The triad of noise-generated, drug-induced, and age-related hearing loss is the major cause of acquired sensorineural hearing loss (ASNHL) in modern society. Although these three forms of hearing loss display similar underlying mechanisms, detailed studies have revealed the presence of sex differences in the auditory system both in human and animal models of ASNHL. However, the sexual dimorphism of hearing varies among noise-induced hearing loss (NIHL), ototoxicity, and age-related hearing loss (ARHL). Importantly, estrogen may play an essential role in modulating the pathophysiological mechanisms in the cochlea and several reports have shown that the effects of hormone replacement therapy on hearing loss are complex. This review will summarize the clinical features of sex differences in ASNHL, compare the animal investigations of cochlear sexual dimorphism in response to the three insults, and address how estrogen affects the auditory organ at molecular levels.

Background and Objectives: Cervical space infection could also extend to the mediastinum due to the anatomical vicinity. The mortality rate of descending necrotizing mediastinitis is 85% if untreated. The aim of this study was to identify risk factors for the progression of deep neck abscesses to descending necrotizing mediastinitis. Materials and Methods: We retrospectively reviewed the medical records of patients undergoing surgical treatment of deep neck abscesses from August 2017 to July 2022. Computed tomography (CT) was performed in all patients. Before surgery, lab data including hemoglobulin (Hb), white blood cell count, neutrophil percentage, C-reactive protein (CRP) level, and blood glucose were recorded. Patients’ characteristics including gender, age, etiology, and presenting symptoms were collected. Hospitalization duration and bacterial cultures from the wound were also analyzed. Results: The C-reactive protein (CRP) level was higher in patients with a mediastinal abscess than in patients without a mediastinal abscess (340.9 ± 33.0 mg/L vs. 190.1 ± 72.7 mg/L) (p = 0.000). The submandibular space was more commonly affected in patients without a mediastinal abscess (p = 0.048). The retropharyngeal (p = 0.003) and anterior visceral (p = 0.006) spaces were more commonly affected in patients with a mediastinal abscess. Conclusions: Descending necrtotizing mediastinitis results in mortality and longer hospitalization times. Early detection of a mediastinal abscess on CT is crucial for treatment. Excluding abscesses of the anterior superior mediastinum for which transcervical drainage is sufficient, other mediastinal abscesses require multimodal treatment including ENT and thoracic surgery to achieve a good outcome.

Meniere’s disease (MD) is one of the most complicated diseases in the otologic clinic. The complexity of MD is partially due to the multifactorial etiological mechanisms and the heterogenous symptoms, including episodic vertigo, hearing loss, aural fullness and tinnitus. As a result, the diagnosis of MD and differentiating MD from other diseases with similar symptoms, such as vestibular migraine (VM), is challenging. In addition, it is difficult to predict the progression of hearing loss and the frequency of vertigo attacks. Detailed studies have revealed that functional markers, such as pure tone audiometry (PTA), electrocochleography (ECochG), vestibular evoked myogenic potential (VEMP), caloric test, video head impulse test (vHIT) and magnetic resonance imaging (MRI) could help to evaluate MD with different hearing levels and frequency of vertigo attacks. Investigations of molecular markers such as autoimmunity, inflammation, protein signatures, vasopressin and circadian clock genes in MD are still underway. This review will summarize these functional and molecular markers, address how these markers are associated with hearing loss and vertigo attacks in MD, and analyze the results of the markers between MD and VM.

Objective: To compare cochlear dose and hearing outcomes between intensity‐modulated proton therapy (IMPT) and volumetric modulated arc therapy (VMAT) in patients with nasopharyngeal carcinoma (NPC). Study Design: Prospective matched cohorts. Setting: Tertiary academic center. Methods: A total of 180 newly diagnosed, treatment‐naive NPC patients receiving definitive radiotherapy between 2023 and 2025 were enrolled. Patients were 1:1 matched by sex, age, and disease stage, and assigned to IMPT (n = 90) or VMAT (n = 90). Mean cochlear dose was recorded. Audiological evaluations, including pure‐tone audiometry (PTA), air‐bone gap, and word recognition score, were performed before and after treatment. Results: IMPT delivered significantly lower mean doses to the ipsilateral (47.51 vs 56.82 Gy, P < .001; 95% CI: –14.27 to –4.35) and contralateral cochlea (30.79 vs 45.71 Gy, P < .001; 95% CI: –18.93 to –10.91). Based on each patient's most recent audiometric assessment (median follow‐up, 12.1 months; range, 7.5‐19.5 months), IMPT demonstrated better average PTA thresholds than VMAT (33.72 vs 42.00 dB; P = .016; 95% CI, –14.91 to –1.65), superior high‐frequency hearing at 2 to 8 kHz (37.94 vs 53.82 dB; P < .001; 95% CI, –23.69 to –8.07), lower air‐bone gap (5.67 vs 10.62 dB; P < .001; 95% CI, –6.80 to –3.10), and higher word recognition scores (96.67% vs 94.00%; P = .039; 95% CI, 0.14‐5.20), with less bone conduction loss at 1 to 4 kHz. Conclusion: IMPT reduces cochlear dose compared to VMAT, resulting in better hearing preservation and suggesting its potential to minimize ototoxicity in NPC patients.