BGDB Face and Ear - Fetal

From Embryology
BGDsmall.jpg
Practical 6: Trilaminar Embryo | Early Embryo | Late Embryo | Fetal | Postnatal | Abnormalities



Fetal Growth

<html5media height="480" width="400">File:fetal growth.mp4</html5media>

Click Here to play on mobile device

Links: Fetal Development Movie | MP4 movie | Fetal Development


In this cartoon movie of fetal growth, observe the changing relative sizes of the head, body and limbs.


Then consider fetal skeletal changes occurring within the head associated with ossification processes and palate development.


Finally consider fetal changes that are occurring in auditory pathway.

Fetal Head Growth

Fetal head growth circumference graph01.jpg

Head Circumference Growth (both gestational and post-fertilisation ages are shown)

Skull Ossification

Mall1906 fig04.jpg Mesial view of fetal head (CRL 54 mm)

The centers of the occipital bone surround the foramen magnum.

  • foramen magnum - large oval opening (foramen) in the occipital bone of the skull.

Behind the maxilla may be seen the palate, the pterygoid, and the alisphenoid in order.

  • pterygoid - a paired bone forming part of the palate lies behind the palatine bones.
  • alisphenoid - a wing-like cartilaginous bone within the skull forms part of the eye socket.

These are 2 views of the same 12 week 92 mm CRL human fetus head, double stained to show both cartilage (blue) and newly-formed bone (red). The head undergoes two different forms of ossification (endochondral and intramembranous) in separate regions of the skull.

Lateral view (external) Medial view (internal)
Fetal head lateral.jpg Fetal head medial.jpg
Note the distribution of new bone formation by intramembranous ossification in the plates of the cranial vault, temporal bone, orbit, upper jaw (maxilla) and lower jaw (mandible) regions. Bony regions in the lower jaw (mandible) region also show spaces where tooth formation is occurring. Note the distribution of cartilage from the nasal region through the base of the skull showing endochondral ossification, also occuring in the atlas/axis (with new bone forming). See also the original Meckel's cartilage within the newly forming bony mandible.

Skull superior.gif

Late Fetal Skull

Mandible Ossification

Ossification centre.jpg Intramembranous ossification centre.jpg

Face

The cartilage template of the mandible and the base of the skull are replaced by early bone development.

Fetal head section.jpg Fetal head section 01.jpg

Selected midline medial head view showing key features of head musculoskeletal and neurological development.

Note extensive nasal cartilage, nasal conchae, pituitary, secondary palate, oral cavity, tongue, mandible, hyoid, choana, oropharynx.

Also note the developing tongue musculature and its mandibular attachment site.


Note that the cranial vault, the portion of the skull enclosing the brain, ossifies by a unique bone formation process, intramembranous ossification.

Because the head contains many different structures also review notes on Special Senses (eye, ear, nose), Respiration (pharynx), Integumentary (Teeth), Endocrine (thyroid, parathyroid, pituitary) and Musculoskeletal (tongue, skull).

Palate Development

Secondary palate formation is the growth of the palatal shelves towards the midline.

Inferior view Anterior view
<html5media height="400" width="400">File:Palate_001.mp4</html5media> <html5media height="400" width="400">File:Palate_002.mp4</html5media>
Palate 001 icon.jpg Palate 002 icon.jpg
Early Fetal Palate
Palate 001 icon.jpg
 ‎‎Palate (oral view)
Page | Play
Palate 002 icon.jpg
 ‎‎Palate (front view)
Page | Play
Palate Overview

Embryonic

  • week 4 - pharyngeal arch formation, first pharngeal arch contributes mandible and maxilla.
  • week 6 - 7 - primary palate formation maxillary processes and frontonasal prominence.

Fetal

  • week 9 - secondary palate shelves fuse, separating oral and nasal cavities.

