Ear anatomy

Introduction
• Ear is the organ
and balance.
• Ear is described
mainly as 3
parts.
1. External ear
2. Middle ear
3. Inner ear
 External ear

• External ear can

be split functionally
and structurally into
two sections;
• Auricle (or pinna),
and
• External acoustic
meatus
 Auricle / pinnae
• It is the part seen on the
surface,
• The part layman calls the ear.
The greater part of it is made
up of a single crumpled plate
of elastic cartilage which is
lined on both sides by skin
• Lowest part of the auricle is
soft and consists only of
connective tissue covered by
skin called the lobule
 Parts of the auricle
• In relation to the auricle
there are a number of
muscles.
• These are vestigeal in
man.
 Blood supply of the auricle
• It is derived from the
posterior auricular and
anterior superficial
temporal arteries.
 Lymphatic drainage of the auricle
• The lymphatics drain
into the preauricular,
postauricular and
superficial cervical
lymph nodes
 Nerve Supply:
• The upper two-thirds of the
lateral surface of the auricle are
supplied by the
auriculotemporal nerve;
• Lower one-third by the great
auricular nerve.
• The upper two-thirds of the
medial surface are supplied by
the lesser occipital nerve;
• The root of the auricle is
supplied by the auricular branch
of the vagus.
•
 External Acoustic Meatus
• The external auditory meatus
conducts sound waves from the
concha to the tympanic membrane.
• The canal is S-shaped. Its outer part
is directed medially, forwards and
upwards.
• The middle part is directed medially,
backwards and upwards.
• The inner part is directed medially,
forwards and downwards.
• The meatus can be straightened for
examination by pulling the auricle
upwards, backwards and slightly
laterally
 External Acoustic Meatus
• The meatus or canal is
about 24 mm long, of
which
• The medial two-thirds
or 16mm is bony, and
the
• Lateral one-third or 8
mm is cartilaginous
Blood supply External Acoustic Meatus
• The outer part of the
canal is supplied by the
superficial temporal and
posterior auricular
arteries,
• and the inner part, by
the deep auricular
branch of the maxillary
artery.
 Lymphatics External Acoustic Meatus
• The lymphatics pass to
preauricular,
postauricular and
superficial cervical
lymph nodes
 Nerve supply
• The skin lining the anterior half of the meatus
is supplied by the auriculotemporal nerve,
• And the lining the posterior half, by the
auricular branch of the vagus
 Tympanic Membrane
• This is a thin, translucent
partition between the
external acoustic meatus
and the middle ear.
• It is oval in shape,
measuring 9 x 10 mm. It is
placed obliquely at an
angle of 55 degrees with
the floor of the meatus. It
faces downwards,
forwards and laterally
• The membrane has outer and
inner surfaces.
• Outer surface of the membrane
is lined by thin skin. It is
concave.
• Inner surface provides
attachment to the handle of the
malleus which extends up to its
centre.
• The inner surface is convex. The
point of maximum convexity
lies at the tip of the handle of the
malleus and is called the umbo
 Areas of the tympanic membrane
• Part of the tympanic
membrane which is tightly
stretched is, called the pars
tensa,
• The part between the two
malleolar folds is loose and is
called the pars flaccida.
• The membrane is held tense
by the inward pull of the
tensor tympani muscle which
is inserted into the upper end
of the handle of the malleus
 Structure of tympanic membrane
• It consists of three layers
• 1.The outer cuticular
layer of skin.
• 2.The middle fibrous
layer made up of
superficial radiating fibres
and deep circular fibres.
• 3. The inner mucous layer
is lined by a low ciliated
columnar epithelium.
 Blood Supply of tympanic membrane
1.The outer surface is
supplied by the deep
auricular branch of the
maxillary artery.
2.The inner surface is
supplied by the anterior
tympanic branch of the
maxillary artery and by the
posterior tympanic branch of
the stylomastoid branch of
the posterior auricular artery
 Venous Drainage

