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    20 November 2026 Volume 40 Issue 6
      
    Airway Allergic Diseases: From Mechanism to Practice
    Evaluation of the efficacy and safety of cat dander cluster immunotherapy
    LI Lisha, RU Yi, GUAN Kai, XU Yingyang, BIAN Sainan, LI Lun, PAN Zhouxian
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2026, 40(6):  1-9. 
    Abstract ( 6 )   PDF (1673KB) ( 1 )   Save
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    Objective To evaluate the efficacy and safety of cat dander cluster immunotherapy by comparing the efficacy of cat dander cluster immunotherapy, conventional immunotherapy and symptomatic drug therapy, as well as the adverse reactions of the two immunotherapy regimens. Methods Rhinitis patients with or without asthma caused by cat dander allergy were recruited and randomly assigned to the cluster immunotherapy group(cluster group), conventional immunotherapy group(conventional group), and symptomatic drug treatment group(control group). The rhinoconjunctivitis symptom score, symptomatic medication score, combined symptom medication score, rhinoconjunctivitis quality of life questionnaire score, and asthma control test score were recorded and compared among the three groups at baseline, 1 month of treatment, 6 months of treatment, and 12 months of treatment. Additionally, the incidence and severity of local and systemic reactions associated with immunotherapy injections were evaluated. Results The combined symptom medication score of rhinoconjunctivitis in the cluster group was significantly lower than that in the control group at 1 month(P=0.010), 6 months(P=0.001)and 12 months(P=0.021)of treatment. The combined symptom medication score in the conventional group was lower than that in the control group at 12 months of treatment(P=0.007). The rhinoconjunctivitis quality of life questionnaire score in the cluster group was significantly better than that in the control group at 1 month(P=0.023)and 12 months(P=0.015)of treatment. At 1 month of treatment, the asthma control test score of the cluster group was better than that of the control group and the conventional group(P=0.050). There was no difference in the incidence of local(P=0.353)or systemic reactions(P>0.999)induced by immunotherapy injections between the cluster group and the conventional group. Conclusions In the patient population observed in this study, cat dander cluster immunotherapy was rapid in onset and effective. There was no difference in the incidence of injection-related adverse reactions between the cluster and the conventional immunotherapy.
    Nasal epithelial cell injury and fibroblast inflammatory phenotype activation induced by PM2.5 organic components
    ZHOU Jiayao, ZHU Ying, HU Huilin, LI Zhipeng, LIN Hai, TANG Ru, MAO Song, GU Yuelong, ZHAO Yue, ZHANG Weitian
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2026, 40(6):  10-21. 
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    Objective The present study was conducted with the objective of investigating the differential effects of organic compounds(OCs)within PM2.5 on human nasal epithelial cells(hNEs)and human nasal fibroblasts(hNFs), and elucidating the underlying molecular mechanisms. Methods PM2.5 samples were collected in Shanghai, and OCs were extracted using dichloromethane. Primary hNEs and hNFs were isolated in vitro and stimulated with different concentrations of OCs. The assessment of cell viability and toxicity wasconducted by means of thecell counting kit-8(CCK-8)and lactate dehydrogenase(LDH)assays. The employment of transcriptomic sequencing(RNA-seq)and bioinformatics analysis was undertaken for the identification of differentially expressed genes, the performance of functional enrichment analysis, and the construction of protein-protein interaction networks. The validation of the sequencing results was conducted through the utilisation of quantitative real-time PCR(RT-qPCR). Results The study demonstrated that OCs significantly inhibited the proliferation of hNEs and induced cytotoxicity in a concentration- and time-dependent manner. However, no effect was observed on the viability of hNFs. Subsequent to OC stimulation, the expression levels of CYP1A1 and CYP1B1 were observed to be elevated, while AHRR expression was reduced in hNEs. Concurrently, the expression of MT1 family genes was found to be upregulated, suggesting activation of the AHR-CYP pathway and oxidative stress damage. Conversely, in hNFs, OC stimulation led to an upregulation of inflammatory factors LIF, IL6, and its receptor IL6R, accompanied by a compensatory increase in AHRR expression. Conclusion The induction of hNEs injury and inflammatory phenotype of hNFs by OCs is attributable to differential regulation of AHRR. These two cell types have been shown to synergistically participate in the inflammatory and remodeling processes of chronic rhinosinusitis, thus providing a novel perspective on the pathogenesis of PM2.5-induced CRS.
