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).T...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.展开更多
Hearing loss is the third leading cause of human disability.Age-related hearing loss,one type of acquired sensorineural hearing loss,is largely responsible for this escalating global health burden.Noise-induced,ototox...Hearing loss is the third leading cause of human disability.Age-related hearing loss,one type of acquired sensorineural hearing loss,is largely responsible for this escalating global health burden.Noise-induced,ototoxic,and idiopathic sudden sensorineural are other less common types of acquired hearing loss.The etiology of these conditions is complex and multi-fa ctorial involving an interplay of genetic and environmental factors.Oxidative stress has recently been proposed as a likely linking cause in most types of acquired sensorineural hearing loss.Short non-coding RNA sequences known as microRNAs(miRNAs)have increasingly been shown to play a role in cellular hypoxia and oxidative stress responses including promoting an apoptotic response.Sensory hair cell death is a central histopathological finding in sensorineural hearing loss.As these cells do not regenerate in humans,it underlies the irreversibility of human age-related hearing loss.Ovid EMBASE,Ovid MEDLINE,Web of Science Core Collection,and ClinicalTrials.gov databases over the period August 1,2018 to July 31,2023 were searched with"hearing loss,""hypoxamiRs,""hypoxia,""microRNAs,""ischemia,"and"oxidative stress"text words for English language primary study publications or registered clinical trials.Registe red clinical trials known to the senior author we re also assessed.A total of 222studies were thus identified.After excluding duplicates,editorials,retra ctions,secondary research studies,and non-English language articles,39 primary studies and clinical trials underwent full-text screening.This resulted in 11 animal,in vitro,and/or human subject journal articles and 8 registered clinical trial database entries which form the basis of this narrative review.MiRNAs miR-34a and miR-29b levels increase with age in mice.These miRNAs were demonstrated in human neuroblastoma and murine cochlear cell lines to target Sirtuin 1/peroxisome proliferato r-activated receptor gamma coactivator-1-alpha(SIRT1/P GC-1α),SIRT1p53,and SIRT1/hypoxia-inducible factor 1-alpha signaling pathways resulting in increased apoptosis.Furthermore,hypoxia and oxidative stress had a similar adve rse apoptotic effect,which was inhibited by resve ratrol and a myocardial inhibitorassociated transcript,a miR-29b competing endogenous mRNA.Gentamicin reduced miR-182-5p levels and increased cochlear oxidative stress and cell death in mice-an effect that was corrected by inner ear stem cell-derived exosomes.There is ongoing work seeking to determine if these findings can be effectively translated to humans.展开更多
This editorial critically evaluates the application of foot reflexology as a treatment for sensorineural hearing loss(SNHL)in infants,as proposed in a case report published in the World of Clinical Cases.SNHL is a con...This editorial critically evaluates the application of foot reflexology as a treatment for sensorineural hearing loss(SNHL)in infants,as proposed in a case report published in the World of Clinical Cases.SNHL is a condition characterized by damage to the cochlea or the neural pathways that transmit auditory information to the brain.The etiology of SNHL is often complex,involving genetic mutations,prenatal factors,or perinatal insults.Reflexology,an alternative therapy involving the application of pressure to specific points on the feet,is based on the hypothesis that these points correspond to different organs and systems in the body,including the auditory system.However,the biological plausibility and clinical efficacy of foot reflexology in addressing SNHL lack empirical support.This editorial examines the pathophysiology of SNHL,assesses the clinical claims of reflexology practitioners,and emphasizes the necessity of evidence-based approaches in treating infant hearing loss.While complementary therapies may provide ancillary benefits,they should not supplant validated medical treatments in managing SNHL in infants.Further research is needed to evaluate the safety and efficacy of foot reflexology and other alternative therapies in pediatric audiology.展开更多
