Building on our findings that TNF-α contributes to both VS tumor growth and auditory dysfunction, and recognizing the strong correlation between TWEAK secretion and hearing impairment in patients with VS with high TNF-α secretory capacity, we demonstrated for the first time that tumor secretions, specifically TNF-α and TWEAK, can reach the inner ear in a mouse model of VS-induced SNHL. Here, TNF is linked to Hearing impairment.