Objective To study the changes of tinnitus after cochlear implantation in post-lingual adault recip-ients and analyze the factors that affect tinnitus.Methods A total of 47 postilingually-deafened adult subjects with tinnitus who underwent cochlear implantation at the Department of Otology,the first affiliated hospital of Zheng-zhou University,from January 2017 to December 2021.The subjects were evaluated using tinnitus handicap invento-ry(THI)and visual analogue scale(VAS)before cochlear implantation and 6 months after cochlear implant surger-y.Results Among 47 subjects who were eligible for this study,the THI scores were 36.94±13.337,14.48± 12.726,respectively,before CI and 6 months after cochlear implantation.The VAS scores were 5.13±1.676 be-fore and 2.34±1.903 after cochlear tmplantation.Statistical analysis showed significant differences in THI and VAS scores before and after cochlear implantation(P＜0.05).A total of 18 patients experienced complete tinnitus suppression,14 patients experienced alleviation of tinnitus,tinnitus remained unchanged in 13 patients,tinnitus worsened in 2 patients,and the overall efficiency was 66.0％(31/47).The tinnitus alleviation rate was signifant higher in the patients with tinnitus history of ≤5 years than the patients with tinnitus history of＞5 years(P＜0.05).There was a statistically significant difference in tinnitus alleviation between the patients with mild tinnitus and the patients with more than mild tinnitus before surgery(P＜0.001).Conclusion Cochlear implantation has an inhibitory effect on tinnitus in adults.Patients with shorter duration of the tinnitus and higher tinnitus handicap are more likely to experience tinnitus improvement after cochlear implantation.

Objective To study a distinct type of cochlear malformation,differentiated by its radiological feature,from the current Sennaroglu's classification criteria along with its clinical manifestations.Methods By analyzing the radio-logical findings from high-resolution CT(HRCT)of the temporal bone and 3D-dimensional magnetic resonance imaging(3D-MRI)of the inner ear in 11 cases(13 ears)with special cochlear malformations,we summarized the characteristics of this type of cochlear deformity.Results ① The radiological features of this type of cochlear malformation showed that only a part of the cochlear basal turn originated ventrally from the vestibule,with no or only partial inward turning.There were no upper,middle,or apical turns(cochlea with less than 0.5 turns),and the modiolus and interscalar septa were absent.On HRCT axial images,there was no connection observed between the cochlea and the internal auditory canal(IAC).MRI results consistently showed a cochlear nerve deficiency(CND),with audiometric findings indicating complete hearing loss.Most cases were accompanied by abnormally developed vestibules and malformed semicircular canals,and the cochlea on the opposite side often had severe malformations as well.② Based on the imaging characteristics,this type of cochlear malfor-mation,with only partial development of the basal turn(cochlea with less than 0.5 turns),was categorized as cochlear hy-poplasia(CH).We provisionally designated it as cochlear hypoplasia type X(CH-X).Conclusion Cochlear hypoplasia(CH-X),characterized by cochlea with less than 0.5 turns,represents a severe type of inner ear malformation,accounting for approximately 2％of such deformities.Due to the malformed cochlea lacking a distinct bony cochlear nerve canal(BC-NC)and cochlear nerve(CN),the potential benefits of cochlear implant surgery may be relatively limited.