Week 10 Gestational Age (GA week 12)

Fetal week 10 hard palate 07.jpg

hard palate

Fetal week 10 soft palate 03.jpg

soft palate

Hearing

Hearing Timeline
Developmental Time Event
Week 9 Mesenchyme surrounding membranous labryinth (otic capsule) chondrifies.
Week 12-16 Capsule adjacent to membranous labryinth undegoes vacuolization to form a cavity (perilymphatic space) around membranous labrynth and fills with perilymph.
Week 18 ectodermal plug in external auditory meatus breaks down.
Week 16 - 24 Centres of endochondral ossification appear in remaining cartilage of otic capsule form petrous portion of temporal bone. Continues to ossify to form mastoid process of temporal bone.
Week 18 - 22 Organ of corti structural elements develop. (GA 20 - 24 weeks)
26 weeks human brainstem auditory pathway is anatomically formed.
28 weeks AABR can be recorded.
3rd Trimester Vibration acoustically of maternal abdominal wall induces startle response in fetus.
Links: hearing | timeline


Organ of Corti

Early fetal cochlea week 8.4 (GA 10.4) and week 10 (GA 12)[1]

Note Kölliker’s organ (KO), a transient epithelial structure that is the source of the future sensory cells.



Week 8.4 Week 10
Human fetal cochlea basal turn week 8.4 Human fetal cochlea basal turn week 10



Adult organ of Corti (mouse) that develops through the fetal period.

Mouse organ of corti 02.jpg Mouse organ of corti 03.jpg


Links: inner ear

Central Pathway

  • 26 weeks - human brainstem auditory pathway is anatomically formed.
  • 28 weeks - AABR can be recorded.

less than 34 weeks - latencies of AABR components (I, III, and V) decrease as a function of gestation

Auditory neural pathway.jpg

Auditory neural pathway


Fetal Interactive Component

Attempt the Quiz - Fetal 
BGDsmall.jpg

Here are a few simple Quiz questions that relate to Fetal development from the lecture and practical.

  

1 The bones of the adult skull form only by the process

  intramembranous ossification
  endochondral ossification
  neither intramembranous or endochondral ossification
  intramembranous and not endochondral ossification
  both intramembranous and endochondral ossification
  chondroblast cell replacement of osteoblast cells

2 The secondary palate can be divided into two anatomical parts:

  the maxillary components of the first pharyngeal arch
  the frontonasal prominence
  the anterior hard palate
  posterior soft palate


BGDsmall.jpg
Practical 6: Trilaminar Embryo | Early Embryo | Late Embryo | Fetal | Postnatal | Abnormalities


BGDsmall.jpg
Practical 6: Trilaminar Embryo | Early Embryo | Late Embryo | Fetal | Postnatal | Abnormalities


