The auditory striatum, a caudal sensory-related region of the basal ganglia, has emerged as an important node linking auditory processing to behavioral responses. It integrates bottom-up auditory information conveyed by thalamic and cortical pathways, while top-down cortical signals and neuromodulatory dopamine inputs dynamically shape this integration, positioning the auditory striatum as a flexible interface between sensory processing and action. Recent circuit-level studies suggest that this region contributes to auditory information filtering, temporal processing, and auditory-guided decision-making through the integration of sensory evidence and local inhibitory mechanisms. These findings provide a circuit framework for understanding how auditory signals are transformed into decision-related representations that can guide behavior. Increasing evidence further suggests that disruption of these weighting and selection processes may contribute to auditory disorders such as tinnitus. Thus, the auditory striatum may represent an important circuit component linking auditory processing, cognitive and neuromodulatory control, and maladaptive auditory behavior.

Tinnitus can impair cognitive functions, such as attention, working memory and executive control. Pathophysiologically, this is explained by maladaptive neural plasticity, in which central auditory and nonauditory networks (e.g., prefrontal and limbic structures) become overactive or dysfunctional. Altered activity patterns in the frontoparietal control network and the default mode network (DMN) are associated with increased attention to the ear noise and reduced cognitive capacity in tinnitus patients. In addition, dysfunctional cortico-subcortical interactions (including with the limbic system) exacerbate emotional stress, which further impairs cognitive resources. These mechanisms are used to explain why tinnitus is often associated with reduced cognitive performance, increased distractibility and increased mental fatigue. In some studies, the negative impact of tinnitus is stronger than that of the accompanying reduced hearing ability or psychological comorbidities such as stress or depression/anxiety. The pathophysiological links between tinnitus and cognitive impairment require multidimensional therapeutic approaches. Treatment should aim to reduce maladaptive plasticity and optimize cognitive control. An interdisciplinary approach that combines neurological, psychological and audiological interventions therefore appears necessary in order to sustainably reduce both tinnitus perception and the associated cognitive impairments.

Ménière's disease, characterized by episodic vertigo, sensorineural hearing loss, and tinnitus, is well-documented in humans but rarely reported in veterinary medicine. This case report describes a 15-year-old male mixed-breed dog with recurrent vestibular episodes lasting 30 min to several hours. Clinical signs included ataxia, head tilt, and nystagmus. MRI and diagnostic workups ruled out common structural causes of vestibular signs and ear diseases. Audiometric testing revealed bilateral sensorineural hearing loss with preserved high-frequency hearing in the right ear, a pattern resembling that seen in human Ménière's disease. While the dog improved with supportive care, multiple relapses occurred until the age of 18. This case suggests a Ménière's-like syndrome in dogs and highlights the need for hearing function assessments in idiopathic vestibular disease.

BACKGROUND Loss of smell can impair quality of life. Olfactory disorders are often caused by viral infections, including SARS-CoV-2. The aim of the study was to evaluate the effectiveness of a structured, multidisciplinary rehabilitation program, including pharmacological treatment and speech therapy-guided olfactory training, in patients with post-COVID olfactory disorders. MATERIAL AND METHODS A total of 75 patients (15 men, 60 women) were allocated to a study group (n=50) or control group (n=25) using a systematic assignment method. Both groups received the same pharmacological treatment (intranasal corticosteroids and topical vitamin A), saline nasal irrigation, and elements of speech therapy-guided olfactory training. In addition, the study group performed classical olfactory training using 4 odorants twice daily. Olfactory function was assessed using the Sniffin' Sticks Test (SST). RESULTS For the total SST score, the mean change before and after intervention in the study group was 7.9 points (P<0.001). In the control group, the mean change was 2.8 points (P=0.006). CONCLUSIONS Classical olfactory training was associated with greater improvement in post-COVID olfactory disorders compared with pharmacological treatment supplemented with speech therapy-guided olfactory training alone. The observed effects may be related to the combined use of intranasal corticosteroids, topical vitamin A, and saline nasal irrigation; however, the individual contribution of these interventions cannot be determined. The potential contribution of a multidisciplinary approach involving a physician, speech therapist, and psychologist remains to be established.