Objective To investigate the application value of multiple audiological testing methods in the audi-ological diagnosis of children with no response at maximum output intensity of auditory brainstem response(ABR).Methods We retrospectively studied the clinical data of 69 cases(138 ears)of children with no ABR response with maximum intensity,aged 42 days to 5 years old,with an average of 1 year and 6 months.The tympanogram showed type-A or positive single peak,and acoustic reflex was absent.Imaging examination showed no malformation of the inner ear.All 69 children underwent ABR,cochlear microphonic potential(CM),distortion product otoacoustic e-missions(DPOAE),and auditory steady-state response(ASSR)tests.Results Among 69 cases(138 ears),8 ca-ses(11.59％)recorded CM in 16 ears,of which 10 ears(7.25％)recorded DPOAE.The ASSR response thresh-olds at 0.5,1,2,and 4 kHz were 83.2±13.1,82.9±13.0,75.3±12.4,and 63.1±9.1 dB nHL,respectively.Combined with other examination results,these subjects were diagnosed with auditory neuropathy.The CM and DPOAE responses of the remaining 61 cases(122 ears)were absent,and the extraction rates of ASSR at 0.5,1,2,and 4 kHz were 82.3％,81.9％,76.9％,and 60.2％,respectively.Among them,20 ears of ASSR were absent at all frequencies,and 102 ears had responses in at least one frequency.The response thresholds of ASSR at 0.5,1,2,and 4 kHz were 93.2±6.1,99.8±7.0,105.4±5.4,108.2±9.8 dB nHL,respectively.These subjects were diagnosed with profound sensorineural hearing loss.Conclusion For children with no ABR response at maximum output intensity,while CM and/or DPOAE responses are present and ASSR frequency response thresholds are low-er than those with sensorineural hearing loss are helpful in the diagnosis of auditory neuropathy.Neither CM nor DPOAE response is helpful in the diagnosis of profound sensorineural hearing loss,and ASSR testing is helpful in e-valuating residual hearing.

Objective To induce human umbilical cord mesenchymal stem cells (hUC-MSCs) to hair-cell like cells in the inner ear, using a two-step neural differentiation method.Methods The hUC-MSCs were obtained from human umbilical cords by tissue adherence culture,whose surface antigen CD29, CD34, CD44, CD45, CD90, HLA-ABC, and HLA-DR could be identified by flow cytometry.In the neural stem cells induced phase, the NSE positive cells were analyzed by microscope and immunohistochemistry.In the second stage, the expression of hair-cell like cells markers (Math1, MyosinⅦa, Brn3c) were tested by qRT-PCR and immunofluorescence method.Results The control group and the protocol group had little NSE after differentiation while the protocol B group presented a neurobiological structure and demonstrated a higher NSE positive ratio after 5 days' neural stem cells induction (P<0.05).Compared to the control group, the mRNA and protein level of Math1, MyosinⅦa, and Brn3c exhibited a significant increase in the differential group,which induced for 4 weeks in the hair-cell like cells in the inner ear's induced phase(P<0.05).Conclusion The two-stage induction (hUC-MSCs-neural stem cells-hair-cell like cells) could produce more MyosinⅦa,Brn3c and Math1,which may provide an appropriate way to treat sensorineural deafness.

Objective To investigate the influencing factors of the indwelling catheter time in patients with prostate hyperplasia and malignant tumor after prostate surgery.Methods A total of 447 prostate surgery patients with prostate hyperplasia and malignant tumor were selected for medical record review using convenience sampling method. The demographic data,diagnose,complications,surgical method,medical advice and nursing care items were collected. The indwelling catheter time in or outward of the hospital and its influence factors were analyzed.ResultsA number of 300(44.74%) patients had urination disorders before operation.A number of 258(57.72%) patients had complications. Little information about rehabilitated exercise of urination function was recorded.There were statistically significant differences in indwelling catheter time in the hospital among benign prostatic hyperplasia patients with different education levels, health payments and complications (t/F=5.048, -2.433, 2.086;P<0.05). Significant differences in indwelling catheter time outward of the hospital were also observed in patents with different preoperative urination disorders (t=0.551, P<0.05). Prostate malignancy patients with different resident places and bad habits had statistically significant differences in indwelling catheter time outward of the hospital (t=2.062, -1.974;P<0.05). For patients with benign prostatic hyperplasia, education levels, health payment and complications could explain 60.8% of changes in indwelling catheter time in the hospital. For patients with prostate malignancy, resident place and bad habits could explain 68.4% of changes in indwelling catheter time outward of the hospital. According to medical records, only 42.5% patients had urinary flow rate, urodynamic and residual urine volume examinations. Only 17.4% of medical records had urinary function related admission, which were found in 26.4% of medical records when patients were discharged.ConclusionsMedical workers are lack of attentions to the rehabilitated exercise of urination function for patients with prostate hyperplasia and malignant tumor after prostate surgery. It is urgent to build a scheme of rehabilitated exercise of urination function for postoperative patients of prostate, which based on the fast-track surgery theory and used the time as axis.

