We report the first documented case of facial-stapedial synkinesis (FSS) secondary to Ramsay Hunt syndrome (RHS) by describing the clinical manifestations and definitive surgical treatment outcome of this rare condition. A 35-year-old female presented with initial symptoms of severe right-sided facial weakness, otalgia, hyperacusis, ear fullness, and erythematous vesicles in the external auditory canal and tympanic membrane, suggestive of RHS. She later developed an intermittent “quivering” or “buzzing” sensation in her right ear initiated by facial movements such as closing her eyes and smiling. We performed magnetic resonance imaging of the brain and serial audiometric testing, and administered pharmacological treatment, including prednisone and famciclovir, for the initial infection, followed by stapedial tendon tenotomy for the definitive management of FSS. This case provides valuable clinical insights as the first reported instance of FSS secondary to RHS. RHS causes a more severe facial paralysis with lower rates of complete recovery, with an increased risk of aberrant facial nerve regeneration. FSS should be considered in patients presenting with persistent auditory symptoms after facial paralysis. Stapedial tendon tenotomy is an effective treatment option for patients with severe refractory symptoms.

Compound muscle action potential (CMAP) recording provides an objective electrophysiological assessment of facial nerve function after injury. In rodent models, vibrissal CMAPs serve as quantitative surrogates of facial nerve integrity; however, practical descriptions of CMAP recording setups using widely available systems remain limited. In this study, we detail a practical and reproducible method for recording vibrissal CMAPs following direct stimulation of the facial nerve trunk in rats, using a BIOPAC-based system. CMAPs were recorded before and after unilateral facial nerve crush injury, followed by transection and epineural repair. Direct nerve trunk stimulation reliably elicited stable CMAP waveforms and supramaximal stimulation produced consistent responses suitable for longitudinal assessment. Baseline CMAP amplitudes were comparable to previously reported values. After facial nerve injury, CMAPs on the injured side were absent at 1 week, reappeared at 2 weeks, and increased further by 4 weeks. Because absolute CMAP amplitudes varied across recording sessions despite intact contralateral nerves, functional recovery was evaluated using left/right amplitude ratios. Single-peak CMAP amplitude was used to minimize waveform variability and stimulus-related artifacts. This method provides a straightforward and accessible approach for the electrophysiological assessment of facial nerve injury and recovery in experimental rodent models.

Early identification and management of (central) auditory processing disorder [(C)APD] necessitate a multidisciplinary approach due to its potential effects on listening, communication, and academic performance. It is crucial to assess the awareness and knowledge of the team members involved in the management of (C)APD to bridge the gap between early identification and intervention. The aim of this study was to assess the awareness and knowledge of (C)APD among pediatricians in India. Subjects and Methods: This study used a questionnaire-based cross-sectional survey. Phase I involved the development and content validation of the questionnaire. The questionnaire contained 14 closed-ended questions to assess the awareness and knowledge of the causes, symptoms, assessment, treatment, and management of (C)APD. Phase II involved the administration of the developed questionnaire to 118 pediatricians practicing in India with at least one year of experience. Results: The findings of the study indicated that the majority (94.07%) of the pediatricians were aware of (C)APD, but only a few had diagnosed a child with (C)APD (32.2%). Most pediatricians showed varying levels of accuracy in recognizing common symptoms of (C)APD. Subgroup analyses of the symptom knowledge domain using Fisher’s exact chi-square tests revealed that pediatricians with ≥11 years of experience (p=0.043) and those with postgraduate qualifications demonstrated significantly better recognition of (C)APD symptoms (p=0.009). Participants demonstrated a good understanding of the multidisciplinary team involved in the diagnosis and management of (C)APD. Conclusions: Pediatricians in India possess a good general awareness of (C)APD but limited detailed knowledge of its symptoms and management. Clinical experience and postgraduate qualifications were associated with a greater understanding of (C)APD symptomatology. The gap between knowledge and clinical practice underscores the need for targeted training, curriculum integration, and structured referral pathways to improve early identification and intervention for (C)APD.

