Hypoxic MSC-Derived Extracellular Vesicles Target Photothermal Injury Induced Oxidative Stress to Protect the Facial Nerve

Functionally, hypo-sEVs attenuated oxidative stress and promoted the survival, proliferation, and migration of Schwann cells. In the rat facial nerve injury model, local delivery of hypo-sEVs using a hydrogel system significantly improved facial nerve functional recovery, electrophysiological conduction, and histological integrity. RNA-seq further demonstrated that hypo-sEVs treatment modulated gene programs related to neural repair, extracellular matrix remodeling, and oxidative stress regulation.

Together, these findings identify photothermal exposure as an underrecognized contributor to facial nerve injury during endoscopic surgery and propose a ROS-oriented therapeutic strategy to mitigate neuroinflammation and promote neural repair.