Hair cell innervation in the fetal human cochlea.

Twelve cochleas from human fetuses ranging in age from 13 to 22 gestational weeks were investigated by transmission electron microscopy in order to follow the development of hair cell innervation. First, we were able to confirm the two general gradients of cochlear maturation, i.e. 'internal-to-external' and 'base-to-apex'. In the 14th week of gestation, the inner hair cell pattern of innervation was almost mature, with well formed afferent synapses and axo-dendritic efferent contacts. At the outer hair cell level, only afferents, probably both spiral and radial ones, were present up to week 16. At week 22, axo-somatic synapses were observed between the medial efferents and the outer hair cells, but they were not yet completely mature. At this stage the myelination had begun within the spiral lamina fibres. These findings confirmed that the different stages of synaptogenesis in the human cochlea are similar to that described in other mammals, and thus the same kind of functional relationships could be proposed.