Objective The aim of the present study was to investigate the ability to perceive syllables phrases ,mono-syllabic words ,disyllabic words ,when using a CI and an HA in non -implanted ears (bimodal fitting) ,and the relationship be-tween aided thresholds in the HA ear and bimodal effectiveness .Methods Eighteen children who consistently used a bimodal fitting participated in the study .The loudness of speech in the HA ear matched that with implanted ear ,and the aided thresh-olds in the HA ear were obtained .The recognition rate of syllables phrases ,monosyllabic words ,and disyllabic words was tested under the aforementioned two modes in both the quiet and noisy backgrounds .Results The speech performance of children for monosyllabic words were 82 .67% ± 12 .23% ,83 .61% ± 12 .22% ,for disyllabic words 76 .00% ± 16 .13% ,78 .11% ± 14 .84% , for syllables phrases 60 .11% ± 17 .18% ,65 .43% ± 16 .76% ,with a CI alone or with bimodal fitting in a quiet environment ,re-spectively .In a noisy environment ,monosyllabic words were 75 .50% ± 14 .12% ,76 .83% ± 14 .15% ,and disyllabic words were 68 .22% ± 17 .15% ,77 .18% ± 16 .83% ,and syllables phrases were 49 .39% ± 19 .26% ,56 .33% ± 19 .55% .The results sug-gested that speech performance in a quiet or a noisy environment was significantly better with bimodal hearing than with a CI a-lone .All were statistically significant except the recognition rate of monosyllabic words in quiet background (P<0 .05) .Signifi-cant negative correlations were found between aided thresholds at 250 and 500 Hz ,and the bimodal advantages were noticeable for the some speeching perception .Conclusion Bimodal hearing enhances speech performance for deaf patients .The low -fre-quency residual hearing in the HA ear may play a major role in enhancing auditory and speech performance .

Objective To study the expression of signal transducer and activator of transcription 3 (STAT3) and Suppressor of cytokine signaling 3(SOCS3) in the middle ear cholesteatoma epithelium ,and the possible roles of STAT3 and SOCS3 in middle ear cholesteatoma .Methods The immunohistochemical assay was used to detect ex-pression of STAT3 and SOCS3 protein in 30 cases of middle ear cholesteatoma epithelial tissue and 20 cases of nor-mal external auditory canal skin tissues as the control group .Results STAT3 immunoreactivity was detected in the nuclei and cytoplasm of epithelial cells .The expression rates of STAT3 in middle ear cholesteatoma epithelial tissue were 76 .7% and higher than in the normal epithelium (25 .0% ) .The differences between the two groups were sta-tistically significant (P<0 .05) .SOCS3 immunoreactivity was detected in the cytoplasm of epithelial cells .The ex-pression rates of SOCS3 in middle ear cholesteatoma epithelial tissue were 33 .3% and lower than in the normal epi-thelium (65 .0% ) .The differences were statistically significant (P<0 .05) .The expression of STAT3 and SOCS3 in the middle ear cholesteatoma had negative correlation (r= - 0 .476 ,P<0 .05) .Conclusion The abnormal ex-pression of STAT3 and SOCS3 in the middle ear cholesteatoma may be involved in hyper proliferation and anti -ap-optosis of cholesteatoma cell ,and play an important role in the formation and development of middle ear cholesteatoma .

