EAR
The ear is divided into three main regions:
The external ear, which collects sound waves
and channels them inward
The middle ear, which conveys sound
vibrations to the oval window
The internal ear, which houses the receptors
for hearing and equilibrium.
External (Outer) Ear
The external ear consists of the auricle, external
auditory canal, and eardrum
The auricle (pinna) is a flap of elastic cartilage
shaped like the flared end of a trumpet and covered
by skin.
The auricle has several depressions and elevations.
The concha is the deepest depression, and the
elevated margin of the auricle is the helix, the inferior
portion is the lobule.
The tragus is a tongue-like projection overlapping the
opening of the external acoustic meatus.
The external auditory canal is a curved tube about
2.5 cm (1 in.) long that lies in the temporal bone
and leads to the eardrum. The lateral third of this
slightly S-shaped canal is cartilaginous and lined
with skin, which is continuous with the skin of the
auricle. Its medial two thirds is bony and lined
with thin skin that is continuous with the external
layer of the tympanic membrane.
The tympanic membrane or eardrum,
approximately 1 cm in diameter, is a thin, oval,
semitransparent membrane at the medial end of
the external acoustic meatus. It forms a partition
between the meatus and the tympanic cavity of the
middle ear.
The tympanic membrane is covered by epidermis and
lined by simple cuboidal epithelium.
Tearing of the tympanic membrane is called a
perforated eardrum.
The tympanic membrane may be examined directly
by an otoscope.
Near the exterior opening, the external auditory canal
contains a few hairs and specialized sweat glands
called ceruminous glands that secrete earwax or
cerumen.
The combination of hairs and cerumen helps prevent
dust and foreign objects from entering the ear.
Middle Ear
The middle ear is a small, air-filled cavity in the
petrous portion of the temporal bone that is lined by
epithelium.
It is separated from the external ear by the tympanic
membrane and from the internal ear by a thin bony
partition that contains two small membrane-covered
openings: the oval window and the round window.
The tympanic cavity is connected anteromedially with
the nasopharynx by the pharyngotympanic tube or
eustachian tube.
The contents of the middle ear are the:
Auditory ossicles: malleus, incus, and
stapes.
Stapedius and tensor tympani muscles.
Chorda tympani nerve, a branch of CN
VII.
Joints- b/w malleus and incus- saddle joint
and b/w incus and stapes- ball and socket
joint
The “handle” of the malleus attaches to the internal
surface of the tympanic membrane.
The head of the malleus articulates with the body of
the incus.
The incus , the middle bone in the series, articulates
with the head of the stapes.
The base or footplate of the stapes fits into the oval
window
Directly below the oval window is another opening,
the round window, which is enclosed by a membrane
called the secondary tympanic membrane
WALLS OF TYMPANIC CAVITY
The middle ear, shaped like a narrow box with
concave sides, has six walls –
1. Tegmental wall (roof)- is formed by a thin plate of
temporal bone, the tegmen tympani, which
separates the tympanic cavity from floor of the
middle cranial fossa.
2. Jugular wall (floor)- separates the tympanic cavity
from the superior bulb of the IJV.
3. Membranous wall (lateral wall)- is formed almost
entirely by the the tympanic membrane.
4. labyrinthine wall (medial wall)- separates
the tympanic cavity from the internal ear.
formed by the initial part of the cochlea,
and the oval and round windows.
5. Carotid wall (anterior wall)- separates the
tympanic cavity from the carotid canal,
which contains the internal carotid artery
6. Mastoid wall (posterior wall)- has an
opening in its superior part, the aditus to
the mastoid antrum.
INTERNAL (INNER) EAR
The internal (inner) ear is also called the labyrinth
because of its complicated series of canals.
Structurally, it consists of two main divisions: an outer
bony labyrinth that encloses an inner membranous
labyrinth.
BONY LABYRINTH-
The bony labyrinth is a series of cavities in the petrous
portion of the temporal bone divided into three areas:
(1) The semicircular canals
(2)The vestibule, both of which contain receptors for
equilibrium
(3) The cochlea, shell-shaped part of the bony labyrinth
that contains the cochlear duct, the part of the internal
ear concerned with hearing
The bony labyrinth is lined with periosteum and
contains perilymph. This fluid, which is chemically
similar to CSF, surrounds the membranous labyrinth.
The membranous labyrinth contains endolymph
Vestibule
The vestibule of the bony labyrinth is a small oval
chamber (approximately 5 mm long) that contains the
utricle and saccule which are parts of the balancing
apparatus (vestibular labyrinth).
The vestibule features the oval window on its lateral
wall, occupied by the base of the stapes. The vestibule is
continuous with the bony cochlea anteriorly, the
semicircular canals posteriorly, and the posterior
cranial fossa by the vestibular aqueduct . The aqueduct
extends to the posterior surface of the petrous part of
the temporal bone, where it opens posterolateral to the
internal acoustic meatus. The vestibular aqueduct
transmits the endolymphatic duct and two small blood
Semicircular canals
Projecting superiorly and posteriorly from the vestibule
are the three bony semicircular canals, each of which
lies at approximately right angles to the other two.
Based on their positions, they are named the anterior,
posterior and lateral semicircular canals.
