Embryology and Anatomy

of the Ear

Justin Gull
The ear as you know it.
 The inner ear as it once was.
3 weeks:
•Developing auditory placode
(ectoderm) and gut endoderm
(will contribute to inner and
middle ear)
•Invagination into otic pit, and
migration of otocyst

7 weeks:
•Labyrinths are recognizable,
cochlea has one turn, first
sensory cells in utricle, saccule

11 weeks:
•CN VIII attaches, cochlea has
2 ½ turns
•Adult size, active by week 21
Embryology of Middle Ear:
Tympanomastoid compartment

•3rd wk – tubotympanic
recess (1st branchial pouch
endoderm) approaches 1st
cleft ectoderm
•6th wk – Ossicular
mesenchyme separates cleft
and pouch
•20th wk – tympanic cavity
grows to enclose ossicles
•22nd wk – extension to
form mastoid antrum
•33rd wk – early mastoid
pneumatization
Embryology of Middle Ear:
Ossicles

•1st Branchial Arch

–Meckel’s cartilage: head of
malleus, body and short
process of incus
–Tensor Tympani muscle
–Trigeminal nerve (V):
mandibular branch supplies
tensor tympani mucle
–1st Arch artery – involutes.
Embryology of Middle Ear:
Ossicles

•2nd Branchial Arch

–Reichert’s cartilage: long
process of incus, handle of
malleus, stapes
superstructure and tympanic
surface of footplate.
–Stapedius muscle
–Facial Nerve (VII): stapedial
nerve
–2nd Arch artery – stapedial
artery. – involutes.
Embryology of Middle Ear:
Ossicles

•Derived from Reichert’s

cartilage (superstructure
and tympanic surface of
footplate) and otic capsule
(vestibular surface and
annular ligament).
•Originally circular with
stapedial artery through
middle – obturator foramen
remains after artery
involutes.
Embryology of External Ear

•Six Hillocks of His (wk 5)

–1 – Tragus (first/mandibular
arch)
–2 - Crus of Helix (rest are
from second/hyoid arch)
–3 - Ascending Helix
–4 - Upper Helix, Scapha, &
Antihelix
–5 - Descending Helix, Middle
Scapha & Antihelix
–6 - Inferior Helix, Antitragus
–Lobule
External ear

Motor: post auricular branch of

facial innervates anterior,
superior, posterior
auricular muscles
External ear

Sensory (simplified):
•Greater auricular nerve (C2-3) with anterior and
posterior branches
•Auriculotemporal branch from superior auricle

Arteries
•Posterior auricular, occipital and superficial temporal

Lymph
•Mainly pre- and infraauricular nodes
EAC (East Australian Current)

•2.5 cm long
•Lateral 1/3 cartilaginous, hairy
•Medial 2/3 bony, without hairs or
ceruminous glands
•Fissures of Santorini:
dehiscences of canal
that may lead to
infections of parotid or TMJ
•Sensory:
•Auriculotemporal
(V3) anterosuperiorly
•Branches of VII, IX, X
posteroinferiorly, e.g. Arnold’s
Middle Ear Structures:
Tympanic Membrane

•Attached from umbo to lateral

process
•Medial=towards brain
•From squamous, to fibrous
to mucosal layer
•Radial and circumferential
fibers
•Without an annulus, you’re
flaccida. May hide cholesteatoma in Prussak’s space
•Sensory: lateral from V, VII, IX, X
medial from tympanic plexus of IX
•Vasc: auricular (lateral), tympanic (medial) branches
of internal maxillary
Middle Ear Structures:
Ossicles

Malleus:
head in epitympanum (attic)
vestigial anterior process
tensor tympani muscle

Incus:
incudomalleal, incudostapedial
joints
short process in posteroinferior
epitympanum=landmark can be
seen from mastoid in mastoidectomy

Stapes:
Middle Ear Structures:
Middle Ear Cleft

•Aerated anteroinferiorly by
ET, and posteriorly through
auditus by the antrum of the
mastoid and petrous t-bone

•Modified respiratory mucosa

w/ ciliated and secretory cells

•Sensation from the tympanic

plexus of IX

•Can be described by division into epi, meso and

hypotypanum
Middle Ear Structures:
Boundaries of Tympanic Cleft

Roof: tegmen tympani—beyond is middle cranial fossa

Floor: jugular bulb

Anterior: ET orifice, carotid

wall, tensor tympani canal

Posterior: Pyramidal
eminence, facial recess,
sinus tympani

Lateral: TM
Middle Ear Cleft:
Boundaries of Tympanic Cleft

Medial: cochlear promontory of otic capsule (basal turn

of cochlea which separates oval and round windows),
horizontal segment of VII, anterior portions of superior
and lateral canals, cochleariform process

NB: facial nerve

dehiscent in
55% of people,
which means
the bony facial
ridge is not
intact over the
nerve in the
cleft
Middle Ear Cleft:
More views

Sinus tympani
medial to facial
recess.

