Anatomy of external

ear, middle ear &

mastoid
 Warning system
Functions
of Ear Balance system

Communication system
Embryology
Embryology
 External ear:  Pinna / auricle
 External auditory canal

Middle ear cleft:  Eustachian tube

Parts of ear
 Tympanic cavity (middle ear)
 Mastoid air cell system

Inner ear (labyrinth):  Cochlea

 Vestibule
 Semicircular canals
External Ear
 External auditory canal

 24 mm long; Lateral 1/3 Cartilaginous (8 mm): up + back + medial.

Medial 2/3 Bony (16 mm): down + forward + medial. Pinna pulled up
+ back + lateral to straighten external auditory canal.

 Only cartilaginous skin has hair follicles: furuncle

 Cartilaginous fissure of Santorini & bony foramen of Huschke:

passage of infection to and from parotid gland
Nerve supply of E.A.C.
 Tympanic membrane
 Pearly white semi-translucent membrane

 Obliquely placed at 550 to floor

 2 parts: pars tensa and pars flaccida

 3 layers of pars tensa: outer epithelial, middle fibrous &

inner mucosal

 Fibrous layer disorganized in pars flaccida

 Annulus deficient superiorly as notch of Rivinus

Otoscopic view
  Consists of:
 Eustachian tube
 Tympanic cavity (middle ear)
Middle ear  Aditus
cleft  Mastoid air cell system

 Develops from tubo-tympanic recess

Middle Ear
1. Epitympanum: Bounded laterally by scutum + pars flaccida
& medially by bone above tympanic part of facial nerve
2. Mesotympanum: Middle ear cavity lying opposite pars
tensa & bony tympanic annulus
3. Hypotympanum: Middle ear cavity below level of bony
tympanic annulus
4. Retrotympanum: Middle ear cavity behind bony tympanic
annulus
5. Anterior tympanum or Pro-tympanum: Middle ear cavity in
front of bony tympanic annulus
 Walls of middle ear

Roof: Tegmen tympani, middle cranial fossa

Floor: Jugular bulb, carotid artery

Anterior: Tensor tympani, ET orifice, carotid artery

Posterior: Aditus, fossa incudis, pyramidal eminence,

facial recess, sinus tympani

Lateral: Tympanic membrane, scutum

Medial: Promontory, oval window, round window, lateral

SCC, facial nerve (tympanic part)
 Lateral wall

 Membranous:

a. Tympanic membrane

 Bony

a. Lateral attic wall above pars flaccida (Scutum)

b. Lateral wall of hypotympanum

 Posterior wall

 Aditus ad antrum

 Fossa incudis for short process of incus

 Bulge produced by lateral semicircular canal

 Pyramidal eminence for stapedius tendon

 Bulge produced by vertical part of facial nerve

 Sinus tympani

 Facial recess
 Sinus Tympani

Boundaries:
 Superior: Ponticulus
 Inferior: Subiculum
 Lateral: Mastoid Segment of Facial Nerve
 Medial: Posterior semicircular canal

It evades direct surgical visualization during surgery.

Site for cholesteatoma recurrence
 Anterior wall

 Chorda tympani nerve exits via canal of Huguier

 Canal for tensor tympani on top

 Eustachian tube opening below

 Internal carotid artery is related inferiorly

 Medial wall
 Lateral semicircular canal

 Tympanic part of bony facial nerve canal

 Processus cochleariformis

 Promontory: formed by basal turn of cochlea

 Oval window

 Round window
 Contents of middle ear

 Air

 3 ossicles: malleus, incus and stapes

 2 muscles: tensor tympani & stapedius

 2 nerves: chorda tympani & tympanic plexus

 Mucosal folds & ligaments

 Blood vessels
Middle ear spaces
Eustachian Tube
 Anatomy
 36 mm long in adults

 Directed anteriorly, inferiorly & medially from anterior

wall of M.E., forming angle of 450 with horizontal &

sagittal planes

 Enters naso-pharynx 1.25 cm behind posterior end of

inferior turbinate
 Parts

Lateral 1/3 is bony

Medial 2/3 is fibro-

cartilaginous.

Junction b/w 2 parts is

isthmus, narrowest part
of Eustachian Tube.
Adult vs. Child (< 7 yr)
  1. Ventilation & maintenance of atmospheric
 pressure in middle ear for normal hearing
Functions  2. Drainage of middle ear secretions into
 nasopharynx by muco-ciliary clearance,
pumping action of Eustachian tube & presence
of intra-luminal surface tension
Temporal
Bone
 MacEwen’s Triangle
 Superior: supramastoid crest

 Anterior: postero-superior margin of bony

external auditory canal opening

 Posterior: tangent drawn to mid-point of

posterior wall of external auditory canal

 Contains spine of Henle

 Mastoid antrum lies 12-15 mm deep to triangle

 Trautmann’s triangle

Boundaries

 Superiorly: superior petrosal sinus

 Posteriorly: sigmoid sinus

 Anteriorly: solid angle (semi-circular canals)

 Pathway to posterior cranial fossa from mastoid cavity

& vice versa

 Mastoid cells

Central group Accessory group

 Mastoid antrum  Squamous
 Peri-antral  Occipital
Peripheral group  Styloid
 Dural  Peri-tubal
 Sino-dural  Zygomatic
 Peri-sinus  Petrous apex
 Tip
 Retro-facial
Thank
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