Clinical and Experimental Otorhinolaryngology最新文献

{"title":"Empty Nose Syndrome: An Update on Pathophysiology, Diagnosis, and Treatment.","authors":"Ziang Gao, Yong-Ju Jang","doi":"10.21053/ceo.2026-00115","DOIUrl":"https://doi.org/10.21053/ceo.2026-00115","url":null,"abstract":"<p><p>Empty nose syndrome (ENS) is a chronic sinonasal condition that typically results from overly aggressive turbinate reduction. It is characterized by nasal dryness, crusting, burning sensation, and a paradoxical perception of excessive airflow despite an anatomically wide nasal cavity, leading to significant impairment in quality of life. This narrative review summarized over 70 publications (PubMed, Embase, Google Scholar, and Cochrane Library; 2000-2026) to outline current diagnostic and therapeutic considerations for ENS. ENS most commonly develops following total or near-total inferior turbinectomy. Its pathophysiology involves transient receptor potential melastatin 8 cold receptor hypofunction, histopathological changes, autonomic nervous system dysfunction, and neuroinflammation. Diagnosis is based on the Empty Nose Syndrome 6-Item Questionnaire in combination with the cotton test, while the Standardized Empty Nose Syndrome Evaluation blinded protocol helps reduce placebo bias. The inferior meatus augmentation procedure is the most frequently reported surgical intervention, demonstrating clinically meaningful and sustained improvement in large meta-analyses; no single graft material has demonstrated consistent superiority. Non-surgical-including three-dimensional-printed nasal plugs, resorbable injectable fillers, intranasal trigeminal training, and cognitive behavioral therapy combined with selective serotonin reuptake inhibitors-serve as essential components of comprehensive management.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgery-Based Salvage for Locoregional Recurrent Salivary Gland Carcinoma: Comparative Survival Evidence from a Systematic Review and Meta-analysis.","authors":"Gene Huh, Jeong Wook Kang, Geun-Jeon Kim, Jeong-Yeon Ji, Jooin Bang, Ji Won Kim, Jeon Yeob Jang, Eun-Jae Chung, Soon-Hyun Ahn, Heejin Kim, Sung Joon Park","doi":"10.21053/ceo.2026-00056","DOIUrl":"https://doi.org/10.21053/ceo.2026-00056","url":null,"abstract":"<p><strong>Objectives.: </strong>To compare survival outcomes between surgery-based salvage and non-surgical management in patients with locoregional recurrent salivary gland carcinoma (RSGC), and to explore whether surgery-based salvage is associated with more favorable outcomes in appropriately selected patients.</p><p><strong>Methods.: </strong>A search was performed in MEDLINE (Ovid), EMBASE, and the Cochrane Library. Observational studies were included that reported comparative outcomes for surgery-based salvage (resection ± adjuvant therapy) versus non-surgical management (re-irradiation, brachytherapy, systemic therapy, or palliative treatment) in locoregional recurrent disease. Patients with distant metastasis at recurrence were excluded from the pooled analysis. Primary outcomes were overall survival (OS) and disease-free survival (DFS). Hazard ratios (HRs) were calculated as non-surgical management versus surgery-based salvage and pooled using a random-effects model. Risk of bias was assessed using RoBANS 2.0.</p><p><strong>Results.: </strong>Five retrospective comparative studies (N = 163) met the inclusion criteria. Four studies contributed to a meta-analysis for OS (N = 153) and DFS (N = 145). In pooled observational analyses, non-surgical management showed higher hazard estimates for OS (pooled HR = 3.40; 95% confidence interval [CI], 1.17-9.84; p = 0.024) and DFS (pooled HR = 3.09; 95% CI, 1.21-7.91; p = 0.019) than surgery-based salvage. Heterogeneity was considerable for OS (I² = 80.1%) and moderate for DFS (I² = 56.4%). Most studies had moderate-to-high risk of bias, particularly for participant comparability and residual confounding.</p><p><strong>Conclusion.: </strong>Available comparative observational evidence suggests that surgery-based salvage may be associated with more favorable survival outcomes in appropriately selected patients with locoregional RSGC. However, the evidence base is small, retrospective, and clinically heterogeneous; therefore, these findings should be interpreted as exploratory rather than confirmatory, and treatment decisions should be individualized within a multidisciplinary approach.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148052426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical analysis of HPV-positive oropharyngeal squamous cell cancer according to HPV genotype.","authors":"Siyeon Jin, Sung Joon Park, Youngmi Park, Soyeon Ahn, Jinyi Lee, Seo Young Kim, Jeong-Yeon Ji, Woo-Jin Jeong, Wonjae Cha","doi":"10.21053/ceo.2025-00391","DOIUrl":"https://doi.org/10.21053/ceo.2025-00391","url":null,"abstract":"<p><strong>Objective.: </strong>Oropharyngeal squamous cell carcinoma (OPSCC) has undergone a major epidemiologic transition, with high-risk human papillomavirus (HPV) emerging as the dominant etiologic factor. Although HPV-16 accounts for most HPV-positive OPSCC worldwide, a substantial minority of tumors harbor non-HPV- 16 genotypes, the clinical and prognostic significance of which remains uncertain, particularly in Asian populations. This study aimed to investigate HPV genotype distribution and survival outcomes in a singleinstitution cohort of HPV DNA-positive OPSCC regardless of p16 and to assess the prognostic significance of HPV genotype.