This retrospective study compared the efficacy and toxicity of concurrent triweekly versus weekly cisplatin in patients with previously untreated, biopsy-proven NPC who received definitive CRT followed by adjuvant chemotherapy. Patients with distant metastasis, Karnofsky Performance Status < 80, induction chemotherapy, or no adjuvant therapy were excluded. Medical records of 205 patients treated between June 2000 and June 2023 were reviewed. Patients received triweekly cisplatin (100 mg/m[2] every 3 weeks [administered as 50 mg/m[2] on days 1 and 2 every 21 days]) or weekly cisplatin (40 mg/m[2]), with radiotherapy to 70 Gy/35 fractions or 69.96 Gy/33 fractions. Treatment outcomes were analyzed using the Kaplan-Meier method and Cox proportional hazards model, while toxicity profiles were compared using the chi-square test. After a median follow-up of 76 months, the 10-year overall survival rate was 76.5%. The cumulative cisplatin dose was higher in the triweekly group (263.9 ± 50.1 vs. 247.8 ± 35.4 mg/m[2], p = 0.0107), while the weekly group included more patients older than 50 years (63.2% vs. 46.6%, p = 0.0338). No significant differences were observed between the triweekly and weekly groups in overall survival (p = 0.9096) and progression-free survival (p = 0.9186). The weekly cisplatin group exhibited a higher incidence of Grade 1-2 hypomagnesemia (p = 0.0415). Other acute toxicities, including gastrointestinal, renal, hematologic, otologic, neurologic, and electrolyte toxicities, as well as 1-year post-treatment kidney injury, hearing impairment, tinnitus, and peripheral neuropathy, were comparable between groups. These findings demonstrate similar survival outcomes and toxicity profiles between concurrent triweekly and weekly cisplatin regimens in NPC treated with curative CRT followed by adjuvant chemotherapy.

Sudden sensorineural hearing loss (SNHL) following non-otologic surgery is a rare but potentially devastating complication. We report a case of bilateral SNHL occurring after elective excision of a frontal bone osteoma under general anaesthesia. A 52-year-old woman with no prior hearing impairment developed profound bilateral hearing loss immediately on emergence from anaesthesia, with partial spontaneous improvement over hours and subsequent right-sided predominance with tinnitus. Imaging excluded ischaemic pathology. Audiometry demonstrated a transient bilateral noise-induced pattern, with persistent mild high-frequency SNHL on the right. Further investigation revealed bilateral superior semicircular canal dehiscence (SSCD). We propose that vibrational energy from intraoperative chiselling was abnormally transmitted to the inner ear via a pre-existing "third window" precipitating hearing loss. This case highlights a novel potential mechanism for postoperative SNHL in non-otologic surgery and raises important considerations regarding perioperative risk counselling for procedures involving skull vibration, particularly given the asymptomatic prevalence of SSCD.

Tinnitus refers to the subjective abnormal auditory perception occurring without external sound stimuli, characterized by prominent clinical heterogeneity and complicated pathophysiological mechanisms, which severely impair patients' mental health and quality of life. Adopting a standardized literature retrieval procedure, this paper systematically sorts out the epidemiological characteristics, clinical classifications and diagnostic criteria of tinnitus, and deeply analyzes its dual pathological mechanisms involving peripheral auditory damage (hair cell injury, auditory nerve lesions) and abnormal central nervous system plasticity (auditory cortex remodeling, neurotransmitter imbalance, abnormal activation of the limbic system). It systematically summarizes mainstream Western medical interventions and critically evaluates the clinical efficacy and inherent research limitations of pharmacotherapy, sound therapy, cognitive behavioral therapy, repetitive transcranial magnetic stimulation and other neuromodulation techniques. Meanwhile, it integrates the traditional theories, neuromodulatory mechanisms and available clinical trial evidence of acupuncture for tinnitus treatment. Existing basic and clinical studies indicate that acupuncture can alleviate tinnitus symptoms and regulate autonomic nervous disorders to a certain extent by improving cochlear microcirculation, upregulating the expression of inhibitory GABA neurotransmitters, and remodeling functional connectivity of the brain's default mode network. Nevertheless, clinical trials on acupuncture are plagued by remarkable methodological flaws: acupoint prescriptions and acupuncture manipulation protocols are highly heterogeneous, outcome assessment indicators are inconsistent, most studies adopt single-center small-sample designs, long-term follow-up data exceeding one year are scarce, psychological placebo effects cannot be fully isolated, and efficacy reports vary widely across studies. At present, unified high-quality evidence is still lacking to confirm its stable clinical efficacy. As a narrative review, this paper abandons one-sided positive narratives and applies consistent evaluation criteria to balance the comparison of merits and drawbacks of all Chinese and Western therapeutic interventions. It fully discloses the procedures of literature retrieval, screening and synthesis, aiming to provide objective and reproducible theoretical and clinical references for standardized comprehensive diagnosis and treatment of tinnitus as well as interdisciplinary basic mechanistic research.

Warthin tumour is a benign salivary gland neoplasm strongly associated with smoking and known for avid 18F-FDG uptake. We report a 53-year-old male chronic smoker presenting with tinnitus and ear pain. A resected brain mass demonstrated metastatic carcinoma (TTF-1 positive, CK7 diffuse). 18F-FDG PET/CT revealed a moderately 18F-FDG -avid left upper lobe pulmonary nodule and a small 18F-FDG -avid intraparotid lesion. Given the smoking history and imaging characteristics, Warthin tumour was favoured over metastasis. Lung biopsy confirmed moderately to poorly differentiated adenocarcinoma; parotid FNAC confirmed Warthin tumour. This case highlights the diagnostic pitfall of 18F-FDG -avid benign salivary lesions during lung cancer staging.