    Efficacy and compliance of Artemisia annua pollen allergen sublingual drops in the treatment of monosensitized and polysensitized allergic rhinitis patients
    HU Huixuan, PAN Li, LIAO Wenxi, FENG Yan
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2026, 40(6):  22-29. 
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    Objective To evaluate the efficacy and compliance of Artemisia annua pollen allergen sublingual immunotherapy(SLIT)in patients with Artemisia pollen-induced allergic rhinitis, and to analyze its effectiveness in monosensitized and multisensitized patients. Methods A single-center controlled study was conducted, enrolling 92 patients with Artemisia pollen-induced allergic rhinitis. Among them, 46 patients receiving sublingual immunotherapy(SLIT)formed the SLIT group, while 46 patients receiving only symptomatic medication served as the control group. Compare the total nasal symptom score(TNSS), total medication score(TMS), combined symptom and medication score(CSMS), and visual analogue scale(VAS)scores between the two patient groups during the pollen peak season before treatment initiation, and at 1 and 2 years post-treatment. Additionally, record the dropout rate. Patients in the SLIT group were further divided into monosensitized and multisensitized subgroups to evaluate differences in treatment efficacy between the two groups. Results At baseline, there were no statistically significant differences between the two groups in age, gender, sensitization status, TNSS, TMS, CSMS, or VAS(P=0.385, P=0.569, P=0.227, P=0.138, P=0.524, P=0.133, P=0.255), indicating comparability. In the SLIT group, Artemisia slgE levels predominantly fell within grades 3, 4, 5, and 6, accounting for 85.2%of Artemisia-sensitized individuals. In the control group, 25 subjects exhibited multiple sensitivities, with Artemisia and ragweed as the primary allergens. Artemisia slgE levels primarily clustered at grades 4 and 5, representing 61.54% of Artemisia-sensitized individuals. In the SLIT group, TNSS, CSMS, and VAS scores during pollen peak seasons in the first and second years post-treatment were significantly lower than baseline values, with statistically significant differences observed within the group(P<0.001). Except for TMS scores, statistically significant differences were found between groups for all scores during pollen peak seasons at 1 and 2 years post-treatment(P<0.01). Results from generalized estimating equations analysis showed statistically significant differences in between-group effects, time effects, and interaction effects for TNSS, CSMS, and VAS scores(P<0.001). Only the time effect for TMS scores was not significant(P>0.05). Among nasal symptoms, intergroup differences in sneezing and rhinorrhea were not statistically significant(P>0.05), but differences in nasal itching and nasal congestion scores were significant(P<0.001). Time effects and interaction effects for all symptoms were significant(P<0.001), indicating statistically significant differences in symptom score changes over time between the two groups. There were no statistically significant differences in pre- treatment symptoms between monosensitized and multisensitized patients in the SLIT group(P=0.940, P=0.667, P=0.188, P=0.806), and no statistically significant differences in treatment efficacy were observed between the two groups at one and two years post-treatment(P=0.737, P=0.9, P=0.384, P=0.607, P=0.476, P=0.498, P=0.876, P=0.696). A total of 19 participants ultimately dropped out: 5 cases(26.32%)were unable to persist; 4cases(21.05%)showed no improvement; 3 cases(15.79%)cited personal or work-related factors; 3 cases(15.79%)attributed to pandemic-related reasons; 2 cases(10.53%)cited high costs; 1 case(5.26%)reported improvement;1 case(5.26%)perceived worsening symptoms. Conclusion This study demonstrates that Artemisia annua pollen allergen sublingual drops exhibit long-term efficacy for allergic rhinitis caused by Artemisia pollen, with comparable therapeutic effects observed in both monosensitized and multisensitized patients. This finding provides important reference for clinical treatment. Future research should focus on multicenter, large- sample, long-follow-up designs, and leverage big data and machine learning technologies to develop efficacy prediction tools, thereby further optimizing treatment regimens.