Additional Information

Additional Information - Content shown under this heading is not part of the material covered in this class. It is provided for those students who would like to know about some concepts or current research in topics related to the current class page.
Palate Development (expand to see terms)  
  • cleft - An anatomical gap or space occuring in abnormal development in or between structures. Most commonly associated with cleft lip and cleft palate. Term is also used to describe the external groove that forms between each pharyngeal arch during their formation.
  • cleft lip - An abnormality of face development leading to an opening in the upper lip. Clefting of the lip and or palate occurs with 300+ different abnormalities. Depending on many factors, this cleft may extend further into the oral cavity leading to a cleft palate. In most cases clefting of the lip and palate can be repaired by surgery.
  • cleft palate - An abnormality of face development leading to an opening in the palate, the roof of the oral cavity between the mouth and the nose. Clefting of the lip and or palate occurs with 300+ different abnormalities. In most cases clefting of the lip and palate can be repaired by surgery. Palate formation in the embryo occurs at two distinct times and developmental processes called primary and secondary palate formation. This leads to different forms (classifications) and degrees of clefting.
  • hard palate - anterior part of the palate that becomes ossified. The posterior palate part is the soft palate.
  • epithelial mesenchymal transition - (EMT, epitheliomesenchymal transformation) conversion of an epithelium into a mesenchymal (connective tissue) cellular organization. Process required during lip and palate developmental fusion.
  • epitheliomesenchymal transformation - (epithelial mesenchymal transition) conversion of an epithelium into a mesenchymal (connective tissue) cellular organization.
  • incisive papilla - anterior midline palate near the incisors lying at the end of the palatine raphe.
  • levator veli palatini - Muscle forming part of the soft palate, elevates the soft palate for swallowing.
  • mastication - (chewing) Process of crushing and grinding food within the mouth.
  • maxilla - (pl. maxillae) upper jaw bone forming from the maxillary process of the first pharyngeal arch.
  • medial edge epithelial - (MEE) opposing palatal shelves adhere to each other to form this epithelial seam.
  • musculus uvulae Small muscle forming part of the soft palate lying within the uvula, shortens and broadens the uvula.
  • palatine raphe (median raphe) palate midline ridge (seam) of the mucosa, from the incisive papilla to the uvula.
  • palatal rugae - (palatine rugae, rugae) Transverse series of ridges forming on the secondary hard palate that are sequentially added during development as the palate grows. Involved in the process of mastication.
  • palatal vault - (palatine vault) Term describing the curved "arch" shape of the palate that mainly develops postnatally.
  • palate - The roof of the mouth (oral cavity) a structure which separates the oral from the nasal cavity. Develops as two lateral palatal shelves which grow and fuse in the midline. Initally a primary palate forms with fusion of the maxillary processes with the nasal processes in early face formation. Later the secondary palate forms the anterior hard palate which will ossify and separate the oral and nasal cavities. The posterior part of the palate is called the soft palate (velum, muscular palate) and contains no bone. Abnormalities of palatal shelf fusion can lead to cleft palate.
  • palatine bones - Two bones that with the maxillae form the hard palate.
  • palatogenesis - The process of palate formation, divided into primary and secondary palate development.
  • palatoglossus - (glossopalatinus, palatoglossal muscle) Small muscle forming part of the soft palate required for swallowing.
  • palatopharyngeus - (palatopharyngeal or pharyngopalatinus) Small muscle forming part of the soft palate required for breathing.
  • pharyngeal arch - (branchial arch, Greek, branchial = gill) These are a series of externally visible anterior tissue bands lying under the early brain that give rise to the structures of the head and neck. In humans, five arches form (1,2,3,4 and 6) but only four are externally visible on the embryo. Each arch has initially identical structures: an internal endodermal pouch, a mesenchymal (mesoderm and neural crest) core, a membrane (endoderm and ectoderm) and external cleft (ectoderm). Each arch mesenchymal core also contains similar components: blood vessel, nerve, muscular, cartilage. Each arch though initially formed from similar components will differentiate to form different head and neck structures.
  • philtrum - (infranasal depression, Greek, philtron = "to love" or "to kiss") Anatomically the surface midline vertical groove in the upper lip. Embryonically formed by the fusion of the frontonasal prominence (FNP) with the two maxillary processes of the first pharyngeal arch. Cleft palate (primary palate) occurs if these three regions fail to fuse during development. Fetal alcohol syndrome is also indicated by flatness and extension of this upper lip region.
  • soft palate - (velum, muscular palate) posterior part of the palate that becomes muscular. Forms 5 muscles: tensor veli palatini, palatoglossus, palatopharyngeus, levator veli palatini, musculus uvulae. The anterior palate part is the hard palate.
  • T-box 22 - (TBX22) a transcription factor that cause X-linked cleft palate and ankyloglossia in humans. Tbx22 is induced by fibroblast growth factor 8 (FGF8) in the early face while bone morphogenic protein 4 (BMP4) represses and therefore restricts its expression. (More? OMIM - TBX22)
  • tensor veli palatini - (tensor palati, tensor muscle of the velum palatinum) Small muscle forming part of the soft palate required for swallowing.
  • Transforming Growth Factor-beta - (TGFβ) factors induces both epithelial mesenchymal transition and/or apoptosis during palatal medial edge seam disintegration.
  • uvula - (Latin = a little grape) a pendulous posterior end of soft palate used to produce guttural consonants. First named in 1695.
  • Van der Woude syndrome - common syndromic cause of clefting (2% of cleft lip and palates). Van der Woude syndrome 1 1q32.2 Van der Woude syndrome 2 1p36.11
  • velopharyngeal insufficiency - (VPI) associated with cleft palate repair, describes the velum and lateral and posterior pharyngeal walls failing to separate the oral cavity from the nasal cavity during speech.
Other Terms Lists  
Terms Lists: ART | Birth | Bone | Cardiovascular | Cell Division | Endocrine | Gastrointestinal | Genital | Genetic | Head | Hearing | Heart | Immune | Integumentary | Neonatal | Neural | Oocyte | Palate | Placenta | Radiation | Renal | Respiratory | Spermatozoa | Statistics | Tooth | Ultrasound | Vision | Historic | Drugs | Glossary

Fetal palate growth graph.jpg

Secondary Palate - Retinoic acid signalling

Mammadova A, Zhou H, Carels CE & Von den Hoff JW. (2016). Retinoic acid signalling in the development of the epidermis, the limbs and the secondary palate. Differentiation , 92, 326-335. PMID: 27238416 DOI.

