THE EAR

Diane L. M. Bick, PhD, FAHA

Reading: Gartner & Hiatt, pp 397-399 & 402-418; Gartner, Hiatt and Strum, pp 337-342 Learning Objectives: Describe the structura and hist! !"ica c!mp!nents !# the !uter, midd e, and inner ear$ %n!& the c!mp!nents !# the membran!us and b!n' ab'rinths$ Describe the structures #!und in the 3 sca a !# the inner ear$ Key Words: ('mpanic ca)it', e*terna audit!r' meatus, +ustachian tube, t'mpanic membrane, cupu a, !r"an !# ,!rti, peri 'mph, end! 'mph, ampu a, utric e, saccu e, !t!c!nia, crista ampu aris, macu a, stria )ascu aris, )estibu ar membrane, basi ar membrane, sca as$ BASIC EAR IN OR!ATION -aired sens!r' !r"ans that c!nsist !# the audit!r' s'stem and the )estibu ar s'stem$ ,!mp!sed !# e*terna , midd e, and inner ear$ THE THREE "I#ISIONS O THE EAR

E$TERNAL EAR A%ric&e .!r pinna/ c!nsists !# e astic carti a"e$ ,!)ered b' 0eratini1ed strati#ied s2uam!us epithe ium &ith hairs, sebace!us " ands, and s&eat " ands$ E'terna& a%ditory (eat%s e*tends #r!m the auric e t! the t'mpanic membrane !# the midd e ear$ 3uter !ne-third !# &a c!mp!sed !# e astic carti a"e that is c!ntinu!us &ith auric e$ 4nner t&!-thirds !# &a is #!rmed b' the temp!ra b!ne$ 5ined b' strati#ied s2uam!us epithe ium &ith hairs, sebace!us " ands, and cer%(ino%s g&ands$ Secreti!ns !# sebace!us and cerumin!us " ands c!mbine t! #!rm cer%(en$

!I""LE EAR ,!nsists !# t'mpanic ca)it' and its c!mp!nents - t'mpanic membrane .eardrum/, 3 !ssic es, and audit!r' !r

+ustachian tube$ Ty()anic cavity is an air-#i ed space$ 5ined b' simp e s2uam!us t! !& cub!ida epithe ium$ ,e s bec!me ci iated and cub!ida near the !penin" !# the audit!r' tube$ 5atera &a is c!mp!sed !# the t'mpanic membrane; media &a is shared b' the inner ear$ 6edia &a c!ntains the !)a &ind!& and the r!und &ind!&$ A%ditory ossic&es 7 ma eus .hammer/, incus .an)i /, and stapes .stirrup/$ ,!mp!sed !# c!mpact b!ne 8!ined b' s'n!)ia 8!ints9 6a eus is attached t! inner aspect !# t'mpanic membrane$ Stapes is attached t! the !)a &ind!& !# the inner ear b' a #ibr!us i"ament$ 4ncus 8!ins the ma eus and the stapes$ :ss!ciated &ith 2 s0e eta musc es, the (ens!r ('mpani .attached t! the ma eus/, and the Stapedius .attached t! the stapes/$ Ty()anic (e(brane is a thin, ri"id, semitransparent membrane bet&een e*terna and midd e ears$ ,!nsists !# a centra c!re !# c!nnecti)e tissue c!ntainin" #ibr!us tissue and e astic #ibers$ +*terna sur#ace c!)ered b' strati#ied s2uam!us epithe ium; inner sur#ace c!)ered b' simp e !& cub!ida epithe ium$ Di)ided int! 2 parts$ 5!&er #!ur-#i#ths is the )ars tensa and c!ntains an !r"ani1ed c!re !# c!nnecti)e tissue$ ;pper !ne-#i#th is the )ars *&accida . ac0s a midd e #ibr!us a'er/$ A%ditory T%be .+ustachian tube/ e*tends #r!m t'mpanic ca)it' t! nas!phar'n*$ <a c !sest t! the t'mpanic ca)it' is c!mp!sed !# b!ne$ 4s then rep aced b' e astic carti a"e, e*cept at the !penin" int! the nas!phar'n* &here it bec!mes h'a ine carti a"e$ 5ined b' ci iated epithe ium ran"in" #r!m simp e !& c! umnar t! pseud!strati#ied c! umnar$ (!&ards the nas!phar'n* end, ser!muc!us " ands &ith "!b et ce s and di##use 'mph!id tissue are present$ -rimar' #uncti!n is t! e2ua i1e air pressure bet&een the t'mpanic ca)it' and the e*terna en)ir!nment$ (he &a s are n!rma ' app!sed t! !ne an!ther; h!&e)er, durin" s&a !&in" and 'a&nin", the &a s separate, a !&in" air t! enter the t'mpanic ca)it'$

