This study examined the potential of embryonic stem cell-derived neurons as transplants for cell therapy for the primary loss of spiral ganglion neurons. To assess the ability of embryonic stem cell-derived neurons for innervation into auditory epithelia, they were cocultured with auditory epithelium explants of mice for 7 days. Histological analysis demonstrated massive elongation of neurites from embryonic stem cell-derived neurons toward auditory hair cells. Embryonic stem cell-derived neurites were adjacent to or surrounding hair cells, and exhibited expression of synaptophysin, a marker for synaptic vesicles. These findings demonstrate the ability of embryonic stem cell-derived neurons for reinnervation into auditory epithelia, indicating a high potential of embryonic stem cell-derived neurons as transplants for replacing spiral ganglion neurons. NeuroReport 16:787-790 (c) 2005 Lippincott Williams & Wilkins.