摘要：Objective:To investigate subjective and objective listening abilities in noise in young adults,older adults with normal hearing,and adults with listening difficulties(LiD).Methods:This study examined 20 young adults,20 older adults with normal hearing,and 20 adults with LiD.All participants underwent pure-tone audiometry and the Hearing in Noise Test-Japanese version(HINT-J)and completed the Speech,Spatial and Qualities of Hearing Scale(SSQ).Results:All groups had normal hearing thresholds(125-8,000 Hz).Older adults with normal hearing performed worse on the HINT-J than young adults,while adults with LiD reported greater subjective LiD on the SSQ.No significant correlations were found between HINT-J and SSQ scores with any group.Significant differences were found between groups in terms of both the HINT-J(x2(2)=17.9,p＜0.01)and SSQ(x2(2)=38.7,p＜0.01).Conclusion:Despite normal audiometric thresholds,older adults with normal hearing and adults with LiD experience distinct LiD in noisy environments,highlighting the need for comprehensive assessment beyond traditional audiometry.Future research should focus on developing more sensitive diagnostic tools.

摘要：Objective:To investigate the spatial gradient of intraoperative impedance across the cochlear electrode array in pediatric cochlear implant recipients and assess its potential as a physiological indicator for the electrode-neural interface.Methods:A prospective observational study involving 56 pediatric patients underwent cochlear implantation with Cochlear Nucleus devices.Intraoperative polarized impedance and electrically evoked compound action potential(ECAP)threshold were recorded across all 1232 electrodes using AutoNRT software.Eight electrodes with open-or short-circuit were excluded,leaving 1,224 for analysis.Impedance values were categorized by cochlear region(basal,middle,apical),and electrodes with elevated impedance(10-20 kΩ)were analyzed for regional distribution and clinical relevance.Data were analyzed for spatial patterns and correlation with the ECAP threshold profiles.Results:A consistent basal-to-apical increase in impedance was observed(7.7±1.9,9.2±1.4,10.8±1.5 kΩ;p＜0.001).Impedance and ECAP threshold were weakly correlated(ρ=-0.20,p＜0.001;β=-1.26,p＜0.001),with a positive association in the apical region(ρ=0.12,p=0.048).Electrodes with higher impedance(10-20 kΩ)were less likely to show elevated or absent TNRT(OR=0.175,p=0.02).The impedance gradient persisted across age groups and was significantly correlated with ECAP threshold patterns.Conclusion:Intraoperative impedance monitoring reveals a strong and physiologically consistent gradient,with higher values in apical electrodes.This gradient reflects anatomical and tissue interface variations,which may offer a valuable physiological indicator for intraoperative electrode positioning and neural interface integrity.

摘要：Tinnitus is a concerning condition that affects most adults worldwide,with a prevalence of 6.7％.Theories of tinnitus have explained that an increase in spontaneous neural activity at the level of the thalamus could induce tinnitus.There are no standardized objective tests for tinnitus assessment because of its multifaceted nature.Hence,the current study aimed to explore the effect of Tinnitus on Latency and Amplitude of the Auditory Middle Latency Response in Audiological Attendees.The study recruited 50 individuals(25 normals and 25 individuals with tinnitus)who underwent audiological evaluations like Pure tone audiometry,immittance,pitch and loudness matching,THI and middle latency response.The IHS program was used to record MLR,which was obtained using tone burst stimuli of 500 Hz,1 KHz,2 KHz,and 4 KHz at a rate of 7.1/s with a constant duration of 5 ms,for a total of 1500 sweeps.As a covariate,pure tone thresholds were one of the variabilities that were addressed by ANCOVA.The amplitude of the Pa component varied significantly between the tinnitus and control groups,according to the MLR data and no other components of MLR reached that significance.Furthermore,there was no discernible variation in the latency or amplitude of MLR among any of the other components.The latency of the waveforms increased as the stimulus frequency increased.Karl Pearson correlation coefficient showed no significant correlation between THI scores and any of the outcome measures except for Pa amplitude.As the Pa component of MLR showed maximum changes between controls and individuals with tinnitus,the Pa component could be considered a potential tool for identifying neurophysiological changes related to tinnitus.