</p><p><strong>Methods.: </strong>We retrospectively reviewed patients treated with curative intent for HPV-positive OPSCC at Seoul National University Bundang Hospital between 2003 and 2023. HPV status was determined using p16 immunohistochemistry and HPV DNA genotyping. Patients were classified as having HPV-16 or non-HPV-16 genotype. Overall survival (OS) and disease-free survival (DFS) were analyzed using Kaplan-Meier method and compared using the log-rank test.</p><p><strong>Results.: </strong>Of 254 eligible patients, 174 with HPV DNA-positive tumors and available HPV genotyping results were included in the final analysis. HPV-16 accounted for 74.7% of tumors, while non-HPV-16 genotypes comprised 25.3%, most commonly HPV-33, HPV-35, HPV-58, and HPV-18. A marked male predominance was observed across all genotypes. The clinical stage distribution did not differ significantly between the HPV-16 and non-HPV-16 groups overall; however, HPV-33-positive tumors showed higher nodal stage compared with HPV-16. OS and DFS were similar between the HPV-16 and pooled non-HPV-16 groups. In genotype-specific analyses, DFS did not differ significantly across groups, whereas HPV-35 was associated with poorer OS compared with HPV-16.</p><p><strong>Conclusion.: </strong>In this cohort, non-HPV-16 genotypes accounted for approximately one-quarter of HPV-positive OPSCC cases and demonstrated clinicopathologic heterogeneity with selected genotype-specific prognostic differences. Given the substantial proportion of non-HPV-16 genotypes and the marked male predominance observed in our cohort, our findings may have implications for future HPV prevention strategies.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148053082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Practice Guideline for the Evaluation and Management of Facial Nerve Palsy.","authors":"Se A Lee, Ho Yun Lee, Min Young Kwak, Jin Kim, Myung Chul Yoo, Young Sang Cho, Junhui Jeong, Sanghoon Kim, Je-Young Shin, Jisang Han, Jae Ho Chung, Je Beom Hong, Baek-Kyu Kim, Minbum Kim, Hyun Jung Kim, Jong Dae Lee","doi":"10.21053/ceo.2026-00096","DOIUrl":"https://doi.org/10.21053/ceo.2026-00096","url":null,"abstract":"<p><strong>Objective: </strong>To develop evidence-based clinical practice guidelines for evaluating and managing peripheral facial nerve palsy within the Korean healthcare system.</p><p><strong>Methods: </strong>A multidisciplinary guideline committee-comprising otolaryngologists, a neurologist, a neurosurgeon, a rehabilitation medicine specialist, an ophthalmologist, a plastic surgeon, and a methodology expert-conducted de novo systematic reviews. Literature searches were performed in MEDLINE, Embase, the Cochrane Library, and KoreaMed through November 30, 2024. Evidence was appraised using the GRADE methodology, and nine key clinical questions (KQs) were formulated using the PICO framework. Recommendations were finalized through structured consensus requiring at least 70% agreement. A patient preference survey (n = 51) informed value considerations. The draft guideline underwent external review by seven independent experts.</p><p><strong>Results: </strong>Ten recommendations addressing nine KQs were developed. The House-Brackmann grading system is recommended as the standard assessment tool (Grade A). Routine testing is unnecessary for typical Bell's palsy; selective testing is advised for atypical features (Grade B). Electrodiagnostic studies may be used for prognostic evaluation in severe cases (Grade B). Oral corticosteroids are strongly recommended within 72 hours of symptom onset (Grade A). Antivirals may be added based on clinical judgment and patient preference (Grade B). Facial nerve decompression may be considered in selected patients with severe degeneration (Grade B). Rehabilitation therapy, surgery for chronic palsy, botulinum toxin injection for synkinesis, and multidisciplinary management are conditionally recommended (Grade B).</p><p><strong>Conclusion: </strong>This guideline provides an evidence-based framework for managing facial nerve palsy in Korea. It integrates systematic evidence, patient preferences, and healthcare system factors, including National Health Insurance coverage and regional accessibility.