TNF and hearing loss disorder: Additionally, the link between TNF-α and hearing loss is reinforced by numerous studies [67], including those reporting that TNF-α is one of the most upregulated cytokines in the perilymph 6 h after noise exposure [68], acute intracochlear perfusion of TNF-α induces SNHL and synaptic degeneration [69], and polymorphisms in human TNF-α are associated with the risk of noise-related tinnitus [70] and age-related hearing loss [71].