    Effects of a three-dimensional intervention based on the health belief model on chronic rhinosinusitis
    LIANG Shaoqin, LIN Xinsheng, LI Jiajia
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2026, 40(6):  30-39. 
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    Objective To develop a multidimensional intervention based on the health belief model(HBM)and explore its effects on health beliefs, medication adherence and clinical outcomes in patients with chronic rhinosinusitis(CRS). Methods A total of 110 patients with CRS were randomly allocated into intervention and control groups(55 participants per group). The control group received routine clinical management, while the intervention group was supplemented with a 6-month HBM-based intervention consisting of personalized health education, stratified psychological intervention and optimized medical services, followed by a 24-month follow-up. Outcome measurements included standardized HBM score, the 8-item morisky medication adherence scale(MMAS-8), visual analogue scale(VAS), self-rating anxiety scale(SAS), 22-item sino-nasal outcome test(SNOT-22), lund-mackay CT score, as well as serum IL-5, IL-13, TNF-α levels, nasal mucosal eosinophil count and epithelial injury score. Results At the 24-month follow-up, all assessment scores were significantly improved in the intervention group relative to the control group(all P<0.001). Significant improvements in biological indicators were observed at the 12-month follow-up(all P<0.001). Conclusion HBM-based multidimensional intervention effectively improves health beliefs, medication adherence, symptoms, anxiety, quality of life and nasal mucosal inflammation among patients with CRS.
    Efficacy observation of acupoint massage combined with auricular acupressure in the treatment of moderate to severe persistent allergic rhinitis
    SHENG Xinyue, ZHANG Biaoxin, LIU Yehai, WU Feihu, CAI En, XU Jing
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2026, 40(6):  40-45. 
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    Objective To evaluate the synergistic efficacy of acupoint massage combined with auricular acupressure in the treatment for moderate to severe persistent allergic rhinitis(AR)patients. Methods 60 patients with moderate to severe persistent AR were selected and divided into a control group and an observation group using a random number table, with 30 cases in each group. The control group received treatment with triamcinolone acetonide nasal spray, while the observation group received the same treatment as the control group plus acupoint massage combined with auricular acupressure therapy. Clinical efficacy, nasal symptom/sign scores, quality of life scores and adverse reactions were compared between the two groups. Results After 4 weeks of treatment, the total effective rate in the observation group was higher than that in the control group(χ2=4.320, P=0.038), indicating a statistically difference. The total nasal symptom score, total nasal non-symptom score and rhi-noconjunctivitis quality of life questionnaire scores decreased significantly in both groups compared to pre-treatment levels, and the scores in the observation group were lower than those in the control group for all indicators, with statistical significance(all P<0.001). No serious adverse reactions occurred in either groups during the study period. Conclusion Compared with the treatment using triamcinolone acetonide nasal spray alone, the combination of acupoint massage and auricular acupressure for moderate to severe persistent AR demonstrates definite short-term clinical efficacy and good safety, and significantly improves patients' quality of life.
    The correlation between the expression of IL-8, IFN-γ and systemic inflammatory index in CRSwNP patients and its clinical significance
    WANG Yunuo, LI Zhenglin, ZHAO Jiaxian, LI Wenkai, LU Hui, WU Jingfang, XUE Gang
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2026, 40(6):  46-53. 
