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Evaluations in unilateral tinnitus patients have demonstrated a negative correlation between cochlear nerve fiber thickness and both hearing loss and tinnitus severity, with similar relationships observed in retinal nerve fiber layer thickness, suggesting a possible underlying neurodegenerative component in the disease etiology (Avcu et al., 2021)

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Another proposed mechanism involves the binding of homocysteine to the collagenous matrix of bone, which may modify collagen properties and reduce bone strength (reviewed in 113)