Furthermore, we discovered that the pathways involving PTPRM: Ptprm − Ptprm, NRXN: Nrxn1 − Nlgn1, and COLLAGEN: Col1a2 − Sdc4/Cd44 exhibited similar downregulation trends in IC, with signals primarily originating from autocrine and paracrine secretion of BC across all three types of SNHL (Fig. 6). Here, CD44 is linked to breast cancer.