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    Objective The present study aims to explore the morphological configuration and inflammatory factor expression of CRSwNP in the Zhangjiakou area. In particular, it will analyze the expression of IL-8 and IFN-γ in CRSwNP, as well as its relationship and significance with systemic inflammatory index. Methods A total of 135 patients dignosed with CRSwNP who underwent rhinoscopic surgery at the Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Hebei North University from 8 January 2021 to 8 December 2024 were included in the study(CRSwNP group). Nasal polyp tissues and plasma from these patients were collected for analysis. In order to establish a basis for comparison, normal uncinate process tissues and plasma from patients diagnosed with maxillary sinus cysts during the same period(57 cases)were taken as a control group(control group).The control group was stained with hematoxylin and eosin(HE)and immunohistochemistry(IHC)to observe the morphology of sinus mucosa and the distribution of inflammatory cells. Furthermore,Western blot and enzyme-linked immunosorbent assay(ELISA)were used to detect the expression and semi-quantitative analysis of inflammatory cell markers, interleukin(IL)-8 and interferon(IFN)-γ. ROC analysis was employed to evaluate the diagnostic value of systemic inflammation index, IL-8 and IFN-γ, both individually and in combination, for the diagnosis of CRSwNP. Results The study revealed that CRSwNP tissues exhibited epithelial hyperplasia and hypertrophy, accompanied by squamous epithelial hyperplasia, eosinophil, neutrophil, lymphocyte and plasma cell infiltration in the mesenchyme, and markedly edematous connective tissues. The results of the IHC analysis demonstrated that the AOD values of IL-8, IFN-γ, CD138, CD3, CD79a, and CD68 in the CRSwNP group were significantly higher compared with those in the control group(P<0.05). The results of IL-8 and IFN-γ in CRSwNP tissues were significantly higher than those in the control group by Western blot (P<0.001); In addition, the ELISA assay results showed that the plasma levels of IL-8 and IFN-γ in the CRSwNP group were significantly higher than those in the control group(P<0.001). ROC curve analysis showed that the area under the curve of LMR, plasma IL-8 and IFN-γ in the diagnosis of CRSwNP was 0.656(95%CI:0.509-0.802), 0.894(95%CI:0.809-0.978)and 0.731(95%CI:0.570-0.893), respectively. The area under the curve of the combined diagnosis of CRSwNP was 0.981(95%CI:0.955-0.999 ). Conclusion CRSwNP was predominantly of mixed inflammation(especially neutrophilic type), with high expression of IL-8 and IFN-γ; the combined diagnosis of LMR, IFN-γ and IL-8 significantly improved the diagnostic efficacy of CRSwNP in the Zhangjiakou area.
    Development and validation of a nomogram for predicting asthma comorbidity in elderly patients with allergic rhinitis
    LIU Danfeng, PAN Qingchun, FENG Xuefei, LI Haoyi, REN Jian, LI Daibo
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2026, 40(6):  54-62. 
