Comprehensive reviews emphasize that mitochondrial dysfunction—characterized by diminished ATP synthesis and elevated ROS—is central to NIHL pathogenesis; given ATP6’s and CYB’s roles in complexes V and III, respectively, epigenetic regulation of these genes is biologically plausible and merits further study (Mao and Chen, 2021; Zou et al., 2022). This evidence concerns the gene MT-ATP6 and noise induced hearing loss.