• Veins from the outer

surface drain into the
external jugular vein
 Lymphatic Drainage

• Lymphatics pass to the preauricular and

retropharyngeal lymph nodes
 Nerve Supply

• 1. Outer surface: The anteroinferior part is

supplied by the auriculotemporal nerve, and
the posterosuperior part by the auricular
branch of the vagus nerve.
• 2. Inner surface: This is supplied by the
tympanic branch of the glossopharyngeal
nerve.
 CLINICAl ANATOMY
• 1.When the tympanic
membrane is illuminated for
examination, the concavity
of the membrane produces
a 'cone of light' over the
anteroinferior quadrant.
• Through the membrane one
can see the underlying
handle of the malleus and
the long process of the
incus.
• 2.The membrane is
sometimes incised to
drain pus present in the
middle ear. The
procedure is called
myringotomy.
 Middle ear
• Middle ear is also called
the tympanic cavity,
tympanum.
• Location- Middle ear is
a narrow air filled space
situated in the petrous
part of the temporal
bone between the
external ear and the
internal ear
 Shape and Size of middle ear
• Middle ear is shaped like a cube.
• Its vertical and anteroposterior
diameters are both about 15 mm
• When seen in coronal section the
cavity of the middle ear is
biconcave, as the medial and
lateral walls are closest to each
other in thecentre.
• The distances separating them
are 6mmnear the roof, 2 mm in
the centre, and 4 mm near the
floor.
 Parts of middle ear
• The cavity of the middle
ear can be subdivided
into the tympanic cavity
proper which is opposite
the tympanic
membrane;
• and the epitympanic
recess which lies above
the level of the
tympanic membrane.
 Communications of middle ear
• The middle ear
communicates
anteriorly with the
nasopharynx through
the auditory tube, and
• Posteriorly with the
mastoid antrum and
mastoid air cells
through the aditus to the
mastoid antrum.
 Contents of the middle ear
• Ossicles namely the
malleus, the incus and the
stapes.
• Ligaments of the ear
ossicles.
• Two muscles, the tensor
tympani and the stapedius.
• Vessels supplying and
draining the middle ear.
• Nerves: Chorda tympani
and tympanic plexus.
 Boundaries of middle ear
• Roof or Tegmental Wall
• Floor or Jugular Wall
• Anterior or Carotid Wall
• Posterior orMastoid
Wall
• Lateral or Membranous
Wall
• Medial or Labyrinthine
Wall
Roof or Tegmental Wall
• The roof separates the
middle ear from the
middle cranial fossa.
• It is formed by a thin
plate of bone called the
tegmen tympani
 Floor or Jugular Wall
• Floor is formed by a
thin plate of bone which
separates the middle ear
from the superior bulb
of the internal jugular
vein.
• This plate is a part of
the temporal bone
 Anterior or Carotid Wall
• Anterior wall is narrow .
• Uppermost part of the
anterior wall bears the
opening of the canal for the
tensor tympani.
• The middle part has the
opening of the auditory tube.
• The inferior part of the wall
is formed by a thin plate of
bone which forms the
posterior wall of the carotid
canal. The plate separates the
middle ear from the internal
carotid artery.
 Posterior or Mastoid Wall
• The posterior wall
presents these features
from above downwards.
• 1.Superiorly, there is an
opening or aditus
through which the
epitympanic recess
communicates with the
mastoid or tympanic
antrum.
• 3.A conical projection, called
the pyramid, lies near the
junction of the posterior and
medial walls. It has an opening
at its apex for passage of the
tendon of the stapedius muscle
• 4.Lateral to pyramid and near
the posterior edge of the
tympanic membrane, there is the
posterior canaliculus for the
chorda tympani through which
the nerve enters the middle ear
cavity.
 Lateral or Membranous Wall
• Lateral wall separates the
middle ear from the
external acoustic meatus.
It is formed: (a) Mainly
by the tympanic
membrane along with the
tympanic ring and sulcus
and (b) partly by the
squamous temporal bone,
in the region of the
epitympanic recess.
• 2. Near the tympanic notch there
are two small apertures, (a) The
petrotympanic fissure lies in front
of the upper end of the bony rim. It
lodges the anterior process of the
malleus and transmits the tympanic
branch of the maxillary artery,
• (b) The anterior canaliculus for the
chorda tympani nerve lies either in
the fissure or just in front of it. The
nerve leaves the middle ear
through this canaliculus to emerge
at the base of the skull.
 Medial or Labyrinthine Wall
• Medial wall separates
the middle ear from the
internal ear. It presents
the following features.
• (a) The promontory is a
rounded bulging
Produced by the first
turn of the cochlea.
(a)The fenestra vestibuli is an
oval opening posterosuperior
to the promontory. It leads
into the vestibule of the
internal ear and is closed by
the footplate of the stapes.
 Venous Drainage
• Veins from the middle
ear drain into the
superior petrosal sinus
and the pterygoid plexus
of the veins.
 Lymphatic Drainage

