Limitation
Our study has several limitations.
1. Because EH cannot be detected pathologically in vivo, the presence of EH cannot be confirmed through pathological means in this study. Therefore, animal experiments are necessary to further validate our hypothesis.
2. Our study was limited by the absence of a healthy control group, and previous research has indicated that unilateral MD may progress to bilateral involvement over time19. Although no EH or hearing loss were detected in the unaffected side of our patients, it is possible that some microscopic structures have undergone changes, which could potentially impact the precision of our findings.