Exposure to recreational and electronic noise sources increases the risk of noise-induced hearing loss (NIHL) in pediatric and young adult populations—frequently referred to as Generation Z. Extended high-frequency audiometry (EHFA) is commonly used for the early detection and prognostication of NIHL. Here, we used EHFA to evaluate the potential hearing loss associated with the use of technological devices in Generation Z individuals. Subjects and Methods: This was a cross-sectional, descriptive investigation. Individuals aged 10-22 years who presented to our clinic with any complaint between January 15, 2023, and January 15, 2024 and who were scheduled for routine hearing assessment were included. All participants underwent conventional audiometry covering conventional frequencies (CFs) as well as EHFA. Participants were divided into two groups based on weekly use of personal listening devices (PLDs): less than 10 h/week and 10 h/week or more. Differences between the groups were analyzed with respect to CFs and extended high frequencies (EHFs), as well as the presence of vertigo, tinnitus, and subjective hearing loss. Results: No significant differences were observed between the groups regarding the presence of symptoms, vertigo, tinnitus, or hearing loss (p=0.47, p=0.75, p=0.10, and p=0.99, respectively). No significant differences were observed in the average CFs between the right and left ears (p=0.53 and p=0.38, respectively). In the right ear at 10 kHz, the mean threshold for participants using PLDs less than 10 h/week was 7.50±7.70, compared to 5.0±10.88 for those using PLDs 10 h or more per week (p=0.02). For all other frequencies, average thresholds in both ears were higher in participants with weekly PLDs ≥10 h compared to those with <10 h, although these differences were not statistically significant (p>0.05). Conclusions: EHFs tended to be higher in individuals using PLDs for ≥10 h/week, although the differences were not statistically significant at most frequencies. A significant difference was observed only at 10 kHz in the right ear; however, this may reflect interindividual variability rather than a consistent exposure effect. This study is the first in which NIHL in Generation Z was the focus, and replication in larger cohorts is warranted.

Neurotrophins reportedly improve hearing outcomes when used in combination with cochlear implants, as they promote the survival of spiral ganglion neurons (SGNs) and stimulate SGN neurite outgrowth in animal models of sensorineural hearing loss. However, their applicability to human patients remains unknown. This review examines the clinical applicability of neurotrophins based on advances in drug delivery techniques to the inner ear and discusses their potential for future application in human patients.

Mild hearing loss, though often overlooked, can substantially affect daily communication and quality of life. Conventional hearing aids remain the mainstay of hearing loss management, yet their high cost has limited their widespread adoption. Recently, alternative amplification devices, such as personal sound amplification products (PSAPs) and over-the-counter (OTC) hearing aids, have gained attention. Emerging evidence suggests that these devices may provide meaningful benefits to individuals with mild hearing loss and could help expand accessibility. Patients with tinnitus may particularly benefit from amplification, because hearing aids improve tinnitus-related outcomes. However, professionals are not usually involved in the purchase and use of PSAPs and OTC hearing aids. This may lead to suboptimal or even harmful results, especially in tinnitus care, for which counselling and cognitive behavioral therapy are essential components of comprehensive management. Amplification alone should not be considered a sufficient treatment strategy. Ultimately, while PSAPs and OTC hearing aids offer promising and cost-effective options for managing mild hearing loss, their integration into clinical practice requires careful consideration. Clear guidelines and professional consensus are needed to ensure that these devices are used appropriately and effectively, maximizing benefits while minimizing potential risks.

Educational counseling is a fundamental component of tinnitus management; however, its structure, content, and clinical outcomes vary. This scoping review analyzed ten peer-reviewed studies to inform the development of standardized, evidence-based protocols. Three studies evaluated educational counseling alone, whereas seven combined it with other therapeutic approaches. Most interventions delivered key content during an initial session. Six studies employed individual face-to-face formats, whereas four compared delivery modes, including individual versus group or traditional versus technology-assisted methods. Counseling content was typically derived from expert consensus or prior research, and three studies explicitly described the theoretical rationales underlying their counseling frameworks. Core topics included auditory anatomy and tinnitus pathophysiology, although these topics were occasionally omitted from brief sessions. Nine studies presented practical management strategies, and five studies tailored content using individual hearing and tinnitus profiles. All studies used self-report measures, with the Tinnitus Handicap Inventory being the most common. Some studies reported improvements from counseling alone, whereas others showed outcome differences when counseling was combined with hearing aids or sound therapy, or delivered in alternative formats. This heterogeneity underscores the need for clearer and more standardized clinical protocols, as outcomes may vary depending on the content provided, patient characteristics, delivery method, patient’s understanding, and application of information.