摘要：Ossiculoplasty remains a challenging surgical procedure,with outcomes heavily influenced by diverse anatomical and pathological factors.Over the decades,numerous scoring systems have been developed to predict the prognosis of ossiculoplasty,each emphasizing different variables such as ossicular status,middle ear environment,and surgical history.This paper provides a comprehensive review of the evolution of prognostic scoring systems,including Austin's original ossicular classification,Bellucci's otorrhea staging,the Middle Ear Risk Index(MERI),the Ossiculoplasty Outcome Parameter Staging(OOPS),and the recently introduced Ear Environment Risk(EER)scale.While these systems have significantly contributed to preoperative assessment,each presents notable limitations in encompassing all variables affecting surgical success.Therefore,the aim of this paper is to provide a review of the ossiculoplasty prognostic scores and show the benefits,innovations and gaps associated with each.To address these gaps,a novel,modified scoring system is proposed,incorporating previously overlooked but clinically significant factors such as tympanic membrane status,type of tympanoplasty,ossicular replacement material,CT scan findings,and the presence of complicated ear conditions.By synthesizing elements from historical scores with updated clinical insights,the proposed system aims to provide a more holistic and predictive framework for preoperative evaluation.Future multicenter studies are encouraged to validate the efficacy and prognostic power of this new scoring system,with the goal of improving surgical planning and patient counseling in ossiculoplasty.

摘要：Objectives:To investigate the imaging characteristics,surgical approaches,and outcomes of cochlear implantation(CI)in patients with special inner ear malformations(IEMs)that show transitional forms between cochlear hypoplasia(CH)and common cavity(CC).Methods:Twelve children(eight males,four females),aged 10 to 43 months,with special IEMs were enrolled,and their inner ear structures were analyzed using detailed segmenta-tion.Two surgical approaches were employed:the transmastoid slot labyrinthotomy approach(TSLA)for cases requiring customized electrodes,and the round window or cochleostomy approach for the remaining cases.Outcomes were evaluated using Categories of Auditory Performance(CAP),Speech Intelligibility Rating(SIR),and Meaningful Auditory Integration Scale(MAIS/IT-MAIS)at 12 months post-implantation.Results:Two main types of malformed cochleae were identified:common cavity-like and primitive CH types.All patients exhibited cochlear nerve deficiency and significant bilateral differences in their inner ear structures.Four patients underwent TSLA with customized electrodes,while the remaining patients received lateral wall electrodes via the round window or cochleostomy approach.Most patients showed improvement in auditory and speech capabilities following implantation.Conclusion:Inner ear malformations with transitional forms between CH and CC present unique chal-lenges,requiring detailed preoperative evaluation and customized surgical plans.Even in severe cases,carefully planned surgery can lead to meaningful auditory rehabilitation.

摘要：Background and Objectives:The perception of sound in the vertical plane supports spatial hearing by enabling listeners to detect sources located above and below.Sounds originating from both the front and back elevations along the mid-sagittal plane further contribute to a three-dimensional auditory experience.This study aimed to characterize the variability in vertical sound localization abilities among normal-hearing(NH)individuals using spatialized audio.Materials and Methods:Fifty-one NH participants(aged 18 to 35 years)completed three vertical localization tasks under headphones as part of a single-group,within-subject experimental study.These tasks included two-plane identification:(1)top-down localization,(2)front-back localization,and one discrimination task in the front plane.Hierarchical Cluster Analysis(HCA)was employed to identify distinct patterns in spatial localization profiles specific to the vertical-median plane.Fisher's Discriminant Function Analysis(FDA)was used to validate the accuracy of HCA and estimate classification error.Results:HCA revealed three distinct listener clusters:(1)cluster 1 with good performance across all three tasks,(2)cluster 2 with selective impairment in top-bottom identification,and(3)cluster 3 with selective deficits in front-back identifica-tion.FDA validated group membership of the clusters identified by the HCA,with a prediction accuracy of 98％.Conclusions:Individuals with clinically NH exhibited three distinct vertical localization profiles:uniform performers,those impaired in top-bottom identification,and those impaired in front-back identification.These profiles may be linked to the interplay between acoustic and non-acoustic perceptual factors.