INNER EAR ,!nsists !# a series !# membran!us sacs and ducts= (e(brano%s &abyrint+ - encased &ithin a series !# b!n' ca)ities and cana s, and bony &abyrint+ - !cated &ithin the temp!ra b!ne$ >!n' ab'rinth c!ntains )eri&y()+; membran!us ab'rinth c!ntains endo&y()+$ Ter(ino&ogy A))&ied to t+e Inner Ear Labyrint+s >!n' 5ab'rinth ?estibu e Semicircu ar cana s ,!ch ea 6embran!us 5ab'rinth Saccu e ;tric e Semicircu ar ducts ,!ch ear duct .Sca a 6edia/

BON, LAB,RINTH

#estib%&e - centra ca)it' !# the b!n' ab'rinth$ ,!ntains the utric e and the saccu e$ Se(icirc%&ar cana&s .superi!r, atera , and p!steri!r/ e*tend p!steri!r ' #r!m the )estibu e, !riented at ri"ht an" es t! !ne an!ther$ :t !ne end !# each is a di atati!n, the a()%&&a$ Coc+&ea c!i s i0e a snai she ar!und a centra pi ar !# b!ne, the (odio&%s$ -r!8ectin" #r!m the m!di! us is a partia she # !# b!ne, the s)ira& &a(ina$ Sittin" !n the spira amina is the c!ch ear duct$ !E!BRANO-S LAB,RINTH : epithe ia - ined sacs and ducts c!mmunicate &ith each !ther, and c!ntain endo&y()+$ +*terna t! the membran!us ab'rinth is )eri&y()+$

:re @ sens!r' recept!r re"i!ns ass!ciated &ith the )estibu ar s'stem - !ne in the utric e, !ne in the saccu e, and !ne each #!r the 3 semicircu ar ducts$ (here is a Ath sens!r' recept!r ass!ciated &ith the audit!r' s'stem !cated in the duct !# the c!ch ea$ CROSS.SECTION O THE -TRICLE

-TRICLE AN" SACC-LE

!ac%&a is the sens!r' re"i!n$ 4t is made up !# 3 0inds !# ce s= 1$ Sustentacu ar .!r supp!rtin"/ ce -ta c! umnar &ith sh!rt micr!)i i$ 2$ ('pe 4 sens!r' hair ce .has a sin" e cup-shaped ner)e endin"/$ 3$ ('pe 44 sens!r' hair ce .c!ntains man' a##erent ner)e endin"s/$ +ach hair ce has !ne /inoci&i%( and man' stereoci&ia &hich radiate !ut #r!m the centra 0in!ci ium$ Stere!ci ia and 0in!ci ium are embedded in a "e atin!us membrane, the oto&it+ic (e(brane, &hich

sits !n t!p !# the sens!r' ce s$ (he membrane is pr!duced b' the sustentacu ar ce s$ 3n the sur#ace !# the !t! ithic membrane are oto&it+s !r !t!c!nia$ 3t! iths resp!nd t! "ra)it' and detect p!siti!na chan"es durin" m!)ement !# the b!d'$ (hree se(icirc%&ar d%cts are !cated &ithin their respecti)e semicircu ar cana s$ :t the end !# each duct is the a()%&&a0 &hich c!ntains the sens!r' re"i!n, the crista a()%&&aris$ .G&H, p403/ ,rista ampu aris a s! c!ntains supp!rtin" ce s and 2 t'pes !# sens!r' hair ce s$ Sens!r' hair ce s are embedded in a "e atin!us membrane, the c%)%&a$ (he cupu a is ta and e*tends t!&ard the &a !pp!site the crista ampu aris$ (here are no oto&it+s ass!ciated &ith the cupu a .seen be !&/$

Crista A()%&&aris

"-CT O THE COCHLEA 1Coc+&ear d%ct2 ,!ch ear duct ies in the bony coc+&ear &abyrint+ bet&een the !sse!us spira amina and the e*terna &a !# the b!n' c!ch ea$ 4t spira s ar!und the m!di! us 2 3B4 turns$ (he sca&a (edia is the space &ithin the c!ch ear duct; it is #i ed &ith end! 'mph$ (he c!ch ear duct and the !sse!us spira amina di)ide the c!ch ea int! 2 additi!na spaces= Sca&a vestib%&i and sca&a ty()ani3 are c!ntinu!us &ith !ne an!ther b' means !# a tin' !penin", ca ed the +e&icotre(a, !cated at the b ind end !# the b!n' c!ch ea$ Sca a )estibu i and t'mpani are #i ed 4it+ )eri&y()+$