Background and Objectives: Prior research has demonstrated a significant correlation between hearing loss and dementia; nevertheless, these two disorders have been addressed independently. This study proposes a questionnaire to simultaneously assess auditory and cognitive functions in older adults. As an inaugural pilot investigation, the current study aimed to engineer items for specific facets of cognitive function. Subjects and Methods: A systematic review of articles from six databases identified seven self-report questionnaires (211 items) for cognitive impairment and 31 cognitive items for screening older adults. Forty individuals aged 60 years or older were categorized into four groups based on their auditory and cognitive status using the pure-tone average (PTA) and Cognitive Impairment Screening Test (CIST), respectively. Each group completed the Cognitive Impairment Screening for Elderly (CISE). The internal consistency of the CISE was examined, and principal component and factor analyses were performed. Results: The four groups exhibited strikingly distinct PTA and CIST scores. The CISE demonstrated satisfactory internal consistency (α=0.94). Subsequently, Item 16 was excluded owing to inadequate fit, and the remaining 30 items were grouped by factor analysis into four categories: 10 pertaining to daily activities associated with memory loss, 8 concerning emotional alterations or stress, 7 associated with reduced social interaction and cognitive confusion, and 5 related to language usage difficulties. To comprehensively examine the individual factors, 7 representative items with factor loadings exceeding 0.70 were considered to represent these factors. Conclusions This study validated 30 items for the cognition section, from which 7 representative items were selected. Further development is warranted to create a single integrated questionnaire that incorporates items from the auditory section for effective diagnosis and treatment in future clinical settings.

Objective To investigate the damage mechanism of extracellular vesicles(EVs)derived from ves-tibular schwannoma(VS)on HEI-OC1 cells and the protective effect of the ferroptosis inhibitor ferrostatin-1(Fer-1).Methods Tumor tissues and clinical data were collected from four patients with stage Ⅱ or Ⅲ VS,classified as grade D according to the AAO-HNS hearing classification.Primary VS cells were extracted,and their conditioned supernatant was collected.EVs were isolated using ultracentrifugation and identified.HEI-OC1 cells were cultured in vitro and divided into three groups:the control group(no treatment),the EVs group(treated with 3000 parti-cles/cell VS-EVs for 24 hours),and the EVs+Fer-1 group(pretreated with 20 μmol/L Fer-1 for 2 hours followed by co-culture with 3000 particles/cell VS-EVs for 24 hours).Cell viability was assessed using the CCK-8 assay,re-active oxygen species(ROS)levels were quantified using the DCFH-DA fluorescent probe,and lipid peroxidation was evaluated using the BODIPY 581/591 C11 probe.Results Compared with the control group,the EVs group showed significantly reduced cell viability(P＜0.001)and increased levels of ROS(P＜0.001)and lipid peroxides(P＜0.001).However,the EVs+Fer-1 group exhibited significantly restored cell viability(P＜0.001)and re-duced levels of ROS and lipid peroxidation(P＜0.001).Conclusion VS-derived EVs disrupts redox homeostasis,promotes intracellular accumulation of lipid peroxides and ROS,and induces ferroptosis in HEI-OC1 cells.Fer-1 significantly alleviates VS-EVs-induced ferroptosis,thereby protecting HEI-OC1 cells from damage.

The pathogenesis of tinnitus is unclear and may involve the peripheral and central nervous sys-tems.Recent studies have found that neuroinflammatory response leads to hyperactivity of nerve center,in which tumor necrosis factor-α(TNF-α)has an important impact on neurotransmitter transmission,transmembrane ion concentration,neuronal synaptic structure and functional reorganisation,and may play an important role in the path-ogenesis of acute tinnitus.This article discusses the central mechanism of TNF-α in mediating the onset of acute tin-nitus.