Figure 5.

Endoscopic surface transplantation of donor cells. (A) In patients with non-tumorous auditory neuropathic hearing loss, an endoscope can be introduced in the cerebellopontine angle cistern and DCs placed onto the AuN. Normal facial nerve (VII) and vestibulocochlear nerve (VIII) are shown in the left upper corner of the panel. (B) In open surgery for larger VS, following tumor removal (left), donor cells can be placed on the surface of the AuN. The posterior wall of the internal auditory meatus is drilled to expose the tumor entirely. (C) In radiotherapy for small to medium-sized VS (arrows), a similar approach shown in A can be undertaken immediately after treatment. DCs are placed both on the distal side of the tumor through the internal auditory meatus (shown in this figure) and on its medial side if possible (not shown here). The dotted line indicates tumor shrinkage after radiotherapy. Regenerated bipolar neurons (dotted line) are shown in the nerve in each panel. AuN, auditory nerve; CN, cochlear nucleus cells; Cr, cerebellum; DC, donor cell; En, endoscope; HC, hair cell; IAM, internal auditory meatus; kh, keyhole; Rt, retractor; VS, vestibular schwannoma.