Functional development of auditory sensitivity in the fetus and neonate.

The human fetus responds to sound stimuli while still in utero. The rat and cat begin to hear only after birth. Therefore neonatal rat and cat are used as models of the development of auditory sensitivity in the human fetus. The inner ear of rat responds to stimuli delivered directly to it (bone conduction) before the middle ear can conduct sounds to the inner ear. During this period, middle ear development involves mesenchyme resorption, ossicular hardening and opening of the external canal. The latter stages of inner ear development involve increased magnitude of the endocochlear potential which augments cochlear transduction and the active cochlear amplifier. These developmental stages are probably controlled by thyroid hormone which activates several genes leading to the synthesis of proteins and enzymes required for the structural and functional maturation of the ear. This likely includes the Na+,K(+)-ATPase of the stria vascularis which generates the endocochlear potential. The magnitude of the endocochlear potential is dependent on oxygen supply so that the human fetus in utero whose blood carries less oxygen than the newborn has a hypoxia-induced sensorineural hearing loss. Upon birth and transition from placental to pulmonary oxygenation, the oxygen content of blood is increased, the magnitude of the endocochlear potential is elevated and auditory sensitivity is enhanced.