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NAD+ supports mitochondrial energy production and activates DNA-repair enzymes and sirtuins, while glutathione defends cells against the oxidative stress that can accelerate aging

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Background Epidemiology and clinical burden Reported ototoxicity rates range from 2% to 63% across pediatric populations, reflecting differences in monitoring intensity, diagnostic thresholds, follow-up duration, and population risk profiles ( The inner ear is one of the three anatomical parts of the ear, consisting of the cochlea and the vestibular apparatus (semicircular canals, utricle, and saccule), which together constitute the membranous labyrinth, a fluid-filled (endolymph) system of sensory structures (Figure 1) ( FIGURE 1 Neonatal Vulnerability Age makes a significant difference