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<jats:p>Presbycusis, also known as age\u2010related hearing loss (ARHL), is a progressive auditory impairment and ranks among the most prevalent sensory disorders in the elderly population. It is primarily caused by damage to hair cells, degeneration of spiral ganglion neurons, and atrophy of the stria vascularis, which are integral components of the cochlea. While extensive research has been devoted to hair cells and spiral ganglion neurons, this review focuses on the critical role of the stria vascularis in ARHL. The primary function of the stria vascularis is to maintain the endocochlear potential, which is essential for hearing. This review presents an overview of the research concerning the stria vascularis in ARHL, particularly focusing on the application of single\u2010cell transcriptomics to elucidate its role. Furthermore, this review explores relevant signaling pathways and therapeutic strategies for ARHL. By enhancing the understanding of the stria vascularis in ARHL, this review aims to pave the way for personalized treatment and improved strategies for protection and prevention.<\/jats:p>","DOI":"10.1002\/advs.202410413","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T08:41:45Z","timestamp":1748335305000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Presbycusis: Pathology, Signal Pathways, and Therapeutic Strategy"],"prefix":"10.1002","volume":"12","author":[{"given":"Xiaoxu","family":"Zhao","sequence":"first","affiliation":[{"name":"Medical Science and Technology Innovation Center Shandong First Medical University &amp; Shandong Academy of Medical Sciences  Jinan Shandong 250117 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head &amp; Neck Surgery West China Hospital Sichuan University  Chengdu 610072 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengda","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Qilu Hospital of Shandong University NHC Key Laboratory of Otorhinolaryngology (Shandong University)  Jinan Shandong 250117 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyi","family":"Liu","sequence":"additional","affiliation":[{"name":"Medical Science and Technology Innovation Center Shandong First Medical University &amp; 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