Table 3.

Overview of antioxidant therapy in otorhinolaryngological diseases.

Antioxidant therapy	Disease	Study design	Antioxidant Effects	References
Global antioxidants Vitamin C	ARHL AR	Clinical research	Vitamin C intake, improvement in mid-frequency hearing (2000 and 3000 Hz) Dietary Vitamin C intake, no association with AR	Kang JW et al[97]. García-García C et al[98].
Vitamin E	Otitis Media AR OSA	Clinical research	No effect on the occurrence of chronic suppurative otitis media with or without cholesteatoma. Supplementation with vitamin E (400 IU/d) has no significant effect on perennial AR Vitamin E (800 mg/day) significantly alleviates daily nasal symptoms in patients with seasonal allergic rhinitis. Improves endothelial function, reduces oxidative stress, and enhances sleep parameters	Boesoirie SF et al[100]. Montaño Velázquez BB et al[101]. Shahar E et al[102]. Boppana TK et al[103].
NAC	CIHL SSNHL NIHL AR OSA	Clinical research	Alleviates cisplatin-induced hearing loss Alleviates hearing loss Secondary outcomes and post-hoc analyses indicate that NAC treatment is superior to placebo Reduce nasal symptoms caused by ragweed allergy Improves sleep disorders by attenuating oxidative stress	Orgel E et al[104]. Bai X et al[105]. Kopke R et al[106]. C.J. Lane et al[107]. Wu K et al [109].
Natural Extracts Targeted Antioxidants Resveratrol	NIHL ARHL CRSwNP AR OSA	Animal study (Noise-exposed mouse model) Animal study (age-related mouse model) Animal study (OVA + SEB - induced mouse model) Animal study (OVA - induced mouse model) Animal study (Chronic intermittent hypoxia mouse model)	Improvement of cochlear synaptic loss Significantly reduces the expression of RIPK3, RIPK1, and MLKL during cochlear aging Reducing nasal mucosa eosinophil infiltration and the degree of subepithelial fibrosis Inhibiting the TXNIP oxidative stress pathway to exert anti-allergic and anti-inflammatory effects Mitigating OSA-associated cardiac damage by targeting Nrf2	Yamaguchi T et al[113]. Yang Z et al[114]. Kim S.W et al[115]. Zhang W et al[116]. Sun Z.M et al[117].
Curcumin	ARHL AR OSA	Animal study (age-related mouse model) Clinical research Human study (nasal fibroblasts) Animal study (Chronic intermittent hypoxia mouse model)	Activate the Nrf2 signaling pathway to prevent mitochondrial dysfunction in hair cells Reduced nasal airflow resistance alleviates nasal symptoms (sneezing and runny nose) and nasal congestion. Activating the Nrf2/HO-1 pathway inhibits oxidative stress in nasal fibroblasts induced by particulate matter. Inhibiting AQP4 and p38 MAPK pathways alleviates brain injury caused by chronic intermittent hypoxia	Li N et al[119]. Wu S et al[120]. Kim J.S et al[121]. Wang B et al[122].
Quercetin	NIHL Otitis Media AR CRS	Animal study (Noise-exposed guinea pig model) Animal study (NTHi induced mouse model) Animal study (OVA - induced mouse model) Animal study (TDI - induced mouse model) Animal and Human study (HSNE and MNSE)	Prevent hair cell loss in the cochlea of guinea pigs Inhibit IKKβ phosphorylation and p38 MAPK to block CXCR4 activation. Improving the imbalance between Th1/Th2 cells and Treg/Th17 cells. Inhibiting nasal rubbing and sneezing in allergic rhinitis (AR) rats Increasing chloride ion transport and ciliary beat frequency in nasal epithelial cells	Hirose, Y et al[123]. Ma Y.K et al[124]. Ke X et al[125]. Kashiwabara M et al[126]. Zhang S et al[127].
Sulforaphane	CIHL AR CRS OSA	Animal study (cisplatin -induced rat model Human study (HSNECs) Human study (SEC) Animal study (Chronic intermittent hypoxia mouse model)	Reduced cisplatin-induced loss of outer hair cells and restored ciliary morphology Restored ZO-1 levels reduced by HDM after activating Nrf2 Suppress apoptosis of sinonasal epithelial cells induced by levofloxacin Activate the Nrf2 pathway to enhance SOD activity and reduce MDA levels to improve cognitive dysfunction Nrf2 functions to reduce cardiac fibrosis and inflammation induced by intermittent hypoxia	Wang J et al[128]. London N.R.Jr et al[129]. Kohanski M.A et al[130]. Qiu X et al. Li X et al. Wang J et al[96, 131].
Catechins	CIHL AR	Animal study (Aminoglycoside-induced Zebrafish model) cisplatin -induced Rat model Animal study (OVA - induced mouse model)	Reduces oxidative stress and apoptosis, significantly protecting inner ear hair cells Reduces oxidative stress and apoptosis markers while preserving the antitumor effects of cisplatin Reduces serum IgE levels, COX-2, IL-1β, IL-4, and IL-6 mRNA and protein expression in nasal mucosa Restores the balance between Th2 and Th1 cell types	Zong Y et al[132]. Borse V et al[133]. Fu M et al. Pan Z et al[134, 135].