Foot reflexology is a non-invasive and safe complementary therapy that works by massaging the reflex zones of the feet and exerts systemic or whole-body regulation through meridian nerve conduction.This therapy is com...Foot reflexology is a non-invasive and safe complementary therapy that works by massaging the reflex zones of the feet and exerts systemic or whole-body regulation through meridian nerve conduction.This therapy is commonly used in the treatment of various conditions such as autism and Parkinson's disease.However,there is limited reporting on the use of foot reflexology therapy for infants with sensorineural hearing loss(SNHL).Currently,there is no definitive conclusion on how foot reflexology therapy can influence hearing.This editorial holds some guiding significance regarding this clinical issue.The aim is to present physiological evidence of how foot reflexology therapy can impact infants with SNHL,thereby enhancing clinician’s awareness of foot reflexology in treating infants with SNHL.展开更多
Early intervention for sensorineural hearing loss(SNHL)in childhood is crucial for auditory and language development.In recent years,innovative auditory stimulation techniques and speech therapy strategies,such as mid...Early intervention for sensorineural hearing loss(SNHL)in childhood is crucial for auditory and language development.In recent years,innovative auditory stimulation techniques and speech therapy strategies,such as middle ear implants,cochlear implants,auditory brainstem implants,and midbrain implants,have provided new avenues for improving patient outcomes.Additionally,basic research advancements in cell reprogramming and regeneration,stem cell therapy,and targeted drug delivery offer promising approaches to meet the individualized needs of children with SNHL.However,many challenges and unresolved issues remain in the treatment of SNHL.This article comments on the case report,which describes a female pediatric patient with SNHL who underwent foot reflexology which led to the normalization of hearing thresholds.Reflexology is considered to have potential benefits in physical rehabilitation,but its efficacy in hearing restoration requires further scientific validation through rigorous clinical trials and large-scale prospective studies.展开更多
Sensorineural hearing loss(SNHL),the most commonly-occurring form of hearing loss,is caused mainly by injury to or the loss of hair cells and spiral ganglion neurons in the cochlea.Numerous environmental and physiolog...Sensorineural hearing loss(SNHL),the most commonly-occurring form of hearing loss,is caused mainly by injury to or the loss of hair cells and spiral ganglion neurons in the cochlea.Numerous environmental and physiological factors have been shown to cause acquired SNHL,such as ototoxic drugs,noise exposure,aging,infections,and diseases.Several programmed cell death(PCD)pathways have been reported to be involved in SNHL,especially some novel PCD pathways that have only recently been reported,such as ferroptosis,necroptosis,and pyroptosis.Here we summarize these PCD pathways and their roles and mechanisms in SNHL,aiming to provide new insights and potential therapeutic strategies for SNHL by targeting these PCD pathways.展开更多
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 ...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 triiodothyronine(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“posttreatment 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 inΔFT3 is associated with improved hearing recovery.Additionally,TSH levels showed a significant positive correlation withΔFT3(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 monitoringΔFT3 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.展开更多
Objective: To study the relationship between cortical auditory evoked potential (CAEP) thresholds and behavioral thresholds in pediatric populations with sensorineural hearing loss (SNHL). Methods: Fifteen children (m...Objective: To study the relationship between cortical auditory evoked potential (CAEP) thresholds and behavioral thresholds in pediatric populations with sensorineural hearing loss (SNHL). Methods: Fifteen children (mean age 6.8 years) with bilateral SNHL underwent behavioral pure-tone audiometry and CAEP testing at 0.5, 1, 2, and 4 kHz. CAEP thresholds were determined using tone bursts, and correlations between CAEP and pure-tone thresholds were analyzed using Pearson correlation and t-tests. Results: A strong positive correlation was observed between P1 thresholds and behavioral thresholds across all test frequencies: 0.5 kHz (r = 0.765, p Conclusion: The strong correlation between P1 and behavioral thresholds demonstrates the reliability of CAEP testing for estimating auditory thresholds in children. These findings support the use of CAEP testing as a reliable objective tool for threshold estimation, particularly in cases where behavioral responses cannot be reliably obtained. When adjusted with frequency-specific correction values, CAEP testing provides a reliable method for assessing hearing thresholds in pediatric populations.展开更多
