Dr. Konstantina Stankovic

Exactly.

Yes, indeed.

And some of these viruses, they stay dormant and live with us forever.

And then when the immune system gets weakened, then they can wreak havoc.

And some of the other viruses from the herpes family, like Epstein-Barr virus, CBV, it's actually linked to cancer, different cancer types, including nasopharyngeal cancer.

So that's yet another cause of hearing loss, infectious hearing loss.

Then there is immunologic hearing loss when there is no infection, but it's an inflammation such as people with celiac disease or rheumatoid arthritis.

They may have higher predisposition to developing hearing loss, not only because the little tiny joints in the middle ear become fixed and don't vibrate as well, but also because the inner ear is injured.

So when we now say sensory neural hearing loss, we actually cannot specifically say exactly what's wrong.

And the reason for that really goes back to the tiny size of the inner ear to the point that if you image it using the current state-of-the-art imaging tools that include computed tomography or a CT scan or MRI, which is magnetic resonance imaging, you don't see cells in the living human inner ear.

You just see a gray or white blob.

And the organ is too small to be detectable by technologies of that resolution.

Another issue is that you cannot biopsy it.

It's so tiny that if you did tissue biopsy, you would destroy it.

So that has really stimulated lots of very promising research in the area to improve diagnostics for hearing loss, which include both high resolution imaging of the inner ear and liquid biopsy as opposed to tissue biopsy.

And we have shown that if you take as little

as half a microliter of that fluid, perilymph, we can detect molecular differences between mice with or without hearing loss.

However, we have also collected this fluid from patients who undergo ear surgery.

It's either when we perform cochlear implantation for those who are profoundly deaf, or we literally have to drill through the inner ear to get to the brainstem because they have a tumor such as a vestibular schwannoma or an acoustic neuroma, which is a tumor that causes hearing loss.

So in these two instances,