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From vestibular migraine to cochlear migraine

Ma X, Chen GG, Liu KM, Xiao ZM, Li F, Zhu JH, Zhang SL

Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery, 2026

Abstract

While diagnosis and treatment consensus has been established for vestibular migraine, migraine-related cochlear manifestations (such as sudden/progressive sensorineural hearing loss, tinnitus, and aural fullness, otalgia) still face high rates of misdiagnosis and missed diagnosis. With the proposal of the "cochlear migraine" concept, the establishment of interdisciplinary precise classification is urgently needed. To this end, multidisciplinary experts held a discussion on the hotspots in this field. This article systematically reviews the cognitive evolution of migraine in neuro-otology, comments on the phenotypes and mechanisms of cochlear symptoms, and explores future pathways for precise classification and targeted intervention, aiming to expand clinical thinking and promote the standardized management of this disease.

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