Animal studies demonstrate that noise exposure can permanently damage the synapses
between inner hair cells and auditory nerve fibers, even when outer hair cells are intact and
there is no clinically relevant permanent threshold shift. Synaptopathy disrupts the afferent
connection between the cochlea and the central auditory system and is predicted to impair
speech understanding in noisy environments and potentially result in tinnitus and/or
hyperacusis. While cochlear synaptopathy has been demonstrated in numerous …