[Expert consensus on diagnosis and treatment of refractory inner ear disease (2026 edition)].

Refractory inner ear disease (RIED) encompasses a group of diseases in which pathologic lesions involve both the cochlea and vestibule, disrupting auditory-vestibular conduction pathways and their central projections. Clinically, RIED typically manifests as varying combinations of hearing loss, tinnitus, and vertigo. Despite adherence to standardized treatment protocols recommended by current clinical guidelines, a subset of inner ear diseases remain resistant to therapy and fail to achieve satisfactory outcomes. Recent epidemiological studies from both domestic and international sources indicate an increasing incidence of RIED, which not only compromises patients' hearing and balance function but also exerts profound effects on quality of life, mental health and social participation. These challenges impose a growing burden on healthcare systems and highlight the urgent need for more effective, evidence-based management strategies. To address these issues, a multidisciplinary expert panel encompassing otolaryngology, audiology, vestibular medicine, public health, and basic science in China has established the "China Consortium for Refractory Inner Ear Diseases" and formulated the "Expert consensus on the diagnosis and treatment of refractory inner ear disease (RIED)". This consensus comprehensively reviews the current understanding of RIED, including its epidemiology, pathogenesis, diagnostic criteria, differential diagnosis, therapeutic interventions, and long-term management. It further provides structured recommendations designed to promote standardization of clinical practice and improve diagnostic accuracy and treatment efficacy for RIED in China.