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    Objective To investigate the influencing factors of bronchial asthma(BA)comorbidity in elderly patients with allergic rhinitis(AR)and to develop a nomogram prediction model for early identification of high-risk individuals and individualized prevention. Methods A total of 523 elderly patients with AR were enrolled from Meishan People's Hospital between January 2019 and December 2024. They were randomly divided into a training set(n=366)and a validation set(n=157)at a 7∶3 ratio. Patients were categorized into AR with BA comorbidity group and AR alone group based on the presence of BA. Least absolute shrinkage and selection operator(LASSO)regression was used for preliminary variable selection, followed by multivariate logistic regression to identify independent influencing factors. A nomogram was constructed based on these factors. Model discrimination was evaluated using receiver operating characteristic(ROC)curve, calibration was assessed using Hosmer-Lemeshow test and calibration curves, and clinical applicability was evaluated using decision curve analysis(DCA). Results Among the 523 elderly AR patients, 138(26.39%)had BA comorbidity. Multivariate logistic regression showed that family history of BA(OR=2.224, 95%CI:1.322-3.744), occupational dust exposure(OR=3.614, 95%CI:2.107-6.199), multiple allergens(OR=2.787, 95%CI:1.585-4.900), and irregular use of intranasal corticosteroids or antihistamines(OR=2.381)were independent influencing factors for BA comorbidity(P<0.05). The nomogram yielded an AUC of 0.759(95%CI:0.704-0.813)in the training set and 0.745(95%CI:0.650-0.832)in the validation set. The Hosmer-Lemeshow test indicated good model fit(training set P=0.244; validation set P=0.958), and calibration curves showed good agreement between predicted and observed probabilities. DCA demonstrated positive net clinical benefit across threshold probabilities of 0.090-0.610 in the training set and 0.080-0.900 in the validation set. Conclusion Family history of BA, occupational dust exposure, multiple allergens, and irregular medication use are independent risk factors for BA comorbidity in elderly AR patients. The nomogram constructed based on these factors exhibits good predictive performance and clinical applicability, providing a visual tool for early identification of high-risk individuals and facilitating individualized prevention and community-based stratified management.
    Research progress of Toll-like receptors in allergic rhinitis
    TANG Yuchen, WANG Yan, TAO Zezhang
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2026, 40(6):  63-69. 
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    Allergic rhinitis is a chronic inflammatory disease characterized by the immune imbalance of Th1/Th2 and Th17/Treg response, and its development is affected by a variety of congenital and acquired factors. As a type of pattern recognition receptors, Toll-like receptors(TLRs)play an important role in the nasal immune defense against external pathogens and in the development of adaptive immune response for the close relation with the maturation and differentiation of T cells. TLR agonists have shown advancements in the immunotherapy of airway inflammatory diseases such as allergic rhinitis and asthma. This article summarizes the research progress on TLRs in the development and treatment of allergic rhinitis.
    Mechanism of telomere dysfunction inducing ROS-promoted airway Th2-type inflammation
    SU Yilin, XUE Jinmei
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2026, 40(6):  70-75. 
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    Th2-mediated airway inflammation has emerged as a global health concern due to its increasing prevalence and poor clinical outcomes. A correlation exists between telomere dysfunction and Th2-mediated airway inflammatory diseases. Current research findings from both domestic and international studies indicate that telomere dysfunction can drive mitochondrial dysfunction, induce redox imbalance to promote reactive oxygen species(ROS)production, thereby triggering a cascade of inflammatory mediators, ultimately leading to Th2-mediated inflammation. This paper reviews research findings on the subject and further explores potential mechanisms, with the aim of developing new interventions and providing fresh insights and advances for the study and treatment of related diseases.
    Research progress of CAR-T cell therapy for respiratory allergic diseases
    CHEN Ruien, ZOU Huamei, LIAO Yun, YANG Gui
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2026, 40(6):  76-82. 
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    Chimeric antigen receptor T-cell therapy(CAR-T)is a novel targeted immunotherapy based on gene editing technology, which has strong targeting capability. Although at the stage of development, it has shown promising prospects and has achieved breakthroughs in the treatment of tumor diseases, autoimmune diseases, and allergies. With high incidence, respiratory allergic diseases could not be cured because of limited treatments. As an emerging technology, CAR-T can specifically target the therapeutic sites of respiratory allergy and effectively alleviate airway inflammation. However, the application of this therapy may lead to adverse reactions and early identification and preventive medication are crucial for addressing this issue. This article systematically summarizes the research progress of CAR-T cell therapy for respiratory allergy in recent years, aiming to provide theoretical basis and research ideas for subsequent in-depth studies and clinical transformation.
    Research advances of biologicals targeting IL-5 in the treatment of chronic sinusitis with nasal polyps
    ZHAO Li, XIE Erjie, TANG Yuedi
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2026, 40(6):  83-90. 
