摘要：Background:Probable benign paroxysmal positional vertigo,spontaneously resolved (pBPPVsr),is a variant of benign paroxysmal positional vertigo (BPPV) in which there is no observable nystagmus and no vertigo with any positional maneuver.Objectives:To calculate the incidence pBPPVsr,compare the characteristics of the patients with pBPPVsr and BPPV not spontaneously resolved and describe the spontaneous resolution in the natural course of BPPV.Methods:Multicenter prospective descriptive study.During a one-year period,all patients with suspected BPPV that presented to the Neurotology Units of five participating centers were recruited.The incidence of pBPPVsr was calculated as a percentage of the total number of patients with BPPV.The prevalence of several variables was compared between pBPPVsr and BPPV not spontaneously resolved.The timing of spontaneous resolution was estimated using Kaplan-Meier curves.Results:457 patients met the inclusion criteria.The incidence of pBPPVsr was 33.5％.It was significantly higher in males,in patients with normal bone mass and in patients who were not taking sulpiride,A rate of 18％ of spontaneous resolution after the first month and 51％ after the first year was found.This percentage did not change in a significant way after this moment.The curves for males,patients under 50 and patients with normal blood pressure decreased significantly faster.Conclusions:In our serie,BPPV spontaneously resolved in half of the patients with BPPV during the first year.This seemed to occur more commonly in males and could have been hindered by sulpiride intake,osteoporosis,advanced age and high blood pressure.

摘要：Currently, most people with modern multichannel cochlear implant systems can understand speech in qui-et environment very well. However, studies in recent decades reported a lack of satisfaction in music percep-tion with cochlear implants. This article reviews the literature on music ability of cochlear implant users by presenting a systematic outline of the capabilities and limitations of cochlear implant recipients with regard to their music perception as well as production. The review also evaluates the similarities and differences be-tween electric hearing and acoustic hearing regarding music perception. We summarize the research results in terms of the individual components of music (e.g., rhythm, pitch, and timbre). Finally, we briefly intro-duce the vocal singing of prelingually-deafened children with cochlear implants as evaluated by acoustic measures.

摘要：Whereas much has been learned about age-related auditory changes in the inner ear, relatively little is known about the aging effects on the vestibular part of the inner ear-the peripheral vestibular system. Here we review relevant literature with regard to the prevalence of vestibular dysfunction, vestibular functional and structural changes in the elderly. The prevalence of vestibular dysfunction increases with age. Functionally, as age in-creases, VEMP amplitudes decrease, VEMP thresholds increase, VOR gain of HIT decreases. Due to the com-plexity of the vestibular system, variations in subject age and measurement techniques, findings in VEMP latency and caloric tests are conflicting. To address this, a direct measure of the peripheral vestibular system should be applied. Structurally, age-related loss in vestibular ganglion and otoconia have been noted; hair cell changes are not well defined; while subcellular changes remain to be explored. Defining how the onset of vestibular dys-function correlates with structural degeneration will offer insights into the mechanisms underlying vestibular aging.

摘要：Objective: The present study aimed to evaluate the possibility of using coherent anti-Stokes Raman spectroscopy (CARS) microscopy to determine the specific molecular morphology of cholesteatoma by detecting the natural vibrational contrast of the chemical bonds without any staining. <br> Materials and methods: Specimens from the mastoid and tympanic membrane with and without cholesteatoma were analyzed using CARS microscopy, two-photon excited fluorescence (TPEF) microscopy, and the second harmonic generation (SHG) microscopy. <br> Results:In cholesteatoma tissues from the mastoid, a strong resonant signal at 2845 cm?1 was observed by CARS, which indicated the detection of the CH2 hydro-carbon lipid bonds that do not generate visible signals at 2940 cm?1 suggestive of CH3 bonds in amino acids. A strong resonant signal at 2940 cm?1 appeared in an area of the same specimen, which also generated abundant signals by TPEF and SHG microscopy at 817 nm, which was suggestive of collagen. In the tympanic membrane specimen with cholesteatoma, a strong resonant signal with corrugated morphology was detected, which indicated the presence of lipids. A strong signal was detected in the tympanic membrane with chronic otitis media using TPEF/SHG at 817 nm, which indicated collagen enrichment. The CARS and TPEF/SHG images were in accordance with the histology results. <br> Conclusion: These results suggest the need to develop a novel CARS microendoscope that can be used in combination with TPEF/SHG to distinguish cholesteatoma from inflammatory tissues. <br> Copyright ? 2016, PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (

