Contributing factors to noise-induced hearing loss and their interactions

Noise-related dysfunction of the stria vascularis leads to ischemia-reperfusion injury, which increases the level of reactive oxygen species (ROS) in the cochlea. The overproduction of ROS and cochlear inflammation are two biochemical events that promote each other. With excessive calcium influx triggering glutamate neurotoxicity at the ribbon synapses, both hair cells and synaptic structures are damaged, triggering intrinsic or extrinsic pathways of apoptosis. Abbreviations: ROS: reactive oxygen species; GluR: glutamate receptor. (Source: Xu K, Xu B, Gu J, Wang X, Yu D, Chen Y. Intrinsic mechanism and pharmacologic treatments of noise-induced hearing loss. Theranostics 2023;13[11]:3524-9. Creative Commons Attribution 4.0 International [CC BY 4.0] license, creativecommons.org/licenses/by/4.0.)