Duct is trian"u ar in shape$ (he basi&ar (e(brane #!rms the # !!r !# the c!ch ear duct, and attaches t! the !sse!us spira amina and e*tends atera ' t! the b!n' &a !# the c!ch ea$ ,!mp!sed !# c!nnecti)e tissue c!re !# c! a"en #ibers$ +pithe ia ce s ine the side #acin" the sca a t'mpani$ (he side #acin" the sca a media is c!mp!sed !# c! umnar supp!rtin" and sens!r' ce s that ma0e up the Organ o* Corti$ (he &atera& coc+&ear 4a&& is attached t! the e*terna b!n' &a !# the c!ch ea$ 4t c!nsists !#= S)ira& &iga(ent= a mesh&!r0 !# #ibri s and b !!d )esse s$ Not a tr%e &iga(ent since it is not co()osed o* organi5ed dense connective tiss%e6 S)ira& )ro(inence= ined b' cub!ida epithe ia ce s and in)! )ed in h!me!stasis !# c!ch ear # uids$ Stria vasc%&aris= a hi"h ' )ascu ar re"i!n c!mp!sed !# ce s be ie)ed t! secrete endo&y()+$ (he vestib%&ar (e(brane, a s! 0n!&n as Reissner7s (e(brane0 #!rms the 3rd &a $ 4t is c!mp!sed !# 2 a'ers !# simp e s2uam!us epithe ium$ Organ o* Corti ,!mp!sed !# inner +air ce&&s and o%ter +air ce&&s$ :ppr!*imate ' 4 times as man' !uter as inner hair ce s$ Inner +air ce&&s ie in a sin" e r!& a !n" the en"th !# the basi ar membrane c !se t! the media aspect !# the duct .CinnerC/$ (he' are c!mp ete ' surr!unded b' supp!rtin" ce s$ O%ter +air ce&&s are c' indrica and ie in 3-@ r!&s a !n" the basi ar membrane$ Supp!rtin" ce s surr!und !n ' their apica and basa sur#aces; # uid bathes the media sur#aces$ +ach hair ce has numer!us stere!ci ia !n its apica sur#ace$ 4nner hair ce s ha)e #e&er stere!ci ia than !uter hair ce s$ (he stere!ci ia !# the !uter hair ce s are embedded in a "e atin!us tectoria& (e(brane$ : th!u"h the tect!ria membrane e*tends !)er the t!p !# the inner hair ce s, their stere!ci ia are #ree; inner hair ce stere!ci ia are not embedded in the tect!ria membrane$ :t the base !# each hair ce are e##erent and a##erent ner)e endin"s$ (hese ner)e endin"s transmit impu ses t! the bip! ar neur!ns !# the s)ira& gang&ion$ (here are se)era di##erent 0inds !# supp!rtin" ce s in the !r"an !# ,!rti$ (heir main #uncti!n is t! either direct ' !r indirect ' supp!rt the sens!r' ce s$

Organ o* Corti

HOW "OES IT ALL WORK89 :ir-b!rne )ibrati!ns are c! ected in the e*terna ear and must be c!n)e'ed t! the inner ear &ith!ut !sin" ener"'$ (his is acc!mp ished )ia the midd e ear that matches the ac!ustic pr!perties !# air t! the m!re dense # uid !# the inner ear$ ?ibrati!ns must ha)e access t! the sens!r' ce s !# the inner ear that are bathed in # uid, &hich is encased in b!ne, and p!tentia ' inc!mpressib e .not inc!mprehensib e/$ S! there has t! be !ne !penin" in the inner ear #!r )ibrati!ns t! enter and an!ther !penin" t! act as a re ease )a )e$ (he base !# the stapes r!c0s in and !ut a"ainst the !)a &ind!& - this is the entrance #!r the )ibrati!ns$ D uid )ibrati!ns are transmitted as pressure &a)es thr!u"h the peri 'mph !# the sca a )estibu i$ (he &a)es pass thr!u"h the )estibu ar membrane t! the under 'in" end! 'mph$ (he &a)es c!ntinue !n thr!u"h the basi ar membrane/ t! the peri 'mph !# the sca a t'mpani, and are e)entua ' dissipated )ia the r!und &ind!&$ (he r!und &ind!& ser)es as the re ease )a )e - it can push !ut !r e*pand as needed$ Di##erent #re2uencies !# s!und cause di##erent m!)ements .!r disp acement/ !# the basi ar membrane$ (he stere!ci ia !# the !uter hair ce s !# the !r"an !# ,!rti are embedded in the tect!ria membrane$ D uid disp acement in the inner ear causes the stere!ci ia t! bend; this resu ts in the re ease !# neur!transmitters #r!m the basa p!rti!n !# the hair ce s that eads t! neura impu ses$ (hese impu ses are transmitted )ia bip! ar neur!ns in the spira "an" i!n t! the audit!r' branch !# the 8th crania ner)e$ EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE

EAR LABORATOR, S&ide :;, +*terna +ar$ 4denti#' the #! !&in" structures$ Strati#ied s2uam!us epithe ium c!)erin" a sur#aces$ 4s it 0eratini1ed !r n!n0eratini1edF Hair #! ic es$ Sebace!us " ands and s&eat " ands$ 4nterna c!re !# carti a"e$ <hat 0ind is itF <hat t'pe !# c!nnecti)e tissue is presentF 4denti#' b !!d )esse s and ner)es$ 4# '!u rea ' #ee the need t! !nce a"ain !!0 at the m!n0e' ear, re)ie& S&ide :< as &e $ (he carti a"e sh!&s up particu ar ' &e in this secti!n due t! the t'pe !# stain used$ S&ide ;=0 Coc+&ea: (he tissue has been stained &ith 6a !r'-a1an stain, there#!re= > ue 7 b!ne, Ged 7 ce nuc ei, b!ne marr!&, s0e eta musc e, & ner)e 4t is best t! #irst h! d this s ide up t! the i"ht !r a"ainst a &hite bac0"r!und t! "et '!ur bearin"s$ (he ma8!rit' !# dar0 b ue tissue is b!ne$ 4t surr!unds numer!us c ear spaces, &hich represent p!rti!ns !# the e*terna , midd e, and inner ear .inc udin" cr!ss-secti!ns !# the c!ch ea/$ S!me !# the spaces are the mast!id sinuses c!mp!sed !# mast!id air ce s$ >e#!re puttin" the s ide !n the micr!sc!pe, identi#' the coc+&ea$ S!me secti!ns a s! ha)e a t'mpanic membrane &ith attached ma eus$ 4denti#' the #! !&in" structures= +*terna audit!r' cana $ <hat t'pe !# epithe ium is presentF ('mpanic membrane separatin" e*terna #r!m midd e ear$ 6idd e ear$ Surr!undin" b!ne and b!ne marr!&$ Her)es$ ,!ch ea$ Geca that the c!ch ea is subdi)ided int! 2 ar"er spaces .the sca&a vestib%&i and the sca&a ty()ani/ and a sma er centra space .the sca&a (edia !r coc+&ear d%ct/$ (he r!u"h ' trian"u ar c!ch ear duct has !ne &a c!mp!sed !# the vestib%&ar (e(brane, &hich is )er' thin and !#ten arti#icia ' Ibr!0enJ b' pr!cessin" meth!ds, and !ne &a c!mp!sed !# the basi&ar (e(brane, &hich is #air ' thic0, I" ass'J, and stains )i! et$ (he sca&a vestib%&i is the space ab!)e the )estibu ar membrane; the sca&a ty()ani is the space be !& the basi ar membrane$ <hat are each !# these spaces #i ed &ithF 6!)e t! hi"her ma"ni#icati!n and e*amine the basi ar membrane and the c!mp!nents !# the organ o* Corti$ (he tectoria& (e(brane is !#ten eas' t! !cate as a " ass' )i! et membrane$ ;nder 'in" it, tr' t! identi#' hair ce s and supp!rtin" ce s .the' ma' be a s2uashed ce s/$ H!te red nerve *ibers .#r!m &hat ner)eF/ e*itin" #r!m the basi ar membrane !n the media side$ 4denti#' the red ce b!dies !# the ad8acent s)ira& gang&ion$ 4denti#' the atera &a !# the c!ch ear duct$ K!u ma' be ab e t! determine that it is c!)ered &ith c! umnar epithe ium !)er 'in" c!nnecti)e tissue and numer!us capi aries$ (his is the stria vasc%&aris$