摘要：To gain insights into the ototoxic effects of aminoglycoside antibiotics (AmAn) and delayed peripheral ganglion neuron death in the inner ear, experimental animal models were widely used with several different approaches including AmAn systemic injections, combination treat-ment of AmAn and diuretics, or local application of AmAn. In these approaches, systemic AmAn treatment alone usually causes incomplete damage to hair cells in the inner ear. Co-administration of diuretic and AmAn can completely destroy the cochlear hair cells, but it is impossible to damage the vestibular system. Only the approach of AmAn local application can selectively eliminate most sensory hair cells in the inner ear. Therefore, AmAn local application is more suitable for studies for complete hair cell destructions in cochlear and vestibular system and the following delayed peripheral ganglion neuron death. In current studies, guinea pigs were unilaterally treated with a high concentration of gentamicin (GM, 40 mg/ml) through the tympanic membrane into the middle ear cavity. Auditory functions and vestibular functions were measured before and after GM treatment. The loss of hair cells and delayed degeneration of ganglion neurons in both cochlear and vestibular system were quantified 30 days or 60 days after treatment. The results showed that both auditory and vestibular functions were completely abolished after GM treatment. The sensory hair cells were totally missing in the cochlea, and severely destroyed in vestibular end-organs. The delayed spiral ganglion neuron death 60 days after the deafening procedure was over 50%. However, no obvious pathological changes were observed in vestibular ganglion neurons 60 days post-treatment. These results indicated that a high concentration of gentamycin delivered to the middle ear cavity can destroy most sensory hair cells in the inner ear that subsequently causes the delayed spiral ganglion neuron degeneration. This model might be useful for studies of hair cell regenerations, delayed degeneration of peripheral auditory neurons, and/or vestibular compensation. In addition, a potential problem of ABR recording for unilateral deafness and issues about vestibular compensation are also discussed.

摘要：Objective:To report a scala tympani drill-out technique for managing malformed facial nerve covering the entire oval window (OW). Methods:Data from three cases with OW atresia, malformed stapes and abnormal facial nerve courses were reported, in which a scala tympani drill-out technique was employed with a TORP between the tympanic membrane and scala tympani fenestration for hearing reconstruction. Results: Air conduction hearing improved in two of the three cases following surgery. In the third case, there was no improvement in air conduction hearing following a canal wall up mastoidectomy and tympanoplasty. There were no vertigo, tinnitus or sensorineural hearing loss in the three cases. Conclusion:The scala tympani drill-out technique, which is basically fenestration at the initial part of the basal turn, provides a choice in hearing reconstruction when the OW is completely covered by abarrently coursed facial nerve.

摘要：Mandarin Chinese tone patterns vary in one of the four ways, i.e, (1) high level; (2) rising; (3) low falling and rising; and (4) high falling. The present study is to examine the efficacy of an artificial neural network in recognizing these tone patterns. Speech data were recorded from 12 children (3-6 years of age) and 15 adults. All subjects were native Mandarin Chinese speakers. The fundamental frequencies (FO) of each monosyllabic word of the speech data were extracted with an autocorrelation method. The pitch data(i.e., the FO contours) were the inputs to a feed-forward backpropagation artificial neural network. The number of inputs to the neural network varied from 1 to 16 and the hidden layer of the network contained neurons that varied from 1 to 16 in number. The output of the network consisted of four neurons representing the four tone patterns of Mandarin Chinese. After being trained with the Levenberg-Marquardt optimization, the neural network was able to successfully classify the tone patterns with an accuracy of about 90% correct for speech samples from both adults and children. The artificial neural network may provide an objective and effective way of assessing tone production in prelingually-deafened children who have received cochlear implants.

摘要：To characterize the patterns of ABR waves in tree shrews, we must understand the hearing sensitivity and auditory function of healthy adult tree shrews. Fifteen tree shrews (30 ears) were stimulated with clicks and tone-pips at 11 different frequencies from 1 to 60 kHz. The ABR waves were recorded and analyzed. The ABR consisted of five to seven positive waves in the first 10 ms after a click stimulus, and the average hearing threshold of component Ⅲ was 27.86 ± 3.78 dB SPL. Wave Ⅲ was the largest and most clear. The ABR threshold was related to the tone-pip sitmulus by a "U" shaped curve. The sensitive frequency was approximately 8 kHz in tree shrews. The latencies systematically decreased with increasing stimulus frequencies. The ABR amplitudes of wave Ⅲ increased as the sound pressure level increased. All of these results provide an empirical basis for future studies of hearing diseases in tree shrews.

摘要：A one-year-old baby girl with one-month history of recurrent pus fluid exuding from her left preauricular sinus orifice, who failed multiple courses of surgical drainage of the abscess and persistent debridement for the wound, presented with MRSA infection. The patient was treated with linezolid for three days. Her pain and paresthesia resolved, and C-reactive protein decreased to normal.