Fetal Organ of Corti Development

Week 18 Week 20 Week 22
  • stria vascularis - 18-20 weeks (GA 20 week 3 days - 22 week)
  • tectorial membrane - 18 weeks (GA 20 week 3 days)
  • Afferent nerve ending - 18 weeks (GA 20 week 3 days)
  • Nuel space - 20 weeks (GA 22 week 0 days - 24 week)
  • Efferent nerve ending - 20 weeks (GA 22 week 0 days)
  • Maturation of stereocilia - 20 weeks (GA 22 week 0 days - 24 week 0 days)
  • tunnel of corti - GA 24 week
  • Space between hair and supporting cell - 24 week
  • Presence of kinocilium - GA 24 week 0 days

<pubmed>7188054</pubmed>

Fetal Auricle Development

External Auditory Meatus Timeline

Time EAM Appearance
Embryonic period Ectodermal cells proliferate and fill the entire lumen forming a meatal plug
10 weeks Meatal plug extends in a disc-like fashion. In the horizontal plane the meatus is boot-shaped with a narrow neck and the sole of the meatal plug spreading widely to form the future tympanic membrane medially. Proximal portion of the neck starts to be resorbed.
13 weeks Disc-like plug innermost surface in contact with the primordial malleus, contributes to the formation of the tympanic membrane.
16.5 week Meatus is fully patent throughout its length, lumen is still narrow and curved.
18 week Meatus is already fully expanded to its complete form.

Based on data from PMID 1441991

Historic

Mall FP. On ossification centers in human embryos less than one hundred days old. (1906) Amer. J Anat. 5:433-458.

