The Potential Role of Auditory Nerve Development in Sensorineural Hearing Loss: from Pathophysiology to Treatment Insights.

Sensorineural hearing loss (SNHL), as one of the most common types of hearing impairment, has seen a continuous increase in global incidence. It has seriously affected patients' quality of life and is closely associated with a range of psychological and mental health issues, while also posing a significant burden on healthcare systems. It is known that the etiologies of SNHL mainly include environmental factors (such as noise exposure, ototoxic drugs, and viral infections), genetic factors (including relevant gene mutations), and age-related degenerative changes in the auditory system (presbycusis). These pathogenic factors, whether acting individually or synergistically, can interfere with the normal development and function of the auditory nerves, resulting in damage to cochlear hair cells and auditory neurons, thereby causing irreversible hearing impairment. Therefore, a deep understanding of the regulatory mechanisms of auditory nerve development, structural and functional maturation, as well as its survival capacity and plasticity changes after injury, is crucial for elucidating the pathological basis of SNHL heterogeneity and promoting the development of precise treatment strategies. This article systematically reviews the molecular basis of auditory nerve development, the related pathological mechanisms, and causes of injury, while also exploring the cutting-edge therapeutic advances in this field, aiming to provide new insights for clinical interventions in sensorineural hearing loss and ultimately improve patients' auditory function and quality of life.