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of vulnerable ribbon synapses in aged C57BL/6 mouse cochlea.","authors":"Kwon Woo Kang, Hojin Lee, Jaekwang Lee, Eunyoung Yi","doi":"10.21053/ceo.2026-00037","DOIUrl":"https://doi.org/10.21053/ceo.2026-00037","url":null,"abstract":"","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular Etiology in Idiopathic Labyrinthitis: Implication of NLR and PLR and White Matter Changes.","authors":"Seoui Kwag, Sarah Hyunsoh Park, Tonghoon Woo, Jueun Kim, Minjung Nam, Sun-Uk Lee, Euyhyun Park, Byungjun Kim, Alexander A Tarnutzer, Ji-Soo Kim","doi":"10.21053/ceo.2026-00063","DOIUrl":"https://doi.org/10.21053/ceo.2026-00063","url":null,"abstract":"<p><strong>Objective.: </strong>Vascular mechanisms have been implicated in idiopathic acute unilateral audiovestibulopathy (iAUAV, also known as labyrinthitis), especially in older patients. We investigated the platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and white matter changes in patients with iAUAV/labyrinthitis to determine the potential vascular etiology in this disorder.</p><p><strong>Methods.: </strong>We retrospectively analyzed complete blood count (CBC) data from patients aged over 50 years and diagnosed with iAUAV/labyrinthitis at a tertiary hospital in South Korea between March 2018 and June 2025. CBC data, Fazekas scores for white matter changes, video head-impulse tests (vHIT), and bithermal caloric test results were compared with those of patients with acute unilateral peripheral vestibulopathy (AUVP, i.e., vestibular neuritis [AUVP/VN]) and age- and sex-matched healthy controls.</p><p><strong>Results.: </strong>A total of 74 patients with iAUAV/labyrinthitis (mean age± standard deviation [SD] = 68± 9 years; 34 male), 84 with AUVP/VN (65± 9 years; 46 male), and 58 healthy controls (68± 10 years; 26 male) were included. Both NLR (p<0.001) and PLR (p=0.003) were higher in the iAUAV/labyrinthitis group than in the AUVP/VN or control groups. Patients with iAUAV/labyrinthitis had higher Fazekas scores than those with AUAV/VN (p=0.002). Compared to AUVP/VN, iAUAV/labyrinthitis was associated with a higher PLR (p=0.038), higher Fazekas score (p=0.011), increased VOR gain for the horizontal canal (p<0.001), and decreased VOR gain for the posterior canal (p=0.005).</p><p><strong>Conclusion.: </strong>Elevated PLR and prominent white matter changes suggest a microvascular etiology of iAUAV/labyrinthitis in older adults. These serologic and imaging markers may complement standard neurotologic assessments in diagnosing iAUAV/labyrinthitis.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guideline for the Management of Obesity in Adult Patients With Obstructive Sleep Apnea.","authors":"Soo-Kyoung Park, Yun Jin Kang, Seung Hoon Lee, Chan-Soon Park, Seok Jin Hong, Ji Ho Choi, Jae Hoon Cho","doi":"10.21053/ceo.2025-00396","DOIUrl":"10.21053/ceo.2025-00396","url":null,"abstract":"<p><strong>Objectives: </strong>Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder that is strongly influenced by obesity, the most important modifiable risk factor. Effective weight management is therefore essential for optimal OSA care. This guideline provides updated, evidence-based recommendations for the evaluation and management of obesity in adults with OSA, incorporating recent advances in lifestyle, pharmacologic, and surgical interventions.</p><p><strong>Methods: </strong>The Korean Society of Sleep and Breathing convened a multidisciplinary panel. A systematic literature search was performed across major databases through 2025. Evidence was appraised using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, and recommendations were formulated by consensus using the Evidence-to-Decision framework.</p><p><strong>Results: </strong>Eight statements were developed. Key recommendations include recognizing obesity as a major risk factor; routinely assessing overweight and obesity; and implementing structured weight reduction through diet, exercise, and behavioral therapy. Glucagon-like peptide-1 receptor agonists are recommended when lifestyle interventions are insufficient, and bariatric/metabolic surgery is advised for severe obesity unresponsive to nonsurgical treatment. Weight loss improves the apnea-hypopnea index, symptoms, and cardiometabolic markers and may reduce positive airway pressure needs. Continued follow-up is recommended even after clinical improvement.</p><p><strong>Conclusion: </strong>Weight management is a core component of OSA treatment. This guideline offers practical, evidence-based strategies to support clinicians in delivering effective, obesity-focused care for adults with OSA.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"107-119"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13256478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physiological Measures of Reduced Listening Effort in Active Noise Canceling: Evidence From a Low-β Functional Network in an Event-Related Potential Study.","authors":"Jihoo Kim, Hee Jung Yun, Euijin Kim, Sungkean Kim, Il Joon Moon","doi":"10.21053/ceo.2025-00311","DOIUrl":"10.21053/ceo.2025-00311","url":null,"abstract":"<p><strong>Objectives: </strong>In this study, we investigated the neurophysiological impact of active noise cancellation (ANC) technology on auditory-cognitive processing and listening effort, addressing a critical gap in the literature on ANC efficacy. Although ANC is increasingly adopted in contemporary devices, its influence on underlying neurophysiological mechanisms remains underexplored. Given that current assessment approaches rely predominantly on subjective measures, we employed a multi-condition experimental design integrating subjective self-reports with electroencephalographic assessments, thereby providing a more comprehensive evaluation of ANC's capacity to mitigate cognitive load.