The mTOR Pathway in Hearing Disorders: Mechanistic Links to Aging, Regeneration, and Neurodegeneration

Hearing loss is a prevalent global health problem that most often arises from aging, noise exposure, ototoxic insults, or genetic defects. In addition to its well‑recognized social and economic burden, mounting evidence links hearing loss to neurological disorders such as Alzheimer's disease and dementia, underscoring the urgent need for effective curative strategies. Progress in regenerative therapies has been hindered by the limited capacity of mammalian auditory hair cells to regenerate, making a deep understanding of the underlying molecular pathology essential. The mechanistic target of rapamycin (mTOR), a master regulator of cell growth, metabolism, autophagy, and aging, has recently emerged as a key player in both auditory and neurological disorders. In this review, we summarize the current knowledge on how mTOR signaling shapes auditory cellular physiology, contributes to hearing disorder pathogenesis, and offers novel therapeutic entry points. We further explored the possibility that dysregulated mTOR activity may represent a missing mechanistic link between hearing loss and broader neurological disease processes.