX MCs+LPMPs.Results:The DEX MCs+LPMPs system enabled simultaneous release of both drugs,with DEX exhibiting superior pharmacokinetics(sustained perilymph concentrations up to 7 days)compared to DEX MCs alone.LA release from LPMPs demonstrated prolonged kinetics without burst release.SEM confirmed DEX MCs were localized within/on LPMPs and adhered to the round window membrane(RWM).Histological analysis revealed normal cochlear morphology and no inflammatory response,confirming biocom-patibility.Conclusions:This novel codelivery system combining microcrystals and porous microspheres achieves sustained dual-drug release,enhances therapeutic efficacy,and offers a promising strategy for managing hearing loss via intratympanic administration.

摘要：Background:Sickle cell anemia(SCA),a genetic hemoglobin disorder,suggests essential inner ear compromise and poor auditory processing.In humans,auditory processing differs physiologically between males and females,possibly true for SCA due to gender-specific disease pathophysiological changes.Objective:To investigate gender differences in psychoacoustical abilities,and speech perception in noise in SCA individuals and further compare with normal healthy(NH)population.Methods:80 SCA and 80 NH normal-hearing participants aged 15-40 years were included and further grouped based on gender.Auditory discrimination for frequency,intensity,and duration at 500Hz and 4000Hz;temporal processing(Gap detection threshold & Modulation Detection Threshold)and Speech Perception In Noise(SPIN)at 0dBSNR tests were evaluated and compared between males and females of SCA and NH population.Results:SCA performed poorer compared to NH for all experimental measures.In the NH population,males performed poorer than females in psychoacoustical measures whereas within the SCA population,the reverse was true.Female participants performed better in the SPIN test in both populations.Conclusions:The adverse impact of SCA on the auditory system due to circulatory changes might cause poorer performance in SCA.Poorer performance by Female SCA is possibly due to the contrary impact of lower Hb level overlying Sickle disease.Estrogen levels and gender preference in auditory processing might lead to better performance by females within the NH population.SPIN performance depends on different attentional demands and sensorimotor processing strategies in noise beyond psychoacoustical processing may lead to better female performance in both populations.

摘要：Background:The masseter vestibular evoked myogenic potential(mVEMP)is a novel test that has been explored in various brainstem lesions.How-ever,it has not yet been studied in individuals with definite Meniere's disease.Therefore,the current study aimed to investigate mVEMP responses in individuals with definite Meniere's disease and compare them with those of a reference group.Method:The present study investigated narrowband Claus Elberling chirp-evoked mVEMP responses in 22 ears diagnosed with definite Meniere's disease and 22 ears with hearing sensitivity ≤ 15 dB HL across three stimulation frequencies.Results:mVEMP responses in participants with definite Meniere's disease varied from normal to reduced or absent across three octave frequencies.These individuals exhibited significantly reduced P11-N21 peak-to-peak amplitudes compared to those in the reference group.Although a frequency tuning shift toward 1000 Hz was observed,the inter-frequency amplitude ratio of mVEMP was not found to be a sensitive parameter for detecting individuals with definite Meniere's disease.Additionally,no association was found between the degree of hearing loss or the duration of the disease and mVEMP responses.Conclusion:Participants with definite Meniere's disease exhibited reduced P11-N21 amplitude and a tuning shift toward 1000 Hz.These findings suggest the involvement of the vestibulo-trigeminal reflex pathway in this condi-tion.