摘要：Background:Brucellosis is a zoonotic infection common in Mediterranean countries and the Middle East.Neurological involvement,although rare,can lead to severe complications,including sensorineural hearing loss(SNHL).This case is particularly noteworthy as it highlights irreversible auditory nerve damage in brucellosis,emphasizing the importance of early diagnosis and treatment to prevent permanent neurological consequences.The novelty of this case lies in the severity of auditory involvement despite timely treatment.Case Presentation:A 43-year-old male farmer of Maghrebi origin presented with neurobrucellosis complicated by severe,irreversible bilateral sensorineural hearing loss.The patient initially reported symptoms of hearing loss and dizziness,which were confirmed to be associated with auditory nerve involvement.Wright's serology and polymerase chain reaction(PCR)testing confirmed brucellosis.Despite appropriate and prolonged antibiotic therapy,including drugs that penetrate the meningeal barrier and act intracellularly,the patient's auditory impairment remained permanent.The patient is currently a candidate for cochlear implantation to manage his severe hearing loss.Neurological symptoms did not improve with treatment,but cochlear implantation may offer a potential solution to his hearing deficit.Conclusions:This case highlights the importance of early recognition and intervention in brucellosis cases,particularly those with neurological involvement.Delayed diagnosis and treatment can result in irreversible neurological damage.It also underscores the potential for cochlear implantation in patients with severe,irreversible sensorineural hearing loss caused by neurobrucellosis.Cochlear implantation offers an important solution for patients with brucellosis-related hearing deficits,improving their quality of life despite the neurological damage caused by the infection.

摘要：Background:Early Hearing Detection and Intervention(EHDI)plays a critical role in improving language,cognitive,and socio-emotional outcomes for infants with hearing loss.In Nigeria,however,EHDI implementation remains limited by fragmented service delivery,uneven technological capacity,and sociocultural factors that delay timely diagnosis.This study explored the perspectives of paediatric audiologists and parents to provide a comprehensive understanding of the opportunities and challenges influencing early hearing care across diverse Nigerian settings.Methods:A mixed-methods design was employed across audiology facilities selected systematically from four Nigerian geopolitical zones.Twenty-five paediatric audiologists and twenty-three parents of children with congenital hearing loss participated.Quantitative data were collected using a structured questionnaire assessing awareness,diagnostic access,and intervention experiences.Qualitative data were obtained through semi-structured interviews and two focus group discussions.Thematic analysis followed Braun and Clarke's six-step framework,with dual coding,external auditing,and member validation to enhance credibility.Results:Quantitative findings demonstrated broad agreement on the diagnostic value of otoacoustic emissions(OAEs)and automated auditory brainstem responses(AABRs),the developmental benefits of early intervention,and the importance of active parental involvement.However,respondents identified persistent barriers including high costs of screening and therapy,poor public awareness of early hearing loss symptoms,and a critical shortage of trained personnel,and unequal distribution of diagnostic tools,particularly in rural and northern regions.Thematic analysis further underscored disparities in diagnostic capacity,sociocultural interpretations of deafness that delay clinical consultation,and economic constraints that hinder continuity of care.While families who accessed early intervention reported improved communi-cation,social engagement,and learning readiness in their children,systemic gaps continue to limit widespread success.Conclusions:Despite growing technological capacity and awareness of EHDI benefits,significant structural,financial,and sociocultural challenges continue to impede timely diagnosis and intervention in Nigeria.Strengthening national policies,ensuring equitable distribution of diagnostic tools,expanding professional training,subsidising services,implementing culturally sensitive awareness campaigns and integration of Universal Newborn Hearing Screening into routine postnatal care are essential to improving outcomes for deaf infants.

