A 62-year-old man with a 10-year history of progressive bilateral high-frequency hearing loss presents to the audiology clinic. Pure-tone audiometry shows symmetric sensorineural hearing loss worse at 3–6 kHz. The SISI test is performed at 1000 Hz, 20 dB above threshold, with 1-dB intensity increments presented every 5 seconds. The patient detects 16 out of 20 increments, yielding a SISI score of 80%. The structure marked **A** in the diagram represents this finding. Which of the following best explains the underlying pathophysiology of this SISI result?
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