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    Chronic rhinosinusitis with nasal polyps(CRSwNP)is a common disease both at home and abroad, with a high disease burden that greatly affects the quality of life and physical and mental health of patients. Type 2 inflammation plays a key role in the pathophysiological process of CRSwNP, eosinophils play an important role in mediating type 2 inflammation, and IL-5 is the main cytokine mediating eosinophil proliferation, activation and survival. Many biologics targeting IL-5 such as Mepolizumab, Reslizumab and Benalizumab have shown some clinical efficacy in a series of clinical studies in CRSwNP. Their ability to reduce tissue type 2 inflammation by lowering the level of eosinophils in the blood and nasal polyp tissues through anti-IL-5 or IL-5R has become a new approach for the treatment of CRSwNP.Mepolizumab, in particular, has been approved for use in patients with CRSwNP in foreign countries. In this paper, we review the mechanism of action and current research status of Mepolizumab, Reslizumab, and Benralizumab, three well-researched IL-5-targeting biologics for the treatment of CRSwNP, with the aim of providing a new target for their future treatment of CRSwNP.
    Metabolic reprogramming in the pathogenesis of chronic rhinosinusitis
    WU Yujie, ZHU Xiaoyan, WANG Xu
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2026, 40(6):  91-99. 
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    Chronic rhinosinusitis(CRS)is a chronic inflammatory condition of the sinonasal mucosa, characterized by a complex pathogenesis involving anatomical, environmental, and immunological factors. Metabolic reprogramming, the process of altering metabolic pathways to meet cellular functional demands, frequently involves the metabolism of glucose, lipids and amino acids. The immune response in CRS, orchestrated by sinonasal epithelial cells and various immune cells, exhibits distinct immunological responses and associated metabolic dysregulation in eosinophilic and noneosinophilic CRS. When cells are exposed to inflammatory stimuli, they undergo metabolic reprogramming concurrently with activation of immune signaling. These alterations in metabolic pathways directly influence cellular function and cytokine secretion, representing critical factors in the onset and progression of CRS. With advancements in detection technologies, methods such as metabolomics can identify aberrant metabolic pathways by analysing metabolites.The analysis of cellular metabolic changes has thus become an effective approach for studying the pathogenesis of CRS and developing new therapeutic strategies. This article reviews recent global progress on metabolic dysregulation in CRS pathogenesis, enumerates the metabolic pathways of different CRS endotypes, analyses the relationship between metabolic reprogramming and the immune response, and explores the potential application of targeting dysregulated metabolic pathways in CRS therapy.
    Original Article
    Human umbilical cord mesenchymal stem cellsattenuateage-related hearing loss in mice
    WU Manman, LIAO Kang, MAI Weiyuan, ZHOU Hao, FAN Junqi, ZHOU Zhihan, XU Luhua, JIANG Hongyan
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2026, 40(6):  100-108. 