摘要：1 Introduction A 25-year-old woman presented with a 3-month history of otalgia and aural fullness in the left ear,without associated otological or systemic symptoms.Her medical history was unremarkable,and she denied any history of hepatitis,hypertension,diabetes,cardiovascular disease,or other significant conditions.The patient was diagnosed with external auditory canal cholesteatoma and subsequently underwent canalplasty under general anesthesia.Routine anesthetic drugs,including 2％lidocaine,dexamethasone,propofol,sufentanil,rocuronium bromide,ondansetron,flur-biprofen axetil,neostigmine,and atropine,were used during surgery and anesthesia recovery.No significant events were noted,and the patient experienced only a blood loss of 10 mL.

摘要：Tinnitus:the hearing of a sound that has not been produced by any external or internal source,is a rather heterogeneous hearing disorder.Back-ground/Objectives:Hearing loss has been shown to be the main risk factor for tinnitus while emotional disorders are risk factors for developing intrusive or bothersome tinnitus.Moreover,aging has also been identified as another risk factor.The aim of this paper was to analyse the correlation between hearing loss,age and tinnitus severity in a cohort of 610 tinnitus sufferers.Methods:Age,audiometric(hearing condition)and tinnitus(time duration and severity)data were assessed and analysed for all subjects just after recruiting(baseline).Furthermore,the average hearing loss(HL)curves of the participants for age groups were compared to these with the corresponding Age Related HL(ARHL).Results:For most of the age groups,the measured HL curves exceeded in 10-20 dB those of the ARHL.The average age of tinnitus onset(age minus tinnitus duration)was found to be 44-46 years in both men and women.Weak correlation between audiometric feature and tinnitus distress was observed.Conclusions:Hearing loss has been shown to be a clear risk factor for triggering tinnitus(86％of participants were hearing impaired).In this cohort,average measures of hearing loss showed,at most,weak associations with tinnitus-related distress,suggesting that non-audiological factors may play a pre-dominant role.

摘要：Dear Editor, I am writing in response to Jamil's letter,"Interpretative Chal-lenges of the'Missing Perilymph'Sign in PLF Diagnosis."I concur with the author's emphasis on the necessity for cautious interpre-tation of low-signal areas as evidence of active perilymph leakage,requiring correlation with clinical findings,surgical confirmation,and longitudinal imaging changes.

摘要：Objective:To assess the effectiveness of machine learning in automating the prediction of vestibular abnormalities after cochlear implantation(CI)in patients with sensorineural hearing loss(SNHL),with the goal of developing a practical model that can accurately predict long-term vestibular function outcomes and identify associated risk factors.Methods:Clinical data,including imaging,vestibular evoked myogenic potentials(VEMPs),and auditory information,were collected from patients with sensorineural hearing loss(SNHL)before and after CI.The decision tree algorithm was employed to address missing values and screen pre-CI clinical features.Six machine learning methods were subsequently utilized to predict the relationships between the extracted features and post-CI vestibular dysfunction.The best-performing method determined the ranking of feature importance,which was regarded as risk factors for predicting symptoms and VEMPs results after CI.Results:Logistic regression models effectively predicted both post-CI vestibular dysfunction and abnormal cervical VEMP(cVEMP),with accuracies of 80%and 78%,respectively.The relative importance of the features,in descending order,was as follows:cVEMP latency,cVEMP amplitude,and residual hearing threshold.Moreover,the support vector machine(SVM)model attained an accuracy of 88%in predicting abnormal ocular VEMP(oVEMP)post-CI.For the SVM model,the feature importance ranking was as follows:oVEMP latency,oVEMP amplitude,and residual hearing threshold.Conclusions:This study successfully leverages machine learning techniques,specifically support vector machines(SVM)and logistic regression models,to predict the impact of CI on vestibular function.These predictive models provide valuable insights for presurgical planning and decision-making in CI procedures.Moreover,the findings highlight the critical risk factors associated with vestibular dysfunction,offering a robust reference for guiding vestibular rehabilitation strategies.