Can anyone see the

subiculum or
ponticulus?
Middle Ear Cleft:
More views

Facial nerve superior to oval

window

Tensor arises from

protympanum,makes a right
turn at cochleariform process
before traveling to malleus
Middle Ear:
Vasculature

Subarcuate: AICA or labyrinthine

Superficial petrosal: middle meningeal

Sup. tympanic artery: middle meningeal

Tubal artery: accessory meningeal

Corticotympanic: int. carotid

Inferior tympanic: ascending pharyngeal

Stylomastoid: deep auricular (from int. max.)

Mastoid: occipital

Ant. tympanic: int. maxillary

Eustachian Tube:
In brief

•Opens in protympanum
(anteromedial ME)
•This segment is bony

•Becomes
cartilagenous
•Ends in lateral wall of
pharynx

•Levator is mainly
responsible for distortion of
tubal cartilage when “popping ears.”
Facial Nerve:
In brief

•Muscles: facial expression,

stylohyoid, posterior digastric,
stapedius

•Parasympathetic: lacrimal,
seromucous, submandibular
and subligual glands

•Sensory: taste from anterior

2/3 of tongue
Facial Nerve:
Course

•To geniculate ganglion in

labyrinthine segment

•At first/medial/anterior genu

turns posterior into horizontal/
tympanic segment

•Turns inferior at second/lateral/

posterior genu into the mastoid/
vertical segment and out
stylomastoid foramen

NB: Chorda lies between malleus and incus

Facial Nerve:
Course in relationship to CN VIII

Remember:
7-Up
Inner Ear:
Position and overview

Sup. canal forms

ridge in floor of
middle cranial fossa
(arcuate eminence)
Landmark for IAC
in middle cranial
fossa approach

Horizontal canal
extends into
mastoid
landmark in
mastoidectomy
Inner Ear

Saccule in spherical recess

Utricle in elliptical recess

•Developed and contained in otic

capsule

•Filled with perilymph and endolymph

•Canals are posterior

•Superior canal on one side in same

plane as posterior on other side
Inner Ear:
Bony and Membranous Labyrinths

Blue=endolymph
White=perilymph
•In canals are
ducts

•In vestibule is
utricle, saccule
filled with
endolymph

•Common crus
for sup and lat

•5 openings in
utricle for ducts

•Plane of horizontal canals is angled, with the

anterior portion elevated from true horizontal by 30°
Inner Ear:
Bony and Membranous Labyrinths
Medial to Lateral View
Inner Ear:
Endolymphatic Sac and Cochlear Aqueduct

The endolymphatic sac is at the end of the duct and lies within the dura
overlying the petrous bone of the posterior fossa. Its function is unknown
but it may be involved in the production and resorption of endolymph.

The cochlear aqueduct is thought to play a role in maintaining fluid and

pressure balance between the inner ear and cerebrospinal fluid, though its
exact function is not well characterized. In bacterial meningitis, it is a
possible route for spread of infection from CSF to the inner ear. Studies
of its anatomy and patency reported differing results.

In general, it has a funnel-shaped aperture at the cranial end, and follows a

curved pathway to open into the scala tympani. A dural sheath extends from
the cranial end into the aqueduct for a short distance. The rest of it contains
a meshwork of loose connective tissue with a central lumen. Central lumen
patent (32%), lumen blocked by loose material (60%), lumen blocked
by bone (3%), aqueduct absent (5%). There is no correlation between age
and patency rates or between age and prevalence of bony occlusion.
A human temporal bone study of the normal cochlear aqueduct. S.N. Merchant, Q. Gopen (Massachusetts Eye and Ear Infirmary, Boston, M
Inner Ear:
Balance

•Crista and cupula in each ampulla

sense angular acceleration
•Otoliths in gelatinous matrix
of these organs
•Maculae in saccule and utricle
sense linear acceleration

Stereocilia,
kinocilium
Inner Ear
Cochlea

Sound waves
travel in
oval window,
up scala
vestibuli, back
down scala
tympani and
“out” round
window

High frequency pressure

waves (sound) stimulate hair cells at the basal turn,
and low frequency waves at the apex
Inner Ear
Cochlea

Inner hair cells (Type

I) transduce the
relative movement
between tectorial and
basilar membranes
into nerve impulses
we hear (sound)

Outer hair cells (Type II) receive only

5% of CN VIII innervation, and
increase the sensitivity of the cochlea.
Changes in length of the cell rather
than shear forces determine its
activity. Normal ears will ring following
stimulation, thanks to the outer hair
cells. This is the basis for otoacoustic
emissions.
Inner Ear:
Cochlea
Blood Supply

Drains to inferior petrosal sinus