First, the goal

(or) refers to dysfunction of the inner ear or auditory nerve due to a variety of causes, including noise exposure, aging, infection, and drug toxicity. The main goal of treatment is to restore or improve hearing, reduce the symptoms of tinnitus, stabilize balance function. According to statistics from the Hong Kong Health Bureau, about 15% of adults face hearing impairment to varying degrees. That is why early diagnosis and appropriate treatment are important.

The goal of treatment can be divided into three levels: first, to stop or delay further nerve damage; Secondly, to improve existing symptoms with medications and assistive devices. Finally, we will explore innovative treatments to achieve nerve repair. For example, for people with sudden hearing loss, steroid therapy within 72 hours can significantly improve their chances of recovery. Patients with chronic tinnitus need long-term management that combines noise masking with psychological support.耳神經受損治療

2. Traditional methods of treatment

2.1 Medications

2.1.1 Sterols

Steroids such as prednisolone are the best medications to treat, especially for sudden hearing loss. Its mechanism of action consists in suppressing the inflammatory response of the inner ear and reducing neuroedema. The Hong Kong Association of Otorhinolaryngologists recommends the use of high doses of oral steroids within one week of onset, with an efficacy rate of about 60-70%. For patients who do not respond well to oral administration, intratympanic injection may be considered for delivery of the drug directly into the inner ear.

2.1.2 Other Anti-Inflammatory Drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can be used as adjunctive therapy for mild parotneuritis. In addition, antioxidants (such as ginkgo biloba extract) may act by improving microcirculation in the inner ear, but clinical evidence is limited.

2.1.3 Vasodilators

In case of ear nerve ischemia due to vascular factors (for example, complications of diabetes), the doctor may prescribe vasodilators (for example, betahistine). A study in Hong Kong showed that the combination of vasodilators and steroids increased the success rate of treatment by 12%.

2.2 Hearing aids: suitable for hearing loss

For irreversible hearing loss, digital hearing aids are the mainstream solution. Modern hearing aids distinguish between speech and ambient noise and connect to smart devices via Bluetooth. According to the Hong Kong Hearing Society, proper wearing of hearing aids can improve speech recognition by more than 40%.

2.3 噪音掩蔽器：適用於耳鳴

People with chronic tinnitus often use white noise generators or special tinnitus masks. Its principle is to reduce the perception of tinnitus in the brain through external acoustic stimuli. According to clinical data, approximately 50% of patients report a reduction in symptoms after 3 months of continuous use.

2.4 Vestibular rehabilitation: for balance problems

Damage to the vestibular nerve can cause dizziness and impaired balance. Head movement exercises devised by physiotherapists (e.g. Eppley's Maneuverry) can promote central complacency, and data from the Prince of Wales Hospital in Hong Kong shows that 80% of patients have significantly improved their symptoms after six weeks of training.

3. Innovative Therapies

3.1 Stem Cell Therapy: Research Progress and Potential

The University of Hong Kong School of Medicine conducts animal experiments on stem cell repair of cochlear hair cells. Preliminary results suggest that induced pluripotent stem cells (iPSCs) can differentiate into electrophysiologically active auditory neurons, which may be available for human clinical trials in the future.

3.2 Gene Therapy: For Hereditary Hearing Loss

About 50% of hearing loss in children is related to genetic mutations. CRISPR gene editing technology has successfully repaired a defect in the GJB2 gene in an animal model and restored some auditory function. HKSTP's biotechnology team is developing a vector delivery system for common mutations in Hong Kong.

3.3 Nerve stimulation: directly stimulates the auricular nerve

Percutaneous vagus nerve stimulation (tVNS) is a non-invasive treatment that modulates abnormal activity of the auditory center through electrical stimulation. A study from the University of Hong Kong in China has confirmed that a combination of sound therapy can reduce tinnitus volume by 30%.

3.4 The drug is delivered directly to the inner ear

Novel nanocarriers, such as liposomes, can penetrate circular window membranes and accurately deliver drugs to the inner ear. Compared to systemic administration, topical administration can increase drug concentrations up to 20 times while avoiding hepatorenphrotoxicity. The extended-release system developed by the Hong Kong Polytechnic University has entered a phase II clinical trial.

4. Treatment Selection Considerations

• Degree of loss: Mild disability may require medication only, and severe cases may consider a cochlear implant
• pathogen: Antibiotics are needed for infections (e.g., menarche), and immunosuppressants are needed for autoimmune diseases
• Patient Health: Older people should assess the risk of polypharmacy, and children are focused on language development

5. Future Prospects

With the development of bioelectromedicine, implantable neuroprostheses may be able to directly connect auditory and brain signals. The Hong Kong government has allocated HK$200 million to support hearing research, and it is expected that 3-5 innovative treatments will be launched by 2030.

6. Overview

It is necessary to individualize and integrate traditional and innovative methods. Early intervention and interdisciplinary collaboration are key. Patients should visit a hearing centre accredited by the Hong Kong Department of Health for regular assessments to keep abreast of the latest international treatment progress.

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