摘要：Dear Editor, I am responding to Zou and Li's,The missing perilymph sign on MRI indicates a perilymphatic fistula:A case report Zou J,Li H.Journal of Otology,2025,20(1):1-4. proposing the"missing perilymph"sign on MRI as a novel radiological indicator of perilymphatic fistula(PLF).This study adds to the growing body of work seeking objective,non-invasive diagnostic methods for PLF,a condition that has long eluded definitive radiological confirmation.The avoidance of gadolinium contrast in the imaging technique is an additional strength,given increasing awareness of gadolinium-associated risks(Starekova et al.,2024).

摘要：Objectives:The causal association between presbycusis and changes in cerebral cortex structure was evaluated through Mendelian randomization(MR).Methods:Presbycusis data,serving as the exposure trait,was analyzed using data from the ninth release of the FinnGen biobank.Genome-wide association study(GWAS)datasets for cortical surface area(SA)and thickness(TH)were sourced from the ENIGMA Consortium,whereas cortical volume(V)GWAS data came from the UK Biobank.The inverse-variance weighted(IVW)approach was adopted as the principal analytical method.To ensure robustness,sensitivity analyses were systematically implemented to evaluate potential heterogeneity and pleiotropic effects.Results:Following rigorous filtering through IVW and sensitivity analyses,eleven robust MR associations emerged,offering preliminary evidence for a causal link between presbycusis and cortical architecture,including frontal pole SA with global weighted(GW)(β=1.858 mm2,P=0.004)and without GW(β=1.778 mm2,P=0.012),pars orbitalis SA with GW(β=2.717 mm2,P=0.042),transverse temporal SA with GW(β=2.349 mm2,P=0.033),pars orbitalis TH with GW(β=-0.009 mm,P=0.008)and without GW(β=-0.011 mm,P=0.008),rostral middle frontal TH with GW(β=-0.005 mm,P=0.020)and without GW(β=-0.007 mm,P=0.012),precuneus TH without GW(β=-0.006 mm,P=0.049),left hippocampus V(β=-12.296 mm3,P=0.033)and right hippocampus V(β=-11.991 mm3,P=0.049).Conclusion:From a genetic standpoint,our findings indicate region-specific neuroanatomical modifications in presbycusis patients,supporting the notion of neurodegenerative or adaptive alterations in brain structure from a genetic perspective.

摘要：Human temporal bone specimens are used in experiments to measure the sound transfer function of the middle ear.This standard method for the development of middle ear implants requires temporal bones that possess appropriate mechanical properties and structural stability and are free from pathological conditions.A laser Doppler vibrometer is commonly employed to measure the vibration of the stapes footplate.These experiments are typically conducted in the middle ear by leaving the inner ear intact,exposing the stapes footplate through the tympanic cavity,and directing the laser beam onto the footplate.However,previous studies have shown that the influence of inner ear impedance on the middle ear transfer function cannot be ignored,and any surgical manipulation may cause a change in inner ear pressure,resulting in instability in the middle ear transfer func-tion.Therefore,this study aims to eliminate the influence of the inner ear and to establish a new experimental method in human temporal bone specimens that is more suitable for the study of sound conduction in middle ear implants.As a result,a range for middle ear transfer function was developed,which serves as a reference for assessing the conformity of temporal bone specimens to experimental standards,and the stability of this range was demonstrated under experimental conditions.