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    Objective To investigate the mechanism of prevention and treatment of presbycusis, human umbilical cord mesenchymal stem cells(hUC-MSCs)were used to delay the aging of mouse cochlea. Methods Stable human umbilical cord-derived mesenchymal stem cells(hUC-MSCs)were isolated and cultured, followed by breeding C57BL/6J male mice of corresponding age. In the control group, mice received 0.2 mL of normal saline via tail vein injection using a microsyringeevery month starting at 3 months of age. The MSCs group received injections of fourth-generation hUC-MSCs at a concentration of 5×106 cells/mL via tail vein every month starting at 3 months of age. Auditory brainstem response(ABR)threshold tests were performed at 3, 6, 10,17, and 21 months of age, with threshold data recorded. At 6, 10, and 21 months, the Corti's apparatus in the inner ear was dissected, and the basilar membrane was immunofluorescently stained. Morphological changes in cochlear outer hair cells and the number of zonal synapses were observed and documented using laser confocal microscopy. Serum levels of oxidative stress markers such as MDA, SOD, and GSH were measured and analyzed. Results The hUC-MSCs isolated and cultured in this study exhibited typical elongated, spindle-shaped adhesion growth with stable morphology after passage; flow cytometry analysis met the identification criteria for mesenchymal stem cells. Audiological results demonstrated progressive hearing decline in mice with increasing age, with high-frequency hearing impairment occurring earliest and gradually progressing to middle and low-frequency ranges. The ABR hearing thresholds in the MSCs group were significantly lower than those in the control group across all age groups(P<0.01), with significant differences observed at 32 kHz(6 months), as well as at Click frequency and 8/16 kHz(10 and 21 months, respectively)(P<0.05). Cochlear morphological findings revealed significantly lower total loss rates of outer hair cells in the MSCs group compared to the control group across all age groups(P<0.01), with significant differences observed in the basal, apical, and apical-medial turns at 6, 10, and 21 months(P<0.05). Synaptic banding analysis demonstrated that the MSCs group exhibited a higher density of synapses in the cochlear region at 16-22 kHz compared to the control group at 6 months(P<0.05), and increased synaptic density at medium-high frequencies of 4 kHz and 22 kHz at 21 months(P<0.05). Serum oxidative stress markers revealed no significant differences between the two groups at 6 months for MDA, SOD, or GSH levels; however, at 10 and 21 months, the hUC-MSCs group exhibited significantly lower malondialdehyde levels and significantly higher levels of superoxide dismutase and reduced glutathione(P<0.05). Conclusion Human umbilical cord mesenchymal stem cells(hUC-MSCs)can reduce the loss of outer hair cells and ribbon synapses in the inner ear of mice, as well as delay the aging of the basilar membrane in the cochlea. This suggests that hUC-MSCs effectively mitigate age-related hearing loss in mice and exhibit therapeutic potential for presbycusis.
    Learning curve and clinical efficacy of otoendoscopicossicular prosthesis reconstruction in 52 patients with difficult conductive hearing loss
    DUO Peng, TANG Haobin, LIN Yi, HE Kunwu, CEHN Minqi
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2026, 40(6):  109-116. 
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    Objective To investigate the learning curve and short-term clinical efficacy of otoendoscopic ossicular prosthesis reconstruction in patients with difficult conductive hearing loss. Methods The clinical data of 52 patients(52 ears)with difficult conductive hearing loss who underwent otoendoscopic ossicular prosthesis reconstruction were retrospectively analyzed. The patients included 15 males and 37 females, with a mean age of 44.7 years(range, 18-72 years); 27 patients had left-ear involvement and 25 had right-ear involvement. All procedures were performed by the same surgeon. The preoperative mean air-conduction(AC)threshold was(56.31±18.12)dB HL, the mean bone-conduction(BC)threshold was(23.23±13.59)dB HL, and the mean air-bone gap(ABG)was(33.08±9.09)dB HL. The learning curve for ossicular prosthesis reconstruction time was analyzed using the cumulative sum(CUSUM)method. A cubic polynomial model was used for curve fitting(R2=0.912, P<0.001), and the inflection point of the learning curve was identified at the 25th case. The patients were subsequently divided into a learning group(n=25)and a proficiency group(n=27). Hearing was reassessed 3 months after surgery to evaluate the overall clinical efficacy and compare outcomes between the two groups. Results All procedures were completed entirely under otoendoscopic visualization. No cases of postoperative facial palsy, cerebrospinal fluid otorrhea, persistent vertigo, infection, or total deafness occurred. Postoperative complications included taste disturbance in 3 cases, tympanic membrane graft