感音神经性聋(sensorineural hearing loss,SNHL)是耳科学领域难点及热点问题,内耳毛细胞和螺旋神经元(spiral ganglion neurons,SGNs)的损伤是导致SNHL的主要因素之一,目前治疗SNHL的方法主要有助听器或人工耳蜗植入(cochlear implant,CI),但都无法恢复正常的听觉结构,治疗效果不佳.近年来,有学者提出是否能将干细胞移植与人工耳蜗植入相结合,以实现SGNs损伤修复从而提高人工耳蜗植入的效能,而骨髓间充质干细胞(bone mesenchymal stem cells,BMSCs)由于其高扩增潜能,遗传稳定,易于分离培养,低免疫源性和免疫调节功能,近几年成为现代生物学和医学的研究热点,且已被多个临床试验证实具有很大的临床应用潜能,可被应用于组织损伤修复,如心肌梗死、脊柱及脑损伤、软骨及骨损伤.本文将从SGNs数量与人工耳蜗植入效果的关系、BMSCs移植实现SGNs再生或修复几方面进行综述,包括探讨人工耳蜗植入联合干细胞移植面临的治疗难点.%Sensorineural hearing loss(SNHL)is a difficult and hot issue in the field of otology.The damage of in-ner ear hair cells and spiral ganglion neurons(SGNs)is one of the major factors leading to SNHL.Treatment or rehabili-tation for sensorineural hearing loss can be achieved with hearing aids or cochlear implants,but none of them can re-store the normal auditory structures and the outcomes are often unsatisfactory.In recent years,some scholars have ques-tioned whether cochlear implants can be combined with stem cell transplantation to improve the efficacy of cochlear im-plants.Bone mesenchymal stem cells(BMSCs)have become a research hotspot in modern biology and medicine in re-cent years due to their high amplification potentials,ease to isolate and culture,low immunogenicity and immunomodu-latory functions.BMSCs have been confirmed by a number of clinical trials to have great potentials for clinical applica-tions in tissue damage repair,such as for myocardial infarction,brain injury,and cartilage and bone damage.In this re-view,we will review the relationship between the number of SGNs and efficacy of cochlear implants and transplantation of BMSCs for SGN regeneration/repair,covering challenges in combining cochlear implantation and stem cell transplan-tation.
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