CLINICAL MEDICINE 2021

ROSE NJOGU
ENT SPECIALIST SAMBURU
ANATOMY OF THE INNER
EAR
Also called labyrinth.
Lies in the petrous part of the temporal bone.
Has a bony labyrinth, inside it a membranous
labyrinth.
Membranous labyrinth has a fluid called endolymph.
Cont….
Membranous labyrinth is separated from the bony
labyrinth by a fluid called Perilymph.
DIAGRAM
BONY LABYRINTH
Consists of 3 parts:
A) Cochlear - anteriorly.

B)Vestibule - in the middle.

C)Semicircular canals
- posteriorly.
DIAGRAM
COCHLEAR
Resembles the shell of a snail(some thing moves
slow)
Forms the anterior part of the labyrinth.
Has a conical central axis(the Modiolus) around
which the cochlear canal makes
23/4 turns.
The modiolus is directed laterally.
COCHLEAR cont’d
The cochlear canal is partially divided in two parts by
a spiral ridge of bone which projects from the
modiolus:
A) Scala Vestibuli - above.
B) Scala Tympani - below.
This division is completed by the basilar membrane.
COCHLEAR cont’d
The scala vestibuli communicates with the
Scala tympani at the apex of the cochlea by a small
opening called the Helicotrema.
VESTIBULE
It is the central part of the bony labyrinth.

Lies medial to the middle ear cavity.

Its lateral wall opens into the middle ear at the

Fenestra Vestibuli(Oval Window).
VESTIBULE cont’d
The 3 semi-circular canals open into it at the
posterior wall.

The medial wall is related to the internal acoustic

meatus.
SEMI-CIRCULAR CANALS
These are 3 in number, namely:
 Anterior or superior
 Posterior
 Lateral(Horizontal)

These lie postero-superior to the vestibule,and are set

at right angles to one another.
DIAGRAM
SCCs cont’d
Each canal is about 2/3 of a circle, and is dilated
at one end to form the Ampulla.

The canals open into the vestibule by 5 openings.

The Anterior(superior) scc lies in a vertical plane.

DIAGRAM
SCCs cont’d
The posterior end of the anterior canal unites with
the upper end of the Posterior canal to form the Crus
Commune.

The crus commune opens into the medial wall of the

vestibule.
POSTERIOR SCC
Lies in a vertical plane parallel to the axis of the
petrous temporal bone.

Its upper end joins the Anterior Canal to form the

crus commune.
LATERAL SCC
Also called the horizontal canal.

Forms a prominence into the medial wall of the

middle ear.

Its Ampulla lies anterioly close to the ampulla of the

anterior canal.
SCCs cont’d
NB:
1.The lateral semi-circular canals of the two sides
lie in the same plane.

2.The anterior canal of one side lies in the plane of

the posterior canal of the other side.
MEMBRANOUS LABYRINTH
Complicated and continuous closed cavity filled with
endolymph.
Parts of its epithelium are specialised to form
receptors for:
1) Sound - Organ of Corti
2) Static Balance - Maculae
3) Kinetic Balance - Cristae
DIAGRAM
MEMB. LABY. Cont’d
Like the bony labyrinth, it has 3 main parts:
1) The Spiral Duct of the Cochlea(organ of hearing
anteriorly)
2) The Utricle and Saccule(organs of static balance)
within the Vestibule.
3) The Semi-circular Ducts(organs of kinetic
balance) posteriorly.
DIAGRAM
THE DUCT OF THE COCHLEA
This is the Scala Media(Cochlea Duct).

It is a spiral duct which occupies the middle part of

the cochlea canal between the scala vestibuli and
scala tympani.
COCHLEA DUCT Cont’d
Triangular in cross-section.
Floor formed by the Basilar Membrane.

The roof formed by the Vestibular(Reissner’s)

membrane.
The outer wall formed by the bony wall of the
cochlea.
COCHLEAR DUCT Cont’d
The Basilar Membrane supports the Organ of Corti,
which is the end organ of hearing.

The Organ of Corti is innervated by Peripheral

processes of bipolar cells located in the spiral
ganglion.
COCHLEAR DUCT cont’d
The Spiral Duct is located in the spiral canal within
the modiolus at the base of the spiral lamina.

Posteriorly the duct of the cochlea is connected to the

Saccule by a narrow ductus reuniens.
DIAGRAM
COCHLEAR DUCT cont’d
Sound waves reaching the endolymph make
appropriate parts of the basilar membrane vibrate,
with different parts of the Organ of Corti being
stimulated by different frequencies.
The loudness of the sound will thus depend on the
amplitude of vibration
SACCULE AND UTRICLE
The Saccule lies in the anterior part of the vestibule.
It is connected to the basal turn of the cochlear duct
by the ductus reuniens.

The Utricle is larger than the saccule and lies in the

postero-superior part of the vestibule
DIAGRAM
SACCULE AND UTRICLE cont’d
The three Semi-circular ducts open into the Utricle
through 5 openings.
The duct of the saccule unites with the duct of the
utricle to form the Ductus Endolymphaticus.
This ductus endolymphaticus ends in a dilation called
the Saccus endolymphaticus
DIAGRAM
SACCULE AND UTRICLE cont’d
The medial wall of the saccule and utricle are
thickened to form a Macula in each chamber.
The maculae are end organs that give information
about the position of the head.
They are static balance receptors, supplied by
peripheral processes of neurons in the vestibular
ganglion.
UTRICLE
The utricle has two small rounded bodies called
Otoliths(Ear stones).

The otoliths are suspended in the Endolymph in

contact with the free ends of the hairs projecting from
the Macula.
SEMI-CIRCULAR DUCTS
The three semi-circular ducts lie within the
corresponding bony canals.
Each duct has an Ampulla corresponding to that of
the bony canal.
In each ampulla there is an end organ called the
Ampullary crest(Crista).
Cristae respond to pressure changes in the
endolymph due to head movement.
NB: MEDIAL WALL OF
VESTIBULE:
Has perforations for the transmission of
Vestibulocochlear(8th) Nerve endings.
These transmissions are:
i) Inferior Vestibular nerve to the saccule.
ii)Nerves to the utricle.
iii)Nerves to the ampullae of the superior and lateral
semi-circular canals.
ORGAN OF CORTI
Consists of two types of cells.

These are:
-Supporting cells.
-Hair cells.
DIAGRAM
DIAGRAM
HAIR CELLS
They are the receptor cells of hearing.
Transduce sound(mechanical) energy into Electrical
energy.

They are of two types:

i) Inner hair cells.
ii)Outer hair cells.
INNER HAIR CELLS
Inner hair cells are arranged in a single row.
They are richly supplied by Afferent cochlear fibres.

The Inner hair cells are most important in the

transmission of Auditory Impulses.
OUTER HAIR CELLS
These are arranged in three or four rows.

Mainly receive Efferent innervation from the Olivary

Complex.

Their function is mainly to modulate the function of

the inner hair cells.
DIFFERENCES BTWN INNER
AND OUTER HAIR CELLS
Inner hair cells Outer hair cells
Total no 3500 12,000
Rows One row 3-4 rows
Nerve Supply Primarily afferent fibres Mainly efferent fibres and
and very few efferent very few afferent
Shape Flask shaped cylindrical
Development Develop earlier Develop late
Function Transmit auditory stimuli Modulate function of
inner hair cells
Vulnerability More resistant Easily damaged by
ototoxic drugs and high
intensity noise