The anterior and posterior semicircular canals are
vertically oriented; the lateral one is horizontally
oriented.
At one end of each canal is a swollen enlargement called
the ampulla .
The portions of the membranous labyrinth that lie
inside the bony semicircular canals are called the
semicircular ducts.
Bony cochlea
Anterior to the vestibule is the cochlea, a bony spiral canal
that resembles a snail’s shell and makes almost two and
three quarter turns around a central bony core called the
modiolus (conical central axis)
A spiral ridge of the bone, the spiral lamina, partially
divides the cochlear canal into the scala vestibuli above
and the scala tympani below
The scala vestibuli communicates with the scala tympani
at the apex of the cochlea by a small opening, called the
helicotrema
The scala vestibuli is continous with the vestibule and the
scala tympani opens into the middle ear through the
fenestra cochlea, which closed by the secondary tympanic
membrane.
MEMBRANOUS LABYRINTH
It continuous closed cavity filled with endolymph
It consists of three main parts
1.The semicircular ducts with cristae the organ of
kinetic balance
2. The utricle and saccule with maculae, the organs of
static balance, within the vestibule
3. The spiral duct of the cochlea or organ of corti
Semicircular ducts-
Lies within the corresponding bony canal
Each duct has ampulla, there is an end organ called
the ampullary cristae
Cristae responds to pressure changes in the
endolymph caused by movement of the head
Vestibular apparatus
It consists of the two vestibular sacs called utricle and
the saccule, are membranous sacs present within the
bony cavity of the vestibule
The utricle is the larger of the two vestibular sacs and
occupies the posterosuperior portion of the vestibule
It receives the end of three semicircular ducts through
the five opening .
The saccule globular in shape and is anterior to the
utricle
The saccule is connected to the cochlea by the duct
of reuniens that start from the lower part of the
saccule and curves up to join the base of the
cochlear duct.
The utricle is connected to the saccule by the
utriculosaccular duct
A slender endolymphatic duct strats from the
lower part of the utriculosaccular duct
The medial wall of utricle and saccule are thickened
to form a macula
The maculae are end organs that give information
about the position of the head. They are static
balance receptor
Cochlear Duct (Scala Media )
The cochlear duct (scala media) is a continuation
of the membranous labyrinth into the cochlea; it
is filled with endolymph.
The cochlear duct lies between scala vestibuli and
the scala tympani
The floor is formed by the basilar membrane; the
roof by the vestibular or reissners membrane
The floor of the cochlear duct cantinas the organ
of hearing called the organ of corti.
The spiral organ contains hair cells, the tips of
which are embedded in the tectorial membrane.
The hair cells are the actual sensory receptors cells.
Each hair cell is elongated, has bunch of modified
apical microvillus (stereocilia).
The organ of corti is innervated by peripheral
process of bipolar cells located in the spiral
ganglion
The central processes of the ganglion cells form
the cochlear nerve
BLOOD SUPPLY
EXTERNAL EAR
PINNA –Posterior auricular and superficial temporal
EXTERNAL ACOUSTIC MEATUS – outer part same above
and inner part deep auricular branch of maxillary artery
TYMPANIC MEMBRANE
Outer Surface – deep auricular branch of maxillary artery
Inner Surface – Ant.- Tympanic branch of the maxillary
artery
post.- Tymapnic branch of the post. Auricular
artery
Middle ear – same above
Internal ear- Labyrinth branch of the basilar artery
Posterior auricular artery
CLINICAL ASPECT
External Ear Injury
Bleeding within the auricle resulting
from trauma may produce an auricular
hematoma. As the hematoma enlarges,
it compromises the blood supply to the
cartilage. If untreated (e.g., by
aspiration of blood), fibrosis (formation
of fibrous tissue) develops in the
overlying skin, forming a deformed
auricle (e.g., the cauliflower or boxer's
ear of some professional fighters).
Acute Otitis Externa
an inflammation of the external
acoustic meatus. The infection often
develops in swimmers who do not
dry their meatus after swimming
and/or use ear drops, but it may also
be the result of a bacterial infection
of the skin lining the meatus. The
affected individual complains of
itching and pain in the external ear.
Otitis Media
An earache and a bulging red tympanic
membrane may indicate pus or fluid in
the middle ear, a sign of otitis media.
Infection of the middle ear is often
secondary to upper respiratory
infections.
Inflammation and swelling of the
mucous membrane lining the tympanic
cavity may cause partial or complete
blockage of the pharyngotympanic
tube.
Perforation of Tympanic Membrane
-“ruptured eardrum”
may result from otitis media and is one
of several causes of middle ear deafness.
Perforation may also result from foreign
bodies in the external acoustic meatus,
trauma, or excessive pressure .
Because the superior half of the
tympanic membrane is much more
vascular than the inferior half, incisions
to release pus from a middle ear abscess
(myringotomy), for example, are made
posteroinferiorly through the membrane.
Otoscopic Examination
Examination of the external
acoustic meatus and tympanic
membrane begins by straightening
the meatus.
In adults, the helix is grasped and
pulled posterosuperiorly (up, out,
and back). These movements
reduce the curvature of the
external acoustic meatus,
facilitating insertion of the
otoscope