摘要：Background:The middle ear pneumatic system(MEPS)supports pressure balance,essential for sound conduction.Its volume and surface area are key indicators of pneumatization and ventilation,yet their specific contributions to pressure regulation need further exploration.Objective:To evaluate the accuracy and sensitivity of parameters characterizing the MEPS,including volume(V),surface area(S),and surface-area-to-volume ratio(S/V),in normal ears.Materials and Methods:We collected CT images of the temporal bone from 63 normal ears for this study.The volume(V),surface area(S),and surface-area-to-volume ratio(S/V)of the MEPS were measured and calculated using three-dimensional reconstruction technology.Statistical methods were used to process the data and determine the 95％reference range for the S,V,and S/V of the MEPS in the normal ear.At the same time,we analyzed the impact of differences in gender and the left and right sides on the measurements.Results:The 95％reference values for the S,V,and S/V of the MEPS in normal ears were 1057.10～18239.16 mm2,609.16～9854.11 mm3,and 1.39～2.52 mm1 respectively.There were no significant differences in the measurements between genders and between the left and right sides.Conclusions and Significance:This study has established the 95％reference values for the S,V,and S/V of the MEPS in normal ears,which were 1057.10-18239.16 mm2,609.16-9854.11 mm3,and 1.39-2.52 mm1 respectively.We found that while there is a wide variation in the V values among normal ears,there is less variability in the S/V values.This structural characteristic suggests that changes in the S/V value may have a more significant impact on the balance of middle ear pressure,and it provides important reference data for the construction and functional reconstruction of three-dimensional models of the MEPS.These findings may aid in diagnosing middle ear disorders,such as otitis media with effusion,and guide interventions to restore pressure balance.

摘要：Background:It's crucial to study the effect of changes in thresholds(T)and most comfortable levels(M)on behavioral measurements in young children using cochlear implants.This would help the clinician with the optimization and validation of programming parameters.Objective:The study has attempted to describe the changes in behavioral responses with modification of T and M levels.Methods:Twenty-five participants in the age range 5 to 12 years using HR90K/HiFocus1J or HR90KAdvantage/HiFocus1J with Harmony speech processors participated in the study.A decrease in T levels,a rise in T levels,or a decrease in M levels in the everyday program were used to create experimental programs.Sound field thresholds and speech perception were measured at 50 dBHL for three experimental and everyday programs.Conclusion:The results indicated that only reductions of M levels resulted in significantly(p＜0.01)poor aided thresholds and speech perception.On the other hand,variation in T levels did not have significant changes in either sound field thresholds or speech perception.The results highlight that M levels must be correctly established in order to prevent decreased speech perception and audibility.

摘要：Purpose:The study aimed to investigate the otology-specific and general health-related quality of life(HRQoL)after cochlear implantation,and scrutinize the variables associated with them.Methods:The Ear Outcome Survey-16(EOS-16),which assesses ear-specific symptoms and quality of life(QoL),was administered before and after cochlear implantation along with the post-operative administration of the 15D questionnaire that evaluates general HRQoL.The authors investigated post-implantation changes in the EOS-16 total scores and its category responses,examining their relationship with pre-and post-operative hearing levels,speech perception in noise,and the follow-up period length(time elapsed since cochlear implantation).Results:There were positive changes noted for the hearing,need for care,and QoL categories of the EOS-16 after implanta-tion.The length of the follow-up period was a significant factor associated with improvements in subjective outcome measures.Changes in self-perceived hearing and HRQoL post-implantation seem independent of pre-and post-implantation hearing performance.Conclusion:These results suggest that while patients regain their hearing abilities shortly after implant activation,their subjective hearing-related benefits and QoL improve over time.

摘要：Objectives:The PTPRQ gene is essential for preserving the structure and function of stereocilia in inner ear.However,research on splicing mutations within this gene is limited.This study aims to investigate novel splicing mutations in PTPRQ,clarify their molecular mechanisms,and provide new insights into the genetic factors associated with hearing loss,ultimately enhancing diagnostic accuracy.Method:Clinical data and peripheral blood samples were obtained from members of a family with congenital hearing loss.Variants were identified through high-throughput sequencing and confirmed by Sanger sequencing to ensure genealogical co-segregation.The splicing effects of PTPRQ variants were evaluated using bioinformatics tools and minigene assays.Results:We used whole exome sequencing to identify novel double compound heterozygous splice-altering variants(c.5426+1 G＞A and c.6603-3 T＞G)in the PTPRQ gene with DFNB84A.We molecularly characterized these variants,and they were found to co-segregate with the disease within the family.Minigene assays and Sanger sequencing confirmed that the c.6603-3 T＞G variant caused exon 43 skipping,resulting in a frameshift mutation(p.Ser2201ArgfsTer112).Further bioinformatic analysis supported these findings.Conclusions:This study identifies a novel compound heterozygous splicing variant in the PTPRQ gene in a Chinese family with DFNB84A,expanding the known spectrum of PTPRQ mutations.These findings enhance the understanding of PTPRQ-related hearing loss and may aid in early diagnosis,prevention,and therapeutic strategies.

