MMP14 and neoplasm: Our study is novel for several reasons: (1) we discovered MMP-14, a member of the membrane-type MMP family with previously unknown roles in VS, that was significantly upregulated in VS; (2) using a new functional assay of MMP-14 proteolytic activity, we found significant differences between patients who underwent GTR compared to those with STR; (3) we identified an expanded set of protease candidate markers aberrantly expressed in primary VS tumor cultures; and (4) we provided the first mechanistic demonstration that MMP-14 leads to cochlear damage in a cochlear explant model.