“…Heritability estimates for ARHL lie between 35% and 70% (Christensen, Frederiksen, Frederiksen, & Hoffman, 2001;Gates, Couropmitree, Couropmitree, & Myers, 1999;Hendrickx et al, 2013;Raynor et al, 2009) and noise exposure is a major environmental component that is difficult to separate from the underlying genetic basis (Liberman, 2017;Van Eyken, Van Camp, & Van Laer, 2007). Studies in aged animals and human temporal bones have given great insight into the histological deficit with degenerative changes in the sensory hair cells, the spiral ganglion neurons, and the stria vascularis predominantly described; Figure 1 (Keithley, 2019;Ohlemiller, 2004;Schuknecht, 1964;Schuknecht & Gacek, 1993).…”