摘要：Objective:The aims of this study were to investigate the clinical applicability of 3D segmentation in measuring cochlear anatomical parameters,explore factors that influence the insertion angle of cochlear implant electrodes in patients with inner ear malformations,and determine the value of 3D segmentation in predicting cochlear implant electrode insertion depth by simulating electrode implantation in a reconstructed 3D model.Methods:Data from 208 temporal bone CT scans of patients with a variety of inner ear malformations(including the CH,IP-I,IP-II,and IP-III types)who underwent cochlear implantation at our center were retrospectively analyzed.Preoperative temporal bone CT data were subjected to three-dimensional(3D)segmentation of the cochlea with a 3D slicer.Results:Cochlear malformation types,including IP types I(42 ears),II(278 ears),III(20 ears),and CH(65 ears),were diagnosed and measured in 208 preoperative CT datasets.Cochlear anatomical parameters and electrode length were correlated,which partially explained the variations in electrode insertion angle.The mean angle of implantation among the enrolled patients was 564.33°,and the mean implantation angle prediction error in the 3D segmentation was|23.74|°.Conclusion:Three-dimensional segmentation from temporal bone CT is valuable for surgeons,especially in treating patients with inner ear malformation.Such insights will help surgeons understand overall anatomical variations,predict electrode implantation depth,and complete preoperative imaging assessments for cochlear implant insertion depth in patients with inner ear malformations.

摘要：Objectives:Sudden sensorineural hearing loss(SSNHL)is a sudden onset condition of unknown etiology,often accompanied by tinnitus and vertigo,significantly affecting patients'quality of life.While some individuals experience spontaneous recovery,the unpredictability of treatment outcomes and potential complications pose clinical challenges.Recent studies suggest a potential link between thyroid hormone levels—particularly free tri-iodothyronine(FT3)and thyroid-stimulating hormone(TSH)—and both the pathogenesis and prognosis of SSNHL.However,the precise mechanisms remain unclear.This study aims to investigate the correlation between thyroid hormone abnormalities and hearing recovery in SSNHL patients,providing insights to enhance diagnostic and therapeutic approaches.Methods:This prospective observational study included 66 SSNHL patients admitted to the Affiliated Hospital of Qingdao University between April 2024 and February 2025.Serum TSH and FT3 levels were measured using chemiluminescence immunoassay,while hearing function was evaluated through pure-tone audiometry following standard guidelines.The"post-treatment hearing gap(PTHG)"was introduced as a quantitative measure of treatment efficacy.All patients received comprehensive treatment,including glucocorticoid therapy and hyperbaric oxygen therapy,and were classified into effective and ineffective groups based on hearing recovery outcomes.Results:No significant differences in gender or comorbidities(tinnitus,ear fullness,dizziness)were observed between the abnormal thyroid function group(n=45)and the normal thyroid function group(n=21)(all p>0.05).Similarly,initial TSH and FT3 levels did not differ significantly among patients with varying degrees of hearing impairment(mild,moderate,severe)(p>0.05).However,during treatment,ΔFT3 demonstrated a significant negative correlation with PTHG(r=-0.739,p=0.002),suggesting that a greater increase in ΔFT3 is associated with improved hearing recovery.Additionally,TSH levels showed a significant positive correlation with ΔFT3(p<0.05).Conclusions:Abnormal thyroid function in SSNHL patients was not associated with the severity of hearing loss.However,dynamic changes in FT3 during treatment showed a significant correlation with therapeutic efficacy,suggesting that monitoring ΔFT3 may have clinical value in prognostic assessment.Nonetheless,this study had a limited sample size,and the potential influence of hormone therapy on thyroid function was not accounted for.Therefore,the role of thyroid hormones in SSNHL warrants further validation through large-scale prospective studies and mechanistic investigations.