Hearing loss,which currently affects more than 430 million individuals globally and is projected to exceed 700 million by 2050,predominantly manifests as sensorineural hearing loss(SNHL),for which existing technologie...Hearing loss,which currently affects more than 430 million individuals globally and is projected to exceed 700 million by 2050,predominantly manifests as sensorineural hearing loss(SNHL),for which existing technologies such as hearing aids and cochlear implants fail to restore natural auditory function.Research focusing on protecting inner ear hair cells(HCs)from harmful factors through the regulation of epigenetic modifications has gained significant attention in otology for its role in regulating gene expression without altering the DNA sequence,suggesting potential strategies for preventing and treating SNHL.By synthesizing relevant studies on the inner ear,this review summarizes the emerging roles of histone modifications,DNA methylation,and noncoding RNAs in HC damage,with a focus on their therapeutic potential through epigenetic modulation.Moreover,this review examines the therapeutic potential of epigenetic regulation for the prevention and treatment of SNHL,emphasizing the application of small-molecule epigenetic compounds and their efficacy in modulating gene expression to preserve and restore auditory function.展开更多
目的 根据听力损失程度对全聋型突发性聋患者临床再分型,分析全聋型突发性聋患者的临床特征及预后。方法 选取解放军总医院第六医学中心耳鼻咽喉头颈外科医学部耳鼻咽喉内科住院治疗的全聋型突发性聋患者共计928例,依据治疗前患者的纯...目的 根据听力损失程度对全聋型突发性聋患者临床再分型,分析全聋型突发性聋患者的临床特征及预后。方法 选取解放军总医院第六医学中心耳鼻咽喉头颈外科医学部耳鼻咽喉内科住院治疗的全聋型突发性聋患者共计928例,依据治疗前患者的纯音听阈将患者分为1组(80~<95 dB HL)、2组(95~<110 dB HL)和3组(≥110 dB HL),运用非参数秩检验、分层卡方、多因素logistic回归和趋势性检验等方法比较3组全聋型突发性聋患者的临床特征与疗效。结果 (1)临床特征方面:3组全聋型患者的发病到治疗时间(P=0.002)、眩晕发生率(P<0.001)、糖尿病发生率(P=0.012)以及年龄(P=0.014)、发病侧别(P=0.019)均存在差异;而性别(P=0.469)、伴发耳鸣(P=0.099)、耳闷(P=0.098)、高血压(P=0.906)及诱因(P=0.102)无明显差异。(2)听力转归方面:3组全聋型患者在听力治疗的总有效率方面存在差异(P<0.001)。在发病14 d内(P<0.001)和14~40 d(P=0.041)接受治疗的3组全聋型突发性聋患者听力转归存在差异,发病40~180 d(P=0.110)接受治疗的全聋型突发性聋患者的疗效无明显差异。3组全聋型突发性聋患者在低频(P=0.003)、中频(P=0.002)和高频(P=0.013)的听力转归均存在差异。(3)言语识别率方面:言语识别数据完整的294例全聋型突发性聋患者治疗30 d的言语识别率有效率约为36.7%,180 d内的言语识别率有效率约为39.1%。3组患者在治疗后30 d和治疗后180 d的言语识别率疗效存在明显差异(P<0.001)。(4)听力转归影响因素:共计4个因素与患者预后相关,分别为病程(OR=0.95)、年龄(OR=0.99)、听力损失≥110 dB HL(OR=0.67,以80~95 dB HL的患者为参照)和性别(OR=1.40,男性为参照)。结论 不同程度的全聋型突发性聋患者在临床特征、听力转归和言语识别率的治疗有效率方面均存在差异,对全聋型突发性聋患者进行再分型研究有助于提高突发性聋分型诊治的有效率。展开更多
文摘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.
文摘Hearing loss is the third leading cause of human disability.Age-related hearing loss,one type of acquired sensorineural hearing loss,is largely responsible for this escalating global health burden.Noise-induced,ototoxic,and idiopathic sudden sensorineural are other less common types of acquired hearing loss.The etiology of these conditions is complex and multi-fa ctorial involving an interplay of genetic and environmental factors.Oxidative stress has recently been proposed as a likely linking cause in most types of acquired sensorineural hearing loss.Short non-coding RNA sequences known as microRNAs(miRNAs)have increasingly been shown to play a role in cellular hypoxia and oxidative stress responses including promoting an apoptotic response.Sensory hair cell death is a central histopathological finding in sensorineural hearing loss.As these cells do not regenerate in humans,it underlies the irreversibility of human age-related hearing loss.Ovid EMBASE,Ovid MEDLINE,Web of Science Core Collection,and ClinicalTrials.gov databases over the period August 1,2018 to July 31,2023 were searched with"hearing loss,""hypoxamiRs,""hypoxia,""microRNAs,""ischemia,"and"oxidative stress"text words for English language primary study publications or registered clinical trials.Registe red clinical trials known to the senior author we re also assessed.A total of 222studies were thus identified.After excluding duplicates,editorials,retra ctions,secondary research studies,and non-English language articles,39 primary studies and clinical trials underwent full-text screening.This resulted in 11 animal,in vitro,and/or human subject journal articles and 8 registered clinical trial database entries which form the basis of this narrative review.MiRNAs miR-34a and miR-29b levels increase with age in mice.These miRNAs were demonstrated in human neuroblastoma and murine cochlear cell lines to target Sirtuin 1/peroxisome proliferato r-activated receptor gamma coactivator-1-alpha(SIRT1/P GC-1α),SIRT1p53,and SIRT1/hypoxia-inducible factor 1-alpha signaling pathways resulting in increased apoptosis.Furthermore,hypoxia and oxidative stress had a similar adve rse apoptotic effect,which was inhibited by resve ratrol and a myocardial inhibitorassociated transcript,a miR-29b competing endogenous mRNA.Gentamicin reduced miR-182-5p levels and increased cochlear oxidative stress and cell death in mice-an effect that was corrected by inner ear stem cell-derived exosomes.There is ongoing work seeking to determine if these findings can be effectively translated to humans.
