In the auditory system, ribbon synapses are vesicle-associated structures located between inner hair cells (IHCs) and spiral ganglion neurons that are implicated in the modulation of trafficking and fusion of synaptic vesicles at the presynaptic terminals. Synapse loss may result in hearing loss and difficulties with understanding speech in a noisy environment. This phenomenon happens without permanent hearing loss; that is, the cochlear synaptopathy is “hidden.” Recent studies have reported that synapse loss might be critical in the pathogenesis of hidden hearing loss. A better understanding of the molecular mechanisms of the formation, structure, regeneration, and protection of ribbon synapses will assist in the design of potential therapeutic strategies. In this review, we describe and summarize the following aspects of ribbon synapses: (1) functional and structural features, (2) potential mechanisms of damage, (3) therapeutic research on protecting the synapses, and (4) the role of synaptic regeneration in auditory neuropathy and the current options for synapse rehabilitation.

中文翻译：

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保护耳蜗带突触和预防隐性听力损失

在听觉系统中，带状突触是位于内毛细胞 (IHC) 和螺旋神经节神经元之间的囊泡相关结构，这些结构涉及突触前末梢突触囊泡的运输和融合的调节。突触损失可能导致听力损失和在嘈杂环境中难以理解语音。这种现象不会发生永久性听力损失；也就是说，耳蜗突触是“隐藏的”。最近的研究报告称，突触损失可能在隐性听力损失的发病机制中起关键作用。更好地了解带状突触的形成、结构、再生和保护的分子机制将有助于设计潜在的治疗策略。在这篇综述中，我们描述和总结了带状突触的以下几个方面：