摘要：Otitis media with effusion (OME) is a frequent paediatric disorder.The condition is often asymptomatic,and so can easily be missed.However,OME can lead to hearing loss that impairs the child's language and behavioural development.The diagnosis is essentially clinical,and is based on otoscopy and (in some cases) tympanometry.Nasal endoscopy is only indicated in cases of unilateral OME or when obstructive adenoid hypertrophy is suspected.Otitis media with effusion is defined as the observation of middle-ear effusion at consultations three months apart.Hearing must be evaluated (using an age-appropriate audiometry technique) before and after treatment,so as not to miss another underlying cause of deafness (e.g.perception deafness).Craniofacial dysmorphism,respiratory allergy and gastro-oesophageal reflux all favour the development of OME.Although a certain number of medications (antibiotics,corticoids,antihistamines,mucokinetic agents,and nasal decongestants) can be used to treat OME,they are not reliably effective and rarely provide long-term relief.The benchmark treatment for OME is placement of tympanostomy tubes (TTs) and (in some cases) adjunct adenoidectomy.The TTs rapidly normalize hearing and effectively prevent the development of cholesteatoma in the middle ear.In contrast,TTs do not prevent progression towards tympanic atrophy or a retraction pocket.Adenoidectomy enhances the effectiveness of TTs.In children with adenoid hypertrophy,adenoidectomy is indicated before the age of 4 but can be performed later when OME is identified by nasal endoscopy.Children must be followed up until OME has disappeared completely,so that any complications are not missed.

摘要：Objective:To identify presence of inflammasome activated in mouse cochlea with sensorineural hearing loss (SNHL) caused by cytomegalovirus (CMV) infection. Method:MCMV was injected into the right cerebral hemisphere in neonatal BALB/c mice at 2000 pfu virus titers. Auditory brainstem responses (ABRs) were tested to evaluate hearing at 21 days. Histopathological studies were conducted to confirm localizations of MCMV infected cells in the inner ear. Expression of inflammasome related factors was assessed by immunofluorescence, Quantitative real-time PCR and Western blotting. Results:In the mouse model of CMV induced SNHL, inflammasome related kinase Caspase-1 and downstream inflammatory factor IL-1b and IL-18 were found increased and activated after CMV infection in the cochlea. These factors could further up-regulate expression of IL-6 and TNF-a. These inflammatory factors are neurotoxicity and may contribute to hearing impairment. Furthermore, we also detected significantly increased AIM2 protein that accumulated in the SGN of cochleae with CMV infection. Significance:We have shown that inflammasome as a novel inherent immunity mechanism may contribute to hearing impairment. Conclusion:Our data indicate that imflammasome assemble in mouse inner ear in response to CMV infection. We have revealed a novel pa-thology event in CMV induced SNHL involving activation of inflammasome in mouse cochlea. Additionally, we have shown that inflammasome may be a novel target for prevention and treatment of CMV related SNHL. Copyright ? 2016, The Authors. Production & hosting by Elsevier (Singapore) Pte Ltd On behalf of PLA General Hospital Department of OtolaryngologyHead and Neck Surgery. This is an open access article under the CC BY-NC-ND license (

摘要：Sudden sensorineural hearing loss (SSNHL) is an enigmatic entity,with obscure pathophysiology and debatable efficacy of the treatment agents used.An underlying cause is identified in only 10-15％ of cases.The management of the remaining patients,classified as 'idiopathic',is empirical,and is conventionally with systemic steroids,vasodilator therapy,rheological agents,and antioxidants,to list a few amongst the host of the agents employed for the treatment.The availability of conflicting outcomes and lack of conclusive evidence has resulted in the propagation of consensus-based treatment protocols.In the present review,we discuss the various controversial issues and newer developments in the management of idiopathic SSNHL.The current review aims to present a narrative outlook of the updated evidence base available from PUBMED,augmented with relevant designated publications.