文摘This editorial critically evaluates the application of foot reflexology as a treatment for sensorineural hearing loss(SNHL)in infants,as proposed in a case report published in the World of Clinical Cases.SNHL is a condition characterized by damage to the cochlea or the neural pathways that transmit auditory information to the brain.The etiology of SNHL is often complex,involving genetic mutations,prenatal factors,or perinatal insults.Reflexology,an alternative therapy involving the application of pressure to specific points on the feet,is based on the hypothesis that these points correspond to different organs and systems in the body,including the auditory system.However,the biological plausibility and clinical efficacy of foot reflexology in addressing SNHL lack empirical support.This editorial examines the pathophysiology of SNHL,assesses the clinical claims of reflexology practitioners,and emphasizes the necessity of evidence-based approaches in treating infant hearing loss.While complementary therapies may provide ancillary benefits,they should not supplant validated medical treatments in managing SNHL in infants.Further research is needed to evaluate the safety and efficacy of foot reflexology and other alternative therapies in pediatric audiology.
基金Supported by the Fundamental Research Funds for the Central Universities,No.2022CDJYGRH-004.
文摘Foot reflexology is a non-invasive and safe complementary therapy that works by massaging the reflex zones of the feet and exerts systemic or whole-body regulation through meridian nerve conduction.This therapy is commonly used in the treatment of various conditions such as autism and Parkinson's disease.However,there is limited reporting on the use of foot reflexology therapy for infants with sensorineural hearing loss(SNHL).Currently,there is no definitive conclusion on how foot reflexology therapy can influence hearing.This editorial holds some guiding significance regarding this clinical issue.The aim is to present physiological evidence of how foot reflexology therapy can impact infants with SNHL,thereby enhancing clinician’s awareness of foot reflexology in treating infants with SNHL.
文摘Early intervention for sensorineural hearing loss(SNHL)in childhood is crucial for auditory and language development.In recent years,innovative auditory stimulation techniques and speech therapy strategies,such as middle ear implants,cochlear implants,auditory brainstem implants,and midbrain implants,have provided new avenues for improving patient outcomes.Additionally,basic research advancements in cell reprogramming and regeneration,stem cell therapy,and targeted drug delivery offer promising approaches to meet the individualized needs of children with SNHL.However,many challenges and unresolved issues remain in the treatment of SNHL.This article comments on the case report,which describes a female pediatric patient with SNHL who underwent foot reflexology which led to the normalization of hearing thresholds.Reflexology is considered to have potential benefits in physical rehabilitation,but its efficacy in hearing restoration requires further scientific validation through rigorous clinical trials and large-scale prospective studies.
基金supported by grants from the National Key Research and Development Program of China(2023YFA1801804,2022YFA0807000,2021YFA1101300,2021YFA1101800,and 2020YFA0112503)the National Natural Science Foundation of China(82171149,82371166,81970892,82330033,82030029,92149304,82071053,and 82171144)+5 种基金the Shenzhen Science and Technology Program(JCYJ20230807114700001,JCYJ20210324125608022,and JCYJ20190814093401920)the Guangdong Basic and Applied Basic Research Foundation(2024A1515010548)the Science and Technology Department of Sichuan Province(2021YFS0371)the Jiangsu Provincial Scientific Research Center of Applied Mathematics(BK20233002)the Open Research Fund of Guangdong Academy of Medical Sciences(YKY‐KF202201)the Taishan Scholars Project-Young Experts Program of Shandong Province(tsqn202211357).
文摘Sensorineural hearing loss(SNHL),the most commonly-occurring form of hearing loss,is caused mainly by injury to or the loss of hair cells and spiral ganglion neurons in the cochlea.Numerous environmental and physiological factors have been shown to cause acquired SNHL,such as ototoxic drugs,noise exposure,aging,infections,and diseases.Several programmed cell death(PCD)pathways have been reported to be involved in SNHL,especially some novel PCD pathways that have only recently been reported,such as ferroptosis,necroptosis,and pyroptosis.Here we summarize these PCD pathways and their roles and mechanisms in SNHL,aiming to provide new insights and potential therapeutic strategies for SNHL by targeting these PCD pathways.
