Objective: This systematic review investigates the long-term effect of cochlear implantation (CI) on clinical outcomes in tinnitus patients with sensorineural hearing loss (SNHL). Database Sources: PubMed, Embase, and the Cochrane Library were searched from inception to 30 April 2024. Manual searches of reference lists supplemented these searches when necessary. Review Methods: Original studies included in the meta-analysis had to contain comparative pre- and postoperative data for SNHL patients who underwent CI. Outcomes measured were the Tinnitus Handicap Inventory (THI), Visual Analog Scale (VAS), and Tinnitus Questionnaire (TQ). Results: A total of 28 studies comprising 853 patients showed significant tinnitus improvement after CI: THI mean difference (MD) −14.02 [95%CI −15.29 to −12.76, p < 0.001], TQ MD −15.85 [95%CI −18.97 to −12.74, p < 0.05], and VAS MD −3.12 [95%CI −3.49 to −2.76, p < 0.05]. Subgroup analysis indicated a significant difference between follow-up periods in THI (p < 0.0001) and VAS loudness (p = 0.02). Conclusions: Cochlear implantation substantially improves tinnitus in patients with hearing loss, though the effect may diminish over time. Further research is needed to confirm these findings.

With further research on the relationship between gut microbiota and human health, discussions on various gut-X axis have been increasingly prevalent. Evidence indicates that microbiota dysbiosis is closely linked to the onset and progression of audiovestibular disorders and the gut-ear axis has gradually been recognized as a vital systemic regulatory pathway. This article systematically reviewed the interaction mechanisms between microbiota dysbiosis and audiovestibular diseases, intervention strategies, research limitations and future perspectives. This axis functions mainly through immune-mediated barrier damage, metabolic disorder and neurotransmitter crosstalk. Modulation of the gut microbiota can alleviate symptoms of certain audiovestibular disorders. This review aims to provide novel insights for the pathogenesis, intervention and clinical management of audiovestibular disorders.

With further research on the relationship between gut microbiota and human health, discussions on various gut-X axis have been increasingly prevalent. Evidence indicates that microbiota dysbiosis is closely linked to the onset and progression of audiovestibular disorders and the gut-ear axis has gradually been recognized as a vital systemic regulatory pathway. This article systematically reviewed the interaction mechanisms between microbiota dysbiosis and audiovestibular diseases, intervention strategies, research limitations and future perspectives. This axis functions mainly through immune-mediated barrier damage, metabolic disorder and neurotransmitter crosstalk. Modulation of the gut microbiota can alleviate symptoms of certain audiovestibular disorders. This review aims to provide novel insights for the pathogenesis, intervention and clinical management of audiovestibular disorders.

Tinnitus is a prevalent and distressing medical symptom, and no effective pharmacological treatment currently exists. Despite significant advances, tinnitus remains a scientific enigma. To explore the molecular underpinnings of tinnitus, we developed a noise-induced tinnitus model in mice and utilized metabolomics to identify key differences in metabolic pathways. Our results revealed that oxidative stress-related pathways, including glutathione (GSH) metabolism, were significantly enriched in the auditory cortex of mice exhibiting tinnitus-like behavior. To further explore the role of oxidative stress, we examined the involvement of nuclear factor erythroid 2-related factor 2 (Nrf2) in tinnitus by conducting experiments in Nrf2 knockout (Nrf2-KO) mice. While Nrf2-deficient mice did not develop spontaneous tinnitus or hearing loss, they displayed increased susceptibility to prolonged tinnitus-like behavior after noise exposure. This was accompanied by heightened microglial activation, neuroinflammation, and significant alterations in gut microbiota composition, including greater diversity and dysbiosis. Our findings highlight a novel mechanism underlying tinnitus, emphasizing the role of oxidative stress in the auditory cortex and its connection to noise-induced tinnitus. The deficiency of Nrf2 in mice increases their susceptibility to tinnitus, suggesting that Nrf2 may serve as a promising therapeutic target for preventing noise-induced tinnitus.