OBJECTIVE: To observe the correlation between the threshold of tone burst auditory brain stem response (Tb-ABR) and ASSR (auditory steady-state response) and the threshold of BA (behavioral audiometry). To investigate the accuracy and clinical value of Tb-ABR and ASSR in pediatric hearing assessment. METHOD: From January, 2014 to December, 2014, 76 children (123 ears) recieved hearing examination in the First Affiliated Hospital of Zhengzhou University. They were classified into three groups according to the hearing level: 23 children (46 ears) with normal hearing ability in group A, 27 children (32 ears) with slightly-moderate sensorineural deafness in group B and 26 children (45 ears) with severe-profound sensorineural deafness in group C. Tb-ABR, ASSR, BA in 4 frequencies (0.5, 1.0, 2.0, 4.0 kHz) were tested and the results were statistically analyzed. RESULT: (1) At the 4 frequencies (0.5-4.0 kHz), we obtained 132 thresholds of Tb-ABR, 144 of ASSR, 152of BA. And 166 thresholds were obtained in Tb-ABR+ASSR+BA in total . (2) The thresholds of Tb-ABR, ASSR and those of BA in all 3 groups had linear relations at 0.5-4.0 kHz. The correlation coefficients of group A were 0.76, 0.82, 0.87 and 0.91; 0.52, 0.57, 0.67 and 0.64. Those of Group B were 0.89, 0.95, 0.98 and 0.95; 0.74, 0.82, 0.87 and 0.90. Those of Group C were 0.91, 0.90, 0.92 and 0.89; 0.93, 0.95, 0.95 and 0.91. CONCLUSION (1) Both ASSR and Tb-ABR can allow reasonably accurate predictions for the pediatric hearing assessment. The correlation between Tb-ABR threshold and BA threshold is higher in normal hearing children and slightly-moderate sensorineural deafness children. The correlation between ASSR threshold and BA threshold is higher in severe-profound sensorineural deafness children. (2) The hearing test combination can evaluate the residual hearing ability for children with severe hearing loss.
Audiometry ; Auditory Threshold ; Child ; Evoked Potentials, Auditory, Brain Stem ; Hearing ; Hearing Loss, Sensorineural ; diagnosis ; Hearing Tests ; Humans

Objective To explore the main anatomical factors for relapse in patients underwent radical mas-toidectomy and discuss the preventive measures .Methods A retrospective study was carried out 36 patients who had underwent radical mastoidectomy and 100 patients (100 ears) who had been cured underwent radical mastoidectomy during July 2011 toSeptember 2013 .The patients underwent axial and coronal temporal Computed Tomography (CT) .The incidence of low -lying middle cranial fossa ,high jugular bulb ,anterior locati(36 ears)on of sigmoid si-nus ,dehiscent tympani tegmen ,dehiscent of the facial nerve canal ,large sinus tympani ,low -lying horizontal facial nerve were recorded .Results The incidence of low -lying middle cranial fossa(36 .1% ) ,anterior location of sig-moid sinus(41 .7% ) ,dehiscent tegmen tympani (30 .6% ) ,dehiscent of the facial nerve canal (41 .7% ) ,large sinus tympani(25 .0% ) ,low -lying horizontal facial nerve(22 .2% ) were higher than those of in the normal group .There was no significant difference in high jugular bulb .Conclusion The main anatomical factors for relapse in patients un-derwent radical mastoidectomy were low -lying middle cranial fossa ,anterior location of sigmoid sinus ,dehiscent tegmen tympani ,dehiscent of the facial nerve canal ,large sinus tympani ,low -lying horizontal facial nerve .

Objective To study the changes of the expression of growth associated protein -43(GAP 43) in cochlear nucleus and the inferior colliculus (IC) in rats after unilateral cochlear damage at different time points after surgery ,and explore the remodeling and repair process of synapse in brainstem auditory center of rats after auditory deprivation .Methods Thirty rats were randomly divided into six groups :the 3 ,7 ,15 ,30 ,60 days group (with u-nilateral cochlea damage) and the control group (without cochlea damage) with 5 rats in each group .The immuno-histochemical SP method was used to detect the expression of GAP -43 in cochlear nucleus and inferior colliculus at different time points after cochlea damaged in the control group .Results After the unilateral cochlear ear was dam-aged at 3 ,7 ,15 days ,GAP -43 in operation side cochlear nucleus were expressed and the expression level signifi-cantly increased compared with normal control group .After 30 days postoperatively ,GAP - 43 expression level decreased ,but it was still higher than normal control group .After 60 days postoperatively ,GAP - 43 expression level was slightly higher than that of normal control group .After 3 days postoperatively ,GAP - 43 expression level was higher than normal control group .After 7 ,15 days postoperatively ,expression levels were increased .After 30 , 60 days postoperatively ,the expressions gradually decreased ,but still higher than the normal control group .Conclusion After unilateral cochlea damaged ,GAP - 43 was expressed an obvious dynamic change process in cochlear nucleus and infe-rior colliculus .It may reflect the axonal regeneration and synaptic plasticity after hearing loss in brainstem auditory neurons .