The Ear

Head & Neck Unit

Lecture 8
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The Ear

The Ear is used by the human for hearing and balance. It consists of 3 parts:
1.External Ear
2.Middle Ear (Tympanic Cavity)
3.Internal Ear (Labyrinth) which contains the organs of hearing and balance.

The External Ear

It consists of an auricle and an external

auditory meatus.

The auricle (Pinna): is a thin plate of elastic

cartilage covered by skin and arranged in
specific pattern of elevations & depressions. It
has both extrinsic and intrinsic muscles, which
are supplied by the facial nerve.
The external auditory meatus: is a 1 inch
(2.5 cm) curved tube connecting auricle to
tympanic membrane to conduct sound waves.
It is composed of an outer one third of elastic
cartilage and inner two thirds of bone
(tympanic plate). The meatus is lined by skin
containing wax producing glands (ceruminous
glands). Hairs and wax form sticky barrier to
prevent entrance of foreign bodies.
Nerve supply of the lining skin is derived from
auriculo-temporal nerve and auricular branch of
vagus nerve.

Middle Ear (Tympanic

Cavity)

It is a narrow, oblique, slit-like air-containing cavity in the petrous part of

temporal bone & is lined with mucous membrane. It contains auditory ossicles.
Communications: in front with nasopharynx through auditory tube, and behind
with mastoid antrum through the aditus. Function?
It consists of two parts: Tympanic Cavity & Epi-tympanic recess (Attic).

Boundaries of Middle Ear

Roof: tegmen tympani; separates tympanic cavity from MCF.

Floor: Thin bone separates tympanic cavity from superior bulb of IJV.
Anterior wall: Thin bone; separates tympanic cavity from ICA and at its
upper part are openings into two canals (auditory tube & canal for tensor
tympani).
Posterior wall: Aditus to the mastoid antrum superiorly & Pyramid inferiorly
( for stapedius)

Medial Wall features

Promontory: is a rounded projection formed by first turn of underlying cochlea.

Oval Window (fenestra vestibule): is an oval shaped opening that lies above & behind promontory
and closed by base of stapes. On the medial side of this window is perilymph of scala vestibuli of
internal ear.
Round Window (fenestra cochleae): is around shaped opening that lies below & behind
promontory and closed by secondary tympanic membrane. On its medial side, is perilymph of blind
scala tympani.
Processus Cochleariformis: is the posterior upward curve of the bony shelf that extends from
anterior wall of TC above the promontory. It forms a pulley to support tendon of tensor tympani
muscle to bends laterally reaching its insertion site.
Prominence of the facial nerve canal: is a rounded ridge runs horizontally backward above
promontory & fenestra vestibuli. On reaching the posterior wall, it curves downward behind the
pyramid.

Tympanic Membrane
(TM)

It is a thin, pearly grey, concave & circular fibrous

membrane that is obliquely placed, facing
downward, forward, and laterally on the lateral wall
of middle ear.
At the centre of its concavity, is a small depression
(Umbo) produced by tip of the handle of the
malleus.
When TM is illuminated through an otoscope, its
concavity produces a cone of light ( radiated
antero-inferiorly from the umbo).
TM is about 1 cm in diameter and is thickened at
the periphery and slotted into a groove in the bone
(tympanic sulcus) which is deficient superiorly
forming a notch. From the sides of this notch, two
bands, termed Anterior & Posterior malleolar
folds, pass to the lateral process of the malleus.
Above these folds, small triangular part of TM is
slack (Pars Flaccida) and rest of TM is tense
(Pars Tensa).
TM is extremely sensitive to pain & is innervated
on its outer surface by auriculotemporal nerve &
auricular branch of vagus; while its inner surface is
innervated totally by glossopharyngeal nerve.

Auditory Ossicles

They are malleus, incus & stapes.

Malleus: (largest ossicle) has head, neck, long process
(handle), anterior and lateral processes.
Head articulates posteriorly with incus.
Neck is constricted part below the head.
Handle is firmly attached to medial surface of TM. It can be
seen through TM on otoscopic examination.
Anterior process is a spine-like projection that is connected to
anterior wall of tympanic cavity by a ligament.
Lateral process is attached to anterior & posterior malleolar
folds of TM
Incus: has a large body & 2 processes (Long & Short).
Body is rounded and articulates anteriorly with head of
malleus.
Long process descends parallel to the handle of malleus & its
lower end articulates with head of stapes.
Short process is attached to posterior wall of tympanic cavity
by ligament.
Stapes: has head, neck, two limbs, and base.
Head articulates with long process of incus.
Neck is narrow and receives insertion of Stapedius Muscle.
Two Limbs are attached to the oval base.
Base is attached to margin of Fenestra Vestibuli (oval
window) by a ring of fibrous tissue, Anular ligament.