</p><p><strong>Methods: </strong>Thirty participants underwent comprehensive audiological testing and cognitive event-related potential recordings during an auditory oddball paradigm to elucidate the efficacy of ANC functionality and its impact on cognitive processing, as indexed by the P3 component. Functional connectivity was quantified using the source-localized weighted phase-lag index, and graph-theory-based network analysis was applied to assess changes in neural efficiency under noisy conditions with and without ANC activation.</p><p><strong>Results: </strong>The analyses revealed significant alterations in low-β-band functional architecture across the central executive, dorsal attention, salience, and default mode networks during effortless listening with ANC enabled, compared with the effortful listening condition. Subjective listening effort correlated with network efficiency in the left posterior middle frontal gyrus, dorsal anterior cingulate cortex, and inferior parietal lobule during ANC-aided effortless listening tasks.</p><p><strong>Conclusion: </strong>Our findings suggest that ANC activation significantly reduces neural processing demands across key cognitive networks during effortless listening. These.</p><p><strong>Results: </strong>reinforce the role of ANC in alleviating cognitive load and enhancing neural efficiency in auditory-cognitive processing. Furthermore, the findings provide empirical support to inform evidence-based noise mitigation strategies in both clinical and ecological contexts.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":"19 2","pages":"145-157"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13256480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subjective and Objective Assessments of Olfactory Function in Patients Taking Anti-obesity Medications.","authors":"Hye Jun Lee, Il-Youp Kwak, Hyun Jin Min","doi":"10.21053/ceo.2025-00238","DOIUrl":"10.21053/ceo.2025-00238","url":null,"abstract":"","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"205-208"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13256449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Pcdh15 Deficiency on Cellular Energy Metabolism and Oxidative Stress, and Its Role and Mechanism in Hearing Loss.","authors":"Ying Lan, Yang Wu, Shijie Zhao, Jun Tang, Xingming Liang, Tao Hou, Lu Peng, Yongpeng Li, Xinxing Zhao, Shihua Yin","doi":"10.21053/ceo.2025-00263","DOIUrl":"10.21053/ceo.2025-00263","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to explore the role of the Pcdh15 gene in hearing maintenance and to examine the effects of its deficiency on cochlear structure, cochlear function, and hearing loss in mice.</p><p><strong>Methods: </strong>CRISPR/Cas9 technology was used to generate Pcdh15 knockout (KO) mice. Auditory function was evaluated using hearing tests, while histological approaches were employed to assess morphological changes in cochlear hair cells and spiral ganglion neurons (SGNs). RNA sequencing (RNA-seq) was performed on cochlear tissue from postnatal day 18 (P18) wild-type (WT) and Pcdh15 KO mice to identify differentially expressed genes (DEGs). These DEGs were subjected to functional annotation and pathway analysis, with particular emphasis on oxidative phosphorylation (OXPHOS). Reactive oxygen species (ROS) levels were quantified using flow cytometry and DCFH-DA assays.</p><p><strong>Results: </strong>Pcdh15 KO mice exhibited progressive sensorineural hearing loss, which worsened to profound deafness by P18. Notably, cochlear hair cells and SGNs showed substantial loss and pronounced morphological abnormalities, particularly within the basal high-frequency region. RNA-seq analysis identified 1,359 DEGs, including 1,024 downregulated and 335 upregulated genes. Pathway analysis indicated that Pcdh15 deficiency was associated with inhibition of the OXPHOS pathway, potentially disrupting mitochondrial respiratory chain complexes I, III, IV, and V and thereby impairing energy production and ATP metabolism. In addition, early-stage cochleae from KO mice demonstrated elevated ROS levels and increased oxidative stress, suggesting that redox imbalance may contribute to hearing damage.</p><p><strong>Conclusion: </strong>Pcdh15 plays a critical role in hearing maintenance. Its deficiency is associated with severe hearing loss and marked cochlear abnormalities, which are linked to inhibition of OXPHOS, disruption of energy metabolism, and exacerbation of oxidative stress. Together, these findings provide new insights into the mechanisms underlying hearing loss and suggest potential targets for therapeutic intervention.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"129-144"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13256465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}