Terms

Head Terms (expand to view) 
  • branchial arch - see pharyngeal arch.
  • clefting - the way in which the upper jaw forms from fusion of the smaller upper prominence of the first pharyngeal arch leads to a common congenital defect in this region called "clefting", which may involve either the upper lip, the palate or both structures, see palate and head abnormalities.
  • coronal suture - skull term for the fibrous connective tissue joint that connects the frontal bone with the parietal bones.
  • cranial fossae - skull term for the base bones of the cranial vault that form a container and support for the brain.
  • cranial vault - skull term for the space formed by bones of the skull that enclose the brain.
  • cysts - refers to a cervical sinus abnormality, remants of the cervical sinus remains as a fluid-filled cyst lined by an epithelium, see pharyngeal arch and head abnormalities.
  • dolichocephaly - see scaphocephaly.
  • fistula - refers to a pharyngeal membrane abnormality, a tract extends from pharynx (tonsillar fossa) beween the carotid arteries (internal and external) to open on side of neck, see pharyngeal arch and head abnormalities.
  • lambdoid suture (lambdoidal suture) skull term for the fibrous connective tissue joint that connects the parietal bones with the occipital bone, and is continuous with the occipitomastoid suture.
  • metopic suture - skull term for the fibrous connective tissue joint that connects the two fontal bones. In the adult skull this suture is not always present.
  • oxycephaly - (turricephaly) term meaning premature fusion of coronal suture + others, see skull and head abnormalities.
  • pharyngeal arch - (branchial arch) a structure that forms in the cranial region of the embryo having contributions from all germ layers. In humans, the arches appear in week 4 (GA week 6) in a rostra-caudal sequence and are numbered (1, 2, 3, 4, and 6). Each arch contributes a different part of the head and neck and the associated components.
  • pharyngeal cleft - (groove) surface ectoderm that externally separates each pharyngeal arch. In humans, only first pair persist as the outer ear external auditory meatus.
  • pharyngeal groove - see pharyngeal cleft.
  • pharyngeal membrane - surface ectoderm and pharynx endoderm contact region lying between each pharyngeal arch. In humans, only the first membrane pair persist as the tympanic membrane.
  • pharyngeal pouch - pharynx endoderm internal out-pocketing that separates each pharyngeal arch.
  • plagiocephaly - term meaning premature unilateral fusion of coronal or lambdoid sutures, see skull and head abnormalities.
  • Reichardt's cartilage - (pharyngeal arch 2 cartilage) The superior portion of the hyoid forms the ventral portion of this cartilage and the middle ear stapes is thought to form from the ends of this cartilage.
  • sagittal suture - skull term for the fibrous connective tissue joint that connects the two parietal bones in the midline.
  • scaphocephaly - (dolichocephaly) term meaning premature fusion of sagittal suture, see skull and head abnormalities.
  • sinuses - refers to a pharyngeal groove (cleft) abnormality, when a portion of the pharyngeal groove persists and opens to the skin surface, located laterally on the neck, see pharyngeal arch and head abnormalities.
  • squamosal suture - skull term for the fibrous connective tissue joint that connects the squamous portion of the temporal bone with the parietal bones.
  • suture - skull term for a fibrous connective tissue joint. In humans, the main sutures are coronal, sagittal, lambdoid and squamosal sutures, with the metopic suture (frontal suture) occurring as an anatomical variant in the adult skull.
  • turricephaly - see oxycephaly.
Other Terms Lists  
Terms Lists: ART | Birth | Bone | Cardiovascular | Cell Division | Endocrine | Gastrointestinal | Genital | Genetic | Head | Hearing | Heart | Immune | Integumentary | Neonatal | Neural | Oocyte | Palate | Placenta | Radiation | Renal | Respiratory | Spermatozoa | Statistics | Tooth | Ultrasound | Vision | Historic | Drugs | Glossary
Palate Development (expand to see terms)  
  • cleft - An anatomical gap or space occuring in abnormal development in or between structures. Most commonly associated with cleft lip and cleft palate. Term is also used to describe the external groove that forms between each pharyngeal arch during their formation.
  • cleft lip - An abnormality of face development leading to an opening in the upper lip. Clefting of the lip and or palate occurs with 300+ different abnormalities. Depending on many factors, this cleft may extend further into the oral cavity leading to a cleft palate. In most cases clefting of the lip and palate can be repaired by surgery.
  • cleft palate - An abnormality of face development leading to an opening in the palate, the roof of the oral cavity between the mouth and the nose. Clefting of the lip and or palate occurs with 300+ different abnormalities. In most cases clefting of the lip and palate can be repaired by surgery. Palate formation in the embryo occurs at two distinct times and developmental processes called primary and secondary palate formation. This leads to different forms (classifications) and degrees of clefting.
  • hard palate - anterior part of the palate that becomes ossified. The posterior palate part is the soft palate.
  • epithelial mesenchymal transition - (EMT, epitheliomesenchymal transformation) conversion of an epithelium into a mesenchymal (connective tissue) cellular organization. Process required during lip and palate developmental fusion.
  • epitheliomesenchymal transformation - (epithelial mesenchymal transition) conversion of an epithelium into a mesenchymal (connective tissue) cellular organization.
  • incisive papilla - anterior midline palate near the incisors lying at the end of the palatine raphe.
