Hearing impairment affects 600M people worldwide.  It greatly decreases quality of life, particularly in the elderly, and constitutes an unmet health and medical need.  Regeneration of sensory auditory hair cells is not available as a medical technology.  In concordance with this topic call, we propose a novel strategy based on the development of a new technology, a micronutrient formulation implemented as a pill, to prevent damage, and perhaps recovery of auditory hair cells.  This SME-driven program is based on the scientific rationale that free radical formation and blood flow reduction underlie cell death in sensory systems in response to environmental stress and with aging.  In the auditory system, the stress of intense noise, drugs, cochlear implantation and aging lead to excess free radical formation, blood flow reduction, inner ear sensory cell loss, and irreversible hearing impairment.  Our aim is to demonstrate that a proprietary combination of antioxidants (Vitamins A, C, E) and a vasodilator (Mg++) effectively prevent/treat: 1) hearing loss in the elderly and 2) loss of residual hearing in the elderly and patients receiving cochlear implants.  A combination of human trials and animal studies will create a pathway to market and effectively translate this new technology to human application.