Auditory Tube
Also called Eustachian Tube or
Pharyngotympanic tube
It connects anterior wall of
tympanic cavity to nasal pharynx.
Its posterior third is bony and its
anterior two thirds is
cartilaginous.
As the tube descends it passes
over upper border of superior
constrictor muscle of pharynx.
It serves to equalize air pressures
in the tympanic cavity and the
nasal pharynx.

Mastoid Antrum
It lies behind the middle ear &communicates with
middle ear by the aditus.
Relations of the Mastoid Antrum:
Anterior wall is related to the middle ear and
contains the aditus.
Posterior wall separates the antrum from the
sigmoid venous sinus and the cerebellum.
Lateral wall is thick plate of bone and forms the
floor of the suprameatal triangle.
Medial wall is related to the posterior semicircular
canal.
Superior wall is the thin plate of bone (tegmen
tympani)
Inferior wall is perforated with holes, through which
the antrum communicates with the mastoid air cells.
Mastoid Air Cells: are a series of communicating
cavities within mastoid process. They are continuous
above with mastoid antrum. They are lined with
mucous membrane.

Facial Nerve

It passes through internal acoustic meatus then

enters facial canal. The nerve runs laterally above
vestibule until it reaches medial wall of middle ear
where it expands to form sensory geniculate
ganglion.
On arriving at posterior wall of middle ear, it curves
downward on medial side of aditus. Then descend
behind the pyramid, and finally emerges through
the stylomastoid foramen into the neck.
Important Branches of facial nerve within
petrous bone:
1- Greater Petrosal Nerve: contains preganglionic
parasympathetic fibers that pass to lacrimal gland
and glands of mucous membranes of nose and
palate. It is joined by Deep Petrosal Nerve from
the sympathetic plexus around ICA and they both
form Nerve of Pterygoid Canal. This nerve enters
pterygopalatine fossa & ends in
pterygopalatine ganglion.
2- Nerve to Stapedius muscle: arises behind the
pyramid &supplies Stapedius within the pyramid.
3- Chorda Tympani: supplies:
Taste fibers from anterior 2/3 of tongue that
anastomose at geniculate ganglion.
Preganglionic parasympathetic secretomotor fibers
for submandibular & sublingual glands.

Chorda Tympani

arises above stylomastoid foramen & enters the middle ear close to posterior
border of the tympanic membrane. It then runs forward over the TM &
crosses root of the handle of malleus. It lies between mucous membrane &
fibrous layers of TM. It leaves middle ear through petrotympanic fissure &
enters infratemporal fossa, where it joins lingual nerve.

Tympanic Nerve

It arises from the glossopharyngeal nerve, just below the jugular

foramen and enter the middle ear and onto the promontory to form
the tympanic plexus. The tympanic plexus supplies the lining of the
middle ear and gives off the lesser petrosal nerve, which sends
secretomotor fibers to the parotid gland via the otic ganglion.

The Internal Ear

(Labyrinth)
The labyrinth is situated
in the petrous part of the
temporal bone, medial to the middle ear. It consists of
bony labyrinth (BL) & membranous labyrinth (ML).

Bony Labyrinth (BL)

It is a series of bony cavities within petrous part of temporal bone. They

are lined by endosteum & contain clear fluid (perilymph) in which
membranous labyrinth is suspended. It consists of three parts:
A. Vestibule: is central part of BL that lies posterior to cochlea & anterior
to semicircular canals. In its lateral wall are fenestra vestibule &
fenestra cochleae . Vestibule contains Saccule & Utricle of ML in its
anterior & posterior parts respectively.

B. Three semicircular canals (superior, posterior & lateral):

open into posterior part of vestibule by five orifices. Each
canal has a swelling at one
end (ampulla). Lodged within canals
are semicircular ducts.
C. Cochlea: (Snail shell Like) It opens
Into anterior part of vestibule & consists
of a central pillar (Modiolus) around which
a hollow bony tube makes 2 &
1/2 spiral turns. The first basal turn
of cochlea causes the promontory seen on
medial wall of middle ear.

Cochlea

Modiolus has a broad base perforated by branches of cochlear nerve. A

spiral ledge (Spiral Lamina) winds around modiolus & projects into
interior of canal & partially divides it. Basilar membrane stretches
from free edge of spiral lamina to outer bony wall, thus dividing
cochlear canal into Scala vestibuli above & Scala tympani below.
Perilymph within scala vestibuli is separated from TC by base of stapes &
anular ligament at fenestra vestibuli. Perilymph in scala tympani is
separated from TC by secondary tympanic membrane at fenestra
cochleae.

Membranous Labyrinth
(ML)

Membranous labyrinth is lodged (suspended) within bony labyrinth. It is filled with

endolymph & surrounded by perilymph. It consists of freely communicating parts:
Utricle & saccule: lodged in central bony vestibule.
Three semicircular ducts: lodged within bony semicircular canals.
Duct of Cochlea: lodged within the bony cochlea.

Voice Transmission

End of the Lecture

GOOD LUCK