  • levator veli palatini - Muscle forming part of the soft palate, elevates the soft palate for swallowing.
  • mastication - (chewing) Process of crushing and grinding food within the mouth.
  • maxilla - (pl. maxillae) upper jaw bone forming from the maxillary process of the first pharyngeal arch.
  • medial edge epithelial - (MEE) opposing palatal shelves adhere to each other to form this epithelial seam.
  • musculus uvulae Small muscle forming part of the soft palate lying within the uvula, shortens and broadens the uvula.
  • palatine raphe (median raphe) palate midline ridge (seam) of the mucosa, from the incisive papilla to the uvula.
  • palatal rugae - (palatine rugae, rugae) Transverse series of ridges forming on the secondary hard palate that are sequentially added during development as the palate grows. Involved in the process of mastication.
  • palatal vault - (palatine vault) Term describing the curved "arch" shape of the palate that mainly develops postnatally.
  • palate - The roof of the mouth (oral cavity) a structure which separates the oral from the nasal cavity. Develops as two lateral palatal shelves which grow and fuse in the midline. Initally a primary palate forms with fusion of the maxillary processes with the nasal processes in early face formation. Later the secondary palate forms the anterior hard palate which will ossify and separate the oral and nasal cavities. The posterior part of the palate is called the soft palate (velum, muscular palate) and contains no bone. Abnormalities of palatal shelf fusion can lead to cleft palate.
  • palatine bones - Two bones that with the maxillae form the hard palate.
  • palatogenesis - The process of palate formation, divided into primary and secondary palate development.
  • palatoglossus - (glossopalatinus, palatoglossal muscle) Small muscle forming part of the soft palate required for swallowing.
  • palatopharyngeus - (palatopharyngeal or pharyngopalatinus) Small muscle forming part of the soft palate required for breathing.
  • pharyngeal arch - (branchial arch, Greek, branchial = gill) These are a series of externally visible anterior tissue bands lying under the early brain that give rise to the structures of the head and neck. In humans, five arches form (1,2,3,4 and 6) but only four are externally visible on the embryo. Each arch has initially identical structures: an internal endodermal pouch, a mesenchymal (mesoderm and neural crest) core, a membrane (endoderm and ectoderm) and external cleft (ectoderm). Each arch mesenchymal core also contains similar components: blood vessel, nerve, muscular, cartilage. Each arch though initially formed from similar components will differentiate to form different head and neck structures.
  • philtrum - (infranasal depression, Greek, philtron = "to love" or "to kiss") Anatomically the surface midline vertical groove in the upper lip. Embryonically formed by the fusion of the frontonasal prominence (FNP) with the two maxillary processes of the first pharyngeal arch. Cleft palate (primary palate) occurs if these three regions fail to fuse during development. Fetal alcohol syndrome is also indicated by flatness and extension of this upper lip region.
  • soft palate - (velum, muscular palate) posterior part of the palate that becomes muscular. Forms 5 muscles: tensor veli palatini, palatoglossus, palatopharyngeus, levator veli palatini, musculus uvulae. The anterior palate part is the hard palate.
  • T-box 22 - (TBX22) a transcription factor that cause X-linked cleft palate and ankyloglossia in humans. Tbx22 is induced by fibroblast growth factor 8 (FGF8) in the early face while bone morphogenic protein 4 (BMP4) represses and therefore restricts its expression. (More? OMIM - TBX22)
  • tensor veli palatini - (tensor palati, tensor muscle of the velum palatinum) Small muscle forming part of the soft palate required for swallowing.
  • Transforming Growth Factor-beta - (TGFβ) factors induces both epithelial mesenchymal transition and/or apoptosis during palatal medial edge seam disintegration.
  • uvula - (Latin = a little grape) a pendulous posterior end of soft palate used to produce guttural consonants. First named in 1695.
  • Van der Woude syndrome - common syndromic cause of clefting (2% of cleft lip and palates). Van der Woude syndrome 1 1q32.2 Van der Woude syndrome 2 1p36.11
  • velopharyngeal insufficiency - (VPI) associated with cleft palate repair, describes the velum and lateral and posterior pharyngeal walls failing to separate the oral cavity from the nasal cavity during speech.
Other Terms Lists  
Terms Lists: ART | Birth | Bone | Cardiovascular | Cell Division | Endocrine | Gastrointestinal | Genital | Genetic | Head | Hearing | Heart | Immune | Integumentary | Neonatal | Neural | Oocyte | Palate | Placenta | Radiation | Renal | Respiratory | Spermatozoa | Statistics | Tooth | Ultrasound | Vision | Historic | Drugs | Glossary
BGDsmall.jpg
Practical 6: Trilaminar Embryo | Early Embryo | Late Embryo | Fetal | Postnatal | Abnormalities





BGDsmall.jpg

BGDB: Lecture - Gastrointestinal System | Practical - Gastrointestinal System | Lecture - Face and Ear | Practical - Face and Ear | Lecture - Endocrine | Lecture - Sexual Differentiation | Practical - Sexual Differentiation | Tutorial


Glossary Links

Glossary: A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | Numbers | Symbols | Term Link



Cite this page: Hill, M.A. (2024, March 19) Embryology BGDB Face and Ear - Fetal. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/BGDB_Face_and_Ear_-_Fetal

What Links Here?
© Dr Mark Hill 2024, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G
  1. Locher H, Frijns JH, van Iperen L, de Groot JC, Huisman MA & Chuva de Sousa Lopes SM. (2013). Neurosensory development and cell fate determination in the human cochlea. Neural Dev , 8, 20. PMID: 24131517 DOI.