Refractory inner ear disease refers to a spectrum of inner ear diseases that fail to achieve good therapeutic effects even after standardized treatment recommended by existing clinical practice guidelines. This disease spectrum is characterized by diverse etiological factors, high phenotypic heterogeneity, unclear subtype characteristics, unknown pathogenic mechanisms, and variable prognosis, making it difficult to define precisely. Refractory inner ear disease accounts for a significant proportion of the total population with inner ear diseases and has not been systematically summarized, refined, and deeply studied to date. This article, for the first time, clearly proposes the concept, definition, and scope of refractory inner ear disease, and elaborates on the current research status, challenges, and coping strategies for refractory inner ear disease. With the development and progress of science and technology, we believe that in the future we will witness more innovative technologies and new drugs applied to the treatment of refractory inner ear disease, bringing hope of cure to patients.
Humans ; Labyrinth Diseases/therapy*

As an effective means of local drug delivery, intratympanic administration has shown a wide range of applications in the treatment of inner ear diseases, such as Meniere's disease, sudden deafness, and immune-related inner ear disease. These diseases have complex etiologies and limited treatment effects, leading to many difficulties in clinical diagnosis and treatment. Intratympanic administration significantly enhances the therapeutic effect through bypassing the blood-labyrinth barrier and increasing the local concentration of the drug in the inner ear. This article reviews the historical development, mechanism and technical advantages of intratympanic administration, and analyzes the application effects of glucocorticoids, gentamicin and other drugs in the treatment of inner ear diseases. At the same time, the limitations and challenges of intratympanic administration in terms of drug absorption, bioavailability, individualized dose control and long-term efficacy were discussed. In the future, with the advancement of nanotechnology and precision medicine, intratympanic administration is expected to achieve higher precision and safety in the treatment of inner ear diseases, providing patients with more optimized treatment options.
Humans ; Labyrinth Diseases/drug therapy* ; Injection, Intratympanic

Acupuncture Therapy ; Adult ; Female ; Humans ; Labyrinth Diseases ; therapy

Administration, Topical ; Humans ; Labyrinth Diseases ; drug therapy

Humans ; Labyrinth Diseases ; pathology ; therapy