• Lymphatics pass to the

preauricular and
retropharyngeal lymph
nodes
 Nerve Supply
• Nerve supply is derived from the
tympanic plexus which lies over the
promontory
• The plexus is formed by the following.
• 1.The tympanic branch of the
glossopharyngeal nerve. Its fibres are
distributed to the mucous membrane of
the middle ear, the auditory tube, the
mastoid antrum and air cells.
• 2.The superior and inferior
caroticotympanic nerves arise from the
sympathetic plexus around the internal
carotid artery. These fibres are
vasomotor to the mucous membrane.
 Functions of the Middle Ear
• 1.It transmits sound waves from the external
ear to the internal ear through the chain of ear
ossicles.
• 2.The intensity of the sound waves is
increased ten times by the ossicles.
 THE EAR OSSICLES
• The bones of the middle
ear are called
the auditory ossicles.
• They are the malleus,
incus and stapes. They
are connected in a chain-
like manner, linking the
tympanic membrane to
the oval window of
the internal ear.
 Malleus
• The malleus is so called
because it resembles a
hammer. It is the largest,
and the most laterally
placed ossicle.
 Parts of malleus
It has the following parts, (a)
The rounded head lies in the
epitympanic recess.
It articulates posteriorly with
the body of the incus
(b) The neck lies against the
pars flaccida.
(c) The anterior process is and
a lateral process
(d) The handle extends
downwards, backwards and
medially, and is attached to the
upper half of the tympanic
membrane
 Incus or Anvil
• It is so called because it resembles
an anvil, used by blacksmiths.
• It resembles a molar tooth and has
the following parts, (a) The body is
large and bears an articular surface
that articulates with the head of the
malleus,
• (b) The long process projects
downwards just behind and parallel
with the handle of the malleus. Its
tip bears a lentiform nodule
directed medially which articulates
with the head of the stapes.
 Stapes
• This bone is so called
because it is shaped like
a stirrup.
• It is the smallest, and
the most medially
placed ossicle of the ear.
 Parts of the stapes