文摘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 triiodothyronine(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“posttreatment 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 inΔFT3 is associated with improved hearing recovery.Additionally,TSH levels showed a significant positive correlation withΔFT3(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 monitoringΔFT3 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.
文摘Objective: To study the relationship between cortical auditory evoked potential (CAEP) thresholds and behavioral thresholds in pediatric populations with sensorineural hearing loss (SNHL). Methods: Fifteen children (mean age 6.8 years) with bilateral SNHL underwent behavioral pure-tone audiometry and CAEP testing at 0.5, 1, 2, and 4 kHz. CAEP thresholds were determined using tone bursts, and correlations between CAEP and pure-tone thresholds were analyzed using Pearson correlation and t-tests. Results: A strong positive correlation was observed between P1 thresholds and behavioral thresholds across all test frequencies: 0.5 kHz (r = 0.765, p Conclusion: The strong correlation between P1 and behavioral thresholds demonstrates the reliability of CAEP testing for estimating auditory thresholds in children. These findings support the use of CAEP testing as a reliable objective tool for threshold estimation, particularly in cases where behavioral responses cannot be reliably obtained. When adjusted with frequency-specific correction values, CAEP testing provides a reliable method for assessing hearing thresholds in pediatric populations.
基金supported by the National Natural Science Foundation of China(Nos.82271158,82301312,82071045,82101219,82071048).
文摘Hearing loss,which currently affects more than 430 million individuals globally and is projected to exceed 700 million by 2050,predominantly manifests as sensorineural hearing loss(SNHL),for which existing technologies such as hearing aids and cochlear implants fail to restore natural auditory function.Research focusing on protecting inner ear hair cells(HCs)from harmful factors through the regulation of epigenetic modifications has gained significant attention in otology for its role in regulating gene expression without altering the DNA sequence,suggesting potential strategies for preventing and treating SNHL.By synthesizing relevant studies on the inner ear,this review summarizes the emerging roles of histone modifications,DNA methylation,and noncoding RNAs in HC damage,with a focus on their therapeutic potential through epigenetic modulation.Moreover,this review examines the therapeutic potential of epigenetic regulation for the prevention and treatment of SNHL,emphasizing the application of small-molecule epigenetic compounds and their efficacy in modulating gene expression to preserve and restore auditory function.
文摘目的 根据听力损失程度对全聋型突发性聋患者临床再分型,分析全聋型突发性聋患者的临床特征及预后。方法 选取解放军总医院第六医学中心耳鼻咽喉头颈外科医学部耳鼻咽喉内科住院治疗的全聋型突发性聋患者共计928例,依据治疗前患者的纯音听阈将患者分为1组(80~<95 dB HL)、2组(95~<110 dB HL)和3组(≥110 dB HL),运用非参数秩检验、分层卡方、多因素logistic回归和趋势性检验等方法比较3组全聋型突发性聋患者的临床特征与疗效。结果 (1)临床特征方面:3组全聋型患者的发病到治疗时间(P=0.002)、眩晕发生率(P<0.001)、糖尿病发生率(P=0.012)以及年龄(P=0.014)、发病侧别(P=0.019)均存在差异;而性别(P=0.469)、伴发耳鸣(P=0.099)、耳闷(P=0.098)、高血压(P=0.906)及诱因(P=0.102)无明显差异。(2)听力转归方面:3组全聋型患者在听力治疗的总有效率方面存在差异(P<0.001)。在发病14 d内(P<0.001)和14~40 d(P=0.041)接受治疗的3组全聋型突发性聋患者听力转归存在差异,发病40~180 d(P=0.110)接受治疗的全聋型突发性聋患者的疗效无明显差异。3组全聋型突发性聋患者在低频(P=0.003)、中频(P=0.002)和高频(P=0.013)的听力转归均存在差异。(3)言语识别率方面:言语识别数据完整的294例全聋型突发性聋患者治疗30 d的言语识别率有效率约为36.7%,180 d内的言语识别率有效率约为39.1%。3组患者在治疗后30 d和治疗后180 d的言语识别率疗效存在明显差异(P<0.001)。(4)听力转归影响因素:共计4个因素与患者预后相关,分别为病程(OR=0.95)、年龄(OR=0.99)、听力损失≥110 dB HL(OR=0.67,以80~95 dB HL的患者为参照)和性别(OR=1.40,男性为参照)。结论 不同程度的全聋型突发性聋患者在临床特征、听力转归和言语识别率的治疗有效率方面均存在差异,对全聋型突发性聋患者进行再分型研究有助于提高突发性聋分型诊治的有效率。