摘要：Diabetes mellitus (DM) is a chronic systemic disease characterized by hyperglycemia, with various patho-genic mechanisms. From absolute or relative insulin deficiency, patients with DM often demonstrate vari-ous levels of metabolic disorders. Major clinical manifestations of DM include metabolic disorders, vascu-lar lesions, circulatory disturbances and neurologic complications. Along with advances in DM research, re-ports of DM related tinnitus and hearing impairment have increased continuously. Research on DM related auditory system dysfunction has focused on cochlear microcirculation, cellular homeostasis, genetics and ag-ing. Cochlear microcirculation plays an important role in cochlear physiology and its disorders are associat-ed with many inner ear diseases. Ischemia and subsequent reperfusion seen in cochlear microcirculation dis-orders are important factors in hearing damage. Understanding cochlear microcirculation and structural as well as functional changes in DM patients with hearing loss and their causal factors will help reveal patho-genic mechanisms in diabetic hearing loss and provide new ideas in developing interventions and preventing damages caused by diabetes.

摘要：Background: Sudden sensorineural hearing loss (SSNHL) is a common disease in otology, and steroids play an important role in its treatment. Steroids can be administered systemically or locally, and the efficacies of different administration routes remain controversial. Methods: We searched the Cochrane, EMBASE, PubMed, Web of Science, CNKI, Wanfang and Weipu databases for randomized controlled trials (RCTs) on glucocorticoid treatments for SSNHL to compare the efficacy of topical and systemic steroid administration. The Review Manager 5.4 software was used for synthesis of data:the rate of reported hearing improvement and change in pure-tone audiometry (PTA). Results: In all the included studies, when intratympanic administration was compared to systemic therapies, the risk difference (RD) using reported hearing improvement as an outcome measure was 0.08 (95％ CI: 0.01-0.14, I2 = 45％). Using PTA changes as an outcome measure in 4 studies, the mean dif-ference (MD) was 10.43 dB (95％CI:3.68-17.18, I2=81％). Hearing improvement RD was also compared among different types of steroid, recovery criteria, follow-up times and diagnostic criteria, and showed no significant differences exception for recovery criteria (>10 dB) (RD-0.06, 95％ CI:0.14-0.2, I2= 0％). Conclusion: As the initial treatment for SSNHL, topical steroids seem to be superior to systemic steroid administration, especially in patients with contraindications to systemic steroids usage. However, further verification based on high-quality research is needed.

摘要：Global demographic changes related to longevity are leading to increasing numbers of the elderly, for whom hearing loss is a significant cause of morbidity and disability. Once met with reticence, severely hearing impaired older adults are increasingly being considered for cochlear implantation (CI). Significant data indicate that CI in the elderly population is safe, well-tolerated, and effective. Risks from CI surgery and anesthesia are low and generally comparable to rates in other age groups. Outcomes studies regarding CI in older adults have shown excellent improvements to speech perception, quality of life, and even cognition. Overall, currently available data suggests that advanced age should not, in itself, be considered a barrier to implantation. This review paper will highlight selected articles from recent medical literature regarding the safety and efficacy of CI in the elderly population. <br> Copyright ? 2016, PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (

摘要：Cell—cell junctions in the cochlea are highly complex and well organized. The role of these junctions is to maintain structural and functional integrity of the cochlea. In this review, we describe classification of cell junction-associated proteins identified within the cochlea and provide a brief overview of the function of these proteins in adherent junctions, gap junctions and tight junctions. Copyright ? 2016, PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (

摘要：Objective:Patients with dizziness may present with symptoms of tilting,swaying,rocking,floating or with disequilibrium.This may be suggestive of an isolated otolithic dysfunction yet,there is little emphasis on this emerging clinical entity.To characterize and describe the prevalence of isolated otolith dysfunction in a local tertiary hospital and correlate them with clinical diagnosis.Methodology:Retrospective medical chart review of patients who presented with dizziness to the specialist outpatient Otolaryngology clinic,who required vestibular laboratory investigation.Results:Of the 206 patients,more than half of them (52.4％) fulfilled the criteria for either probable or definite isolated otolith dysfunction.When there are clinical symptoms of otolith dysfunction reported,there is a 1.62 odds of a remarkable laboratory otolith finding.The most common clinical finding was "no clear diagnosis" (65.5％) followed by Vestibular Migraine (13.6％).Conclusion:The prevalence of isolated otolith dysfunction is quite high.Laboratory tests of otolith function should be performed more routinely.This can be done in a sequential way to optimize cost effectiveness in countries with no insurance reimbursement.Prospective cohort studies on isolated otolith dysfunction,will lay the groundwork for achieving diagnostic consensus and formulating reha-bilitation plans to aid this group of patients.