(a) The small head has a concave

facet which articulates with the
lentiform nodule of the incus,
(b) A narrow neck.
(c) Two limbs or crura; anterior,
the shorter and less curved; and
posterior, the longer which
diverge from the neck and are
attached to the footplate.
• (d) The footplate, a footpieceor
base, is oval in shape, and fits
into the fenestra vestibuli.
 CLINICAL ANATOMY
• 1. Throat infections
commonly spread to the
middle ear through the
auditory tube and cause
otitis media.
• Chronic otitis media and
mastoid abscess are
responsible for
persistent discharge of
pus through the ear.
Otitis media is more
common in children
than in adults.
• Fracture of the middle cranial fossa breaks the
roof of the middle ear, rupture the tympanic
membrane, and thus cause bleeding through
the ear along with discharge of CSF.
• Inflammation of eustachian tube can occur
after an attach of common cold
 Inner ear
• Internal ear, or labyrinth, lies
in the petrous part of the
temporal bone.
• It consists of the bony
labyrinth within which there is
a membranous labyrinth.
• The membranous labyrinth is
filled with a fluid called
endolymph.
• It is separated from the bony
labyrinth by another fluid
called the perilymph.
 Bony Labyrinth
• The bony labyrinth
consists of three parts:
(a) The cochlea
anteriorly;
(b) The vestibule, in the
middle;
(c) The semicircular
canals posteriorly
 Cochlea
• Bony cochlea resembles
the shell of a common
snail.
• It forms the anterior part
of the labyrinth. Ithas a
conical central axis
known as the modiolus
around which the
cochlear canal makes two
and three quarter turns.
• A spiral ridge of the
bone, the spiral lamina,
projects from the
modiolus and partially
divides the cochlear
canal into the scala
vestibuli above, and the
scala tympani below
 Vestibule
• This is the central part
of the bony labyrinth.
• It lies medial to the
middle ear cavity.
• Its lateral wall opens
into the middle ear at
the fenestra vestibuli
which is closed by the
footplate of the stapes
• The medial wall is related
to the internal acoustic
meatus,and presents the
spherical recess in front,
and theelliptical recess
behind. The two recesses
are separated by a
vestibular crest which
splits inferiorly to enclose
the cochlear recess
 Semicircular Canals
• There are three bony
semicircular canals:
1. Anterior/Superior,
2. Posterior
3. Lateral.
• They lie posterosuperior to the
vestibule, and are set at right
angles to each other. Each
canal describes two-thirds of a
circle, and is dilated at one
end to form the ampulla.
• Non ampullary end of
the lateral semi circular
canal opens into
vestibule.
• Posterior and superior
semi circular canals
form a common opening
called Crus commune
 Membranous Labyrinth
• It is a continuous closed
cavity filled with
endolymph.
• Parts of the epithelium of the
membranous labyrinth are
specialized to form receptors
• For sound organ of Corti,
• For static balance the
maculae,
• For kinetic balance the
cristae.
 Parts of membraneous labrynth
(a) The spiral ductof the
cochlea or organ of
hearing, anteriorly.
(b) The utricle and saccule
the organs of static
balance,within the
vestibule.
(c) The semicircular ducts
the organs of kinetic
balance, posteriorly
 Duct of the Cochlea or the Scala Media

• The spiral duct occupies

the middle part of the
cochlear canal between
the scala vestibuli and
the scala tympani.
• It is triangular in cross-
section
• The floor is formed by
the basilar membrane;
• The roof by the
vestibular or Reissner's
membrane;
• The basilar membrane
supports the spiral
organ of Corti
 Saccule and Utricle
• Saccule lies in the anteroinferior
part of the vestibule, and is
connected to the basal turn of the
cochlear duct by the ductus
reuniens.
• Utricle is larger than the saccule
and lies in the posterosuperior
part of the vestibule. It receives
three semicircular ducts through
five openings.
• The duct of the saccule unites
with the duct of the utricle to
form the ductus endolymphaticus.
 Blood Supply and venous drainage of
Labyrinth
• Labyrinthine branch of
the basilar artery

• Labyrinthine vein drains

into the superior
petrosal sinus or the
transverse sinus
 Clinical anatomy
• Lesions of cochlear nerve
cause hearing defects.
• If there is any impairment of
hearing one must determine
whether it is really due to
disease of the nerve, i.e.
nerve deafness, or merely
due to disease of the middle
ear, i.e. conductive deafness.
This is done by Rinne's test
and Weber's test.
 Rinne's test
• A vibrating tuning fork
is held opposite the ear
and then placed on the
mastoid process.
• The patient is asked to
compare the relative
loudness of the fork in
the two instances
 Weber's test,
• The vibrating tuning
fork is placed on the
centre of the forehead.
The fork is heard better
on the side of middle
ear disease than on the
normal side.