Compared with normal stapes tissue samples, the mRNA expression of OPG is reduced in patients with otosclerosis.35, 36 In addition, homozygous mutations in TNFRSF11B play a role in Paget’s disease, which may also lead to hearing loss,37 making it an interesting candidate gene for otosclerosis. The gene discussed is TNFRSF11B; the disease is otosclerosis.