摘要：Over the past two decades considerable progress has been made in understanding the ototoxic effects and mechanisms underlying loop diuretics. As typical representative of loop diuretics ethacrynic acid or furosemide only induces temporary hearing loss, but rarely permanent deafness unless applied in severe acute or chronic renal failure or with other ototoxic drugs. Loop diuretic induce unique pathological changes in the cochlea such as formation of edematous spaces in the epithelium of the stria vascularis, which leads to rapid decrease of the endolymphatic potential and eventual loss of the cochlear microphonic potential, summating potential, and compound action potential. Loop diuretics interfere with strial adenylate cyclase and Nat/Kt-ATPase and inhibit the Na-K-2Cl cotransporter in the stria vascularis, however recent reports indicate that one of the earliest effects in vivo is to abolish blood flow in the vessels supplying the lateral wall. Since ethacrynic acid does not damage the stria vascularis in vitro, the changes in Nat/Kt-ATPase and Na-K-2Cl seen in vivo may be secondary effects results from strial ischemia and anoxia. Recent observations showing that renin is present in pericytes surrounding stria arterioles suggest that diuretics may induce local vasoconstriction by renin secretion and angiotensin formation. The tight junctions in the blood-cochlea barrier prevent toxic molecules and pathogens from entering cochlea, but when diuretics induce a transient ischemia, the barrier is temporarily disrupted allowing the entry of toxic chemicals or pathogens.

摘要：Aminoglycosides (AmAn) are widely used for their great efficiency against gram-negative bacterial infections. However, they can also induce ototoxic hearing loss, which has affected millions of people around the world. As previously reported, individuals bearing mitochondrial DNA mutations in the 12S rRNA gene, such as m.1555A>G and m.1494C>T, are more prone to AmAn-induced ototoxicity. These mutations cause human mitochondrial ribosomes to more closely resemble bacterial ribosomes and enable a stronger aminoglycoside interaction. Consequently, exposure to AmAn can induce or worsen hearing loss in these individuals. Furthermore, a wide range of severity and penetrance of hearing loss was observed among families carrying these mutations. Studies have revealed that these mitochondria mutations are the primary molecular mechanism of genetic susceptibility to AmAn ototoxicity, though nuclear modifier genes and mitochondrial haplotypes are known to modulate the phenotypic manifestation.

摘要：miRNA-183 family, in normal biology, is expressed in a harmonious and stable manner in the neurosensory organs and cells. Studies have also shown that miRNA-183 family, in different pathways, affects the neurosensory development, maintenance, survival and function. In addition, it has potential neuroprotective effects in response to neurosensory destructive stimulations. miRNA-96 mutation causes hereditary deafness in humans and mice, and therefore affects the inner ear activity and its maintenance. Certain roles have been identified for miR-96 in the maintenance and function of the inner ear. The comparison of the target genes of family-183 in transcriptomes of newborn and adult hair cells shows that hundreds of target genes in this family may affect development and maintenance of the ears. Identifying the genes that are regulated by miRNA-183 family provides researchers with important information about the complex development and environmental regulation of the inner ear, and can offer new approaches to the maintenance and regeneration of hair cells and auditory nerve.

摘要：Objective:To report outcomes of balloon dilation Eustachian tuboplasty combined with tympanostomy tube insertion and middle ear pressure equalization therapy in treatment of recurrent secretory otitis media.Methods:Fifty one patients with recurrent secretory otitis media (62 ears) underwent balloon dilation of Eustachian tube and tympanic tube insertion under general anesthesia,followed by long term middle ear pressure equalization therapies.The Eustachian tube score (ETS) and Eustachian tube function questionnaire (ETDQ-7) were used for pre-and postoperative (up to 12 months) evaluation of Eustachian tube functions.Results:The mean ETS score was 2.34 ± 0.97 preoperatively,and 6.17 ± 1.54,7.23 ± 1.62,8.24 ± 1.97,and 7.63 ± 1.86at 1,3,6 and 12 months postoperatively,respectively (P＜ 0.05).The ETDQ-7 score was 4.82 ± 1.07 preoperatively,and 2,20 ± 0.54,2.32 ± 0.68,2.53 ± 0.79,and 2.67 ± 0.76 at 1,3,6 and 12 months postoperatively,respectively (P ＜ 0.05).Conclusion:Balloon dilation of Eustachian tube combined with tympanostomy and catheterization resulted in significant improvement of subjective symptoms and objective evaluation of Eustachian tube functions in most patients with recurrent secretory otitis media,as indicated by the ETS and ETDQ-7 scores,demonstrating high levels of efficacy and patient satisfaction.