摘要：Background: Tympanomastoid paragangliomas are usually benign, slowly growing, painless tumors. The common presenting symptoms of this tumor are pulsatile tinnitus and conductive hearing loss. Vertigo as the cardinal or initial symptom is extremely rare, especially in the early stages of the disease.Case presentation: A 53-year-old female patient presented only with intermittent recurrent vertigo and was later found to have a tympanomastoid paraganglioma. Her symptoms disappeared completely after resection of the tumor. This is the first report in literature of a case of tympanomastoid paraganglioma with vertigo as the single symptom. Conclusion: The tympanomastoid paraganglioma is rare and its clinical symptoms are nonspecific, so it is easy to be misdiagnosed or missed. It is worth noting that although clinically uncommon, vertigo can also be the first or sole symptom of tympanomastoid paraganglioma. Detailed physical examination and imaging examination of the ear are necessary and should be carried out meticulously.

摘要：Trimethyltin (TMT) is an occupational and environmental health hazard behaving as a potent neurotoxin known to affect the central nervous system as well as the peripheral auditory system. However, the mechanisms underlying TMT-induced ototoxicity are poorly understood. To elucidate the effects of TMT on the cochlea, a single injection of 4 or 8 mg/kg TMT was administered intraperitoneally to adult rats. The compound action potential (CAP) threshold was used to assess the functional status of the cochlea and histological techniques were used to assess the condition of the hair cells and auditory nerve fibers. TMT at 4 mg/kg produced a temporary CAP threshold elevation of 25e60 dB that recovered by 28 d post-treatment. Although there was no hair cell loss with the 4 mg/kg dose, there was a noticeable loss of auditory nerve fibers particularly beneath the inner hair cells. TMT at 8 mg/kg produced a large permanent CAP threshold shift that was greatest at the high frequencies. The CAP threshold shift was associated with the loss of outer hair cells and inner hair cells in the basal, high-frequency region of the cochlea, considerable loss of auditory nerve fibers and a significant loss of spiral ganglion neurons in the basal turn. Spiral ganglion neurons showed evidence of soma shrinkage and nuclear condensation and fragmentation, morphological features of apoptotic cell death. TMT-induced damage was greatest in the high-frequency, basal region of the cochlea and the nerve fibers beneath the inner hair cells were the most vulnerable structures. Copyright ? 2016, PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (

摘要：Given the interdependence of multiple factors in age-related vestibular loss (e.g.,balance,vision,cognition),it is important to examine the individual contributions of these factors with ARVL.While the relationship between the vestibular and visual systems has been well studied (Bronstein et al.,2015),little is known about the association of the peripheral vestibular system with neurodegenerative dis-orders (Cronin et al.,2017).Further,emerging research developments implicate the vestibular system as an opportunity for examining brain function beyond balance,and into other areas,such as cognition and psychological functioning.Additionally,the bidirectional impact of psychological functioning is under-studied in ARVL.Recognition of ARVL as part of a multifaceted aging process will help guide the development of integrated interventions for patients who remain at risk for decline.In this review,we will discuss a wide variety of characteristics of the peripheral vestibular system and ARVL,how it relates to neurodegenerative diseases,and correlations between ARVL and balance,vision,cognitive,and psy-chological dysfunction.We also discuss clinical implications as well as future directions for research,with an emphasis on improving care for patients with ARVL.

摘要：Age-related hearing loss (AHL), or presbycusis, is the most common neurodegenerative disorder and top communication deficit of the aged population. Genetic predisposition is one of the major factors in the development of AHL. Generally, AHL is associated with an age-dependent loss of sensory hair cells, spiral ganglion neurons and stria vascularis cells in the inner ear. Although the mechanisms leading to genetic hearing loss are not completely understood, caspase-family proteases function as important signals in the inner ear pathology. It is now accepted that mouse models are the best tools to study the mechanism of genetic hearing loss or AHL. Here, we provide a brief review of recent studies on hearing improvement in mouse models of AHL by anti-apoptotic treatment.

摘要：Objective:To study central functional network connections and their alterations in tinnitus patients using fMRI. Methods: Regional homogeneity (ReHo) values on fMRI were obtained from 18 tinnitus patients and 20 age and gender-matched control subjects. ReHo values were compared between tinnitus patients and control subjects to evaluate functional network connection differences. Results:Tinnitus patients showed increased ReHo values in gyrus frontalis inferior and decreased ReHo values in the anterior lobe of cerebellum in comparison with the controls. Analysis of functional network connection from the gyrus frontalis interior shows stronger connections to the middle brain (FWE, P<0.001) and right ventral striatum (FEW, P<0.05, small volume correction). Conclusions: The fMRI results indicate that both auditory and non-auditory centers play important roles in tinnitus. Functional connections among the auditory cortex, thalamus, medial temporal gyrus, parahippocampal gyrus and insula may be an underlying cause for the development of tinnitus.