摘要：Objective:This study aims to establish an economically viable and easily accessible adult animal model for optogenetic activation of auditory neurons using adeno-associated viruses(AAVs)carrying ChR2(H134R)to explore the potential of cochlear optogenetics as a hearing restoration technology.Methods:Healthy adult guinea pigs were used in the experiments.The viral vector AAV2/8-ChR2(H134R)-hSyn-eYFP was administered to the right cochlea via the round window membrane.The confocal microscopy and reverse transcription polymerase chain reaction(RT-PCR)were utilized to analyze the ChR2(H134R)expression localized to spiral ganglion neurons(SGNs).The auditory pathway activation was assessed by recording the optical compound action potential(oCAP)and acoustic compound action potential(aCAP)at various laser intensities.Results:The ChR2(H134R)-eYFP expression was confirmed in 90%of the tested animals,localized to the SGNs of the injected ear.Higher mRNA levels of ChR2(H134R)and eYFP were observed in the injected ear compared to the non-injected ear,while actin(Actb)mRNA levels were not significantly different.The oCAP was successfully elicited by a 470 nm blue light laser stimulus,with similar amplitudes and latency periods to those of aCAPs when the oCAP was evoked by 5.80 mW blue light and the aCAP was evoked by a 40 dB SPL click.The amplitudes of oCAPs increased with increasing laser intensity.Conclusion:This study demonstrates the viability of optogenetic activation of the auditory system in adult guinea pigs through the transduction of AAV-ChR2(H134R)in SGNs.Cochlear optogenetics demonstrates potential as a hearing restoration technology,providing a basis for further clinical research and opening new avenues for investigation.

摘要：Purpose:Acute otitis media caused by gram-negative bacteria is a common otological condition among pediatric patients.Eustachian tube dysfunction(ETD)plays a pivotal role in the delayed resolution of acute otitis media,whereas the precise contribution of SIRT3 in this mechanism remains uncertain.This study aims to reveal the involvement of SIRT3 in murine ETD induced by LPS.Results:Histological analysis showed no baseline differences in ET structure between WT and SIRT3 knockout(SIRT3-KO)mice.However,LPS exposure led to increased goblet cell proliferation and MUC5AC mucus secretion in both genotypes,with SIRT3-KO exacerbating these effects.The SIRT3-KO group displayed reduced cilia length.Functionally,SIRT3-KO mice showed a significantly higher initial POP and decreased MCC compared to the WT group after LPS exposure.Additionally,the active clearance of negative pressure(ACNP)was significantly reduced in SIRT3-KO mice,indicating compromised ET function.Conclusions:SIRT3-KO increased resistance to ET opening in mice exposed to LPS,and this effect may be related to the upregulated MUC5AC expression,the increased surface tension of the luminal fluid and the impaired MCC function in mice exposed to LPS.

摘要：Introduction:Hearing loss,particularly congenital hearing loss,poses significant challenges to affected individuals and their families.Recent advancements in regenerative medicine have fueled interest in stem cell therapy as a potential solution for hearing restoration.This review discusses the feasibility of using stem cells to regenerate damaged cochlear structures and auditory neurons,focusing on their differentiation potential and integration into the cochlear environment.Discussion:Congenital hearing loss remains a significant global health challenge,with genetic mutations and syndromic conditions contributing to its high prevalence.Advances in regenerative medicine have led to increased interest in stem cell therapy as a potential solution for auditory restoration.Research on embryonic stem cells(ESCs),induced pluripotent stem cells(iPSCs),and mesenchymal stem cells(MSCs)has demonstrated their ability to differentiate into auditory cell types,offering a potential avenue for cochlear regeneration.Gene therapies also present a promising approach for addressing hereditary hearing loss by targeting specific genetic mutations.iPSCs in particular show promise,especially when combined with gene therapy for hereditary hearing loss.Despite encouraging preclinical findings,persistent hurdles remain:immune rejection,limited cell survival,difficulty with cochlear integration,and complex ethical and regulatory considerations.Addressing these barriers is crucial for safe and effective translation into clinical care.In Pakistan,there is a critical need to promote advancements in this field.Positioning Pakistan as an illustrative case within broader low-and middle-income country(LMIC)disparities underscores how limited infras-tructure,funding gaps,and weak regulatory frameworks constrain progress and highlight opportunities for regional collaboration.Conclusion:As stem cell research advances,it is crucial to address ethical and regulatory considerations to ensure the responsible translation of these therapies into clinical practice.By integrating stem cell therapy with gene editing techniques and biomaterial scaffolding,the future of regenerative treatment for congenital hearing loss holds transformative potential.