retraction in 1 case, collapse of the cartilage graft flap of the external auditory canal in 2 cases, transient tinnitus in 2 cases, and exposed bone of the external auditory canal in 1 case. The mean BC threshold increased by 18 dB HL and 10 dB HL in 2 cases, respectively. There were no statistically significant differences between the learning and proficiency groups in sex, age, affected side, or the type of ossicular prosthesis used(all P>0.05). In all patients, the postoperative mean AC threshold was(45.04±18.75)dB HL, significantly lower than the preoperative value of(56.31±18.12)dB HL(t=6.436, P<0.001). The postoperative mean ABG was(22.63±9.08)dB HL, significantly smaller than the preoperative value of(33.08±9.09)dB HL(t=6.748, P<0.001). The postoperative mean BC threshold was(22.23±13.85)dB HL, with no statistically significant difference from the preoperative value of(23.23±13.59)dB HL(t=1.244, P=0.219). The learning curve for ossicular prosthesis reconstruction time reached its peak at the 25th case. The reconstruction time was significantly shorter in the proficiency group than in the learning group [(13.85±4.03)min vs.(25.44±3.78)min, P<0.001]. No statistically significant differences were observed between the two groups in postoperative audiological outcomes(all P>0.05). Conclusion Otoendoscopic ossicular prosthesis reconstruction is a safe and effective treatment for difficult conductive hearing loss caused by complex middle ear lesions in the short term. For surgeons with a certain level of experience in microscopic otologic surgery, a relatively proficient stage may be reached after approximately 25 cases, as reflected primarily by a reduction in reconstruction time without a decline in short-term hearing outcomes.
    Review
    Pathogenesis and assessment in vestibular disorders with visuospatial cognitive impairment
    FENG Lulu, CHEN Ganggang, LI Yulin, WU Jiaxin, YANG Jie, LI Ying, ZHOU Liyuan, ZHANG Haili
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2026, 40(6):  117-124. 
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    Visuospatial cognitive impairment associated with vestibular dysfunction has increasingly become a critical concern in clinical vestibular medicine. Current research lacks a systematic integration of the distinct cognitive impairment phenotypes across various vestibular disorders. This study is carried out along four main threads: anatomical foundations, injury mechanisms, assessment methods and disease evidence. We delineate the differential patterns of visuospatial cognitive impairment across six common vestibular disorders(bilateral vestibulopathy, unilateral vestibulopathy, Meniere's disease, benign paroxysmal positional vertigo, vestibular migraine, and persistent postural-perceptual dizziness)and identify assessment tools reported in existing studies that can detect the corresponding declines. By establishing a "Disease-Cognitive Impairment Phenotype-Assessment Tool" clinical decision matrix, this study promotes the paradigm shift from generic screening to disease-specific precision assessment. Furthermore, by critically dissecting methodological confounders(such as cognitive reserve, hearing loss, and emotional comorbidities)that contribute to conflicting findings in the literature, we clarify current diagnostic misconceptions. This study proposes a theoretical model of "diagnosis-guided precision assessment", providing a robust framework for the early identification, clinical stratification, and standardized management of vestibular-related visuospatial cognitive impairment.
    Peripapillary hyperreflective ovoid mass-like structures: multimodal imaging features, associated disease spectrum, and clinical significance
    ZHANG Junchen, LI Pengwei, LI Zhigang
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2026, 40(6):  125-132. 
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    Objective Peripapillary hyperreflective ovoid mass-like structures(PHOMS)are an important imaging biomarker that has emerged with the advancement of multimodal imaging technologies. This review, for the first time, adopts axoplasmic stasis as a unifying pathological framework to systematically elucidate the multimodal imaging features and evolutionary rules of PHOMS, clarify their extensive association with various optic nerve and systemic diseases, and highlight the high detection rate of PHOMS in children and adolescents as well as its correlation with optic disc morphology. Meanwhile, this paper systematically establishes a differential diagnostic framework for distinguishing PHOMS from optic disc drusen and defines the potential application value of PHOMS in monitoring disease activity and evaluating prognosis. Notably, this review summarizes the current controversies and unresolved issues in the field and outlines future research frontiers, such as artificial intelligence-assisted quantitative analysis, aiming to provide a more systematic theoretical framework and innovative perspectives for the clinical interpretation of PHOMS and related research.