ANATOMY OF THE EAR

Facilitator: Dr. khamis

ENT surgeon
SJCHAS
 ANATOMY OF THE EXTERNAL EAR
The external ear consists of two parts
(1) The Auricle
(2) The External auditory canal
 THE AURICLE
The auricle is made up of
the: helix, the antihelix, the
tragus and the lobule
The auricle is made up of
skin and fibrocartilage.
 The skin is firmly adherent
into the cartilage anteriorly
and loose posteriorly.
 BLOOD SUPPLY OF THE AURICLE
(i) Posterior auricular artery
(ii) Anterior auricular artery
 VENOUS DRAINAGE OF THE AURICLE
(i) Superficial temporal vein, which join posterior facial vein
and drain into the Internal jugular vein
(ii) Posterior auricular vein which drains into the external
jugular vein
 NERVE SUPPLY OF THE AURICLE
Comes from the second and
third cervical spinal nerves
trigeminal nerve and vgus nerve
(a) Greater auricular (C2, C3)
(b) Lesser occipital (C2)
(c) Auriculotemporal nerve
(Trigeminal)
(d) auricur branch of the vagus
nerve
 LYMPHATIC DRAINAGE
The lymphic drainage is to group of lymph nodes around
the auricle, Post auricular group, Pre auricular group, infra
lobular group of lymph nodes.
These eventually drain into the deep cervical chain of lymph
nodes.
THE EXTERNAL AUDITORY CANAL
The canal is about 2.5 cm long.
The outer one third is made up of cartilage.
The inner two thirds is made up of bone.
The bony part is made up of the squamous and tympanic
parts of the temporal bone.
The canal is s-shaped.
 Contn………….
The skin of the outer one third of the canal contains hairs,
sebaceous glands and ceruminous glands.
The skin of the inner two thirds is devoid of skin
integuments.
The squamous cells covering the outer part of the tympanic
membrane and inner part of the canal migrate outwards
(centrifugal migration) from the umbo
 Relations
Anteriorly, the EAC is related to the Temporomandibular
joint, superficial temporal vessels, Auriculotemporal nerve
and the parotid gland.
Posteriorly, the EAC is related to the mastoid air cells, deep
and vertical portion of the facial nerve and the mastoid
antrum.
Blood supply
(i) Posterior auricular (From External carotid)
(ii) Auriculotemporal (From superficial temporal)

Nerve supply
(i) Auriculo temporal (v) anteriorly
(ii) Auricular nerve (X) Nerve of Arnold.
TYMPANIC MEMBRANE
Tympanic membrane lies at the
distal end of the external acoustic
meatus.

The tranluncency of the tympanic

membrane allows the structures
of the middle ear to be observed
during otoscopy.

it is a relative thin connective

tissue structure, susceptible to
perforation(usually by trauma or
infections)
QUADRANTS OF THE TYMPANIC MEMBRANE
 Contn….Tympanic membrane
The tympanic membrane is an elliptical disc at the medial
end of the EAC.
2 parts, pars tensa and pars flaccida
 It measures (10mm x 8mm).
It is convex towards the tympanic cavity
It is made up of three layers
(a) Outer squamous layer
(b) Middle fibrous layer
(c) Inner columnar epithelial layer
At the periphery the tympanic membrane is thickened into a
fibrocartilaginous annulus that fits into a ring like groove
known as tympanic sulcus.
SULCUS
The sulcus is deficient above and a small part of the
tympanic membrane known as pars flaccida occupies this
portion. The deficient part is known as the notch of Rivinus.
BLOOD SUPPLY-TYMPANIC MEMBRANE
(i) Deep auricular artery
(ii) Anterior tympanic artery (internal maxillary)
(iii) Posterior tympanic artery (stylo mastoid artery)
 NERVE SUPPLY OF TM
(i) Internally: From the tympanic plexus (IX) Nerve of
Jacobson
(ii) Externally: From Auriculotemporal (V) & Auricular nerve
(X).
THE MIDDLE EAR
 Contn….Middle Ear
The middle ear cleft consists of:
(i) The eustachian tube
(ii) The tympanic cavity
(iii) The aditus ad antrum
(iv) The mastoid air cells
The middle ear cleft is lined by respiratory epithelium
 THE EUSTACHIAN TUBE
The eustachian tube is about 36mm long.
It is made up of a bony and a fibrocartilaginous part.
The bony part which is about 1/3 of the tube and 2/3 is
fibrocartilaginous opens into the anterior part of the tympanic
cavity and Nasopharynx.
The tensa tympani muscle lies along the bony part.
The levator palatini lies under the floor of the tube.
The tensor palatini muscle arises from the fibrocartilaginous
part and attached to the aponeurosis of the soft palate.
differencea in adult and infants<7years ET
characteristics adult infant
length 36mm 18
angle 45 10
lumen narrow wide
cartilage rigid flaccid
elastic recoil effective ineffective
ostmanns fat more less
Eustachian Tube.....
• Blood supply of ET
• Ascending pharyngeal artery
• Middle meningeal artery
• artery of pterygoid

• veinous drainage into pterygoid venous plexus

 MIDDLE EAR CAVITY
The cavity measurers:
(i) 15mm (superior- inferior)
(ii) 13mm (posterior-anterior)
(iii) 6-2mm (medial-lateral)
 LATERAL WALL
Consists of the drum and a bony wall above and below the
drum.
Tympanic space above the drum = Epitympanum
Tympanic space below the drum = Hypotympanum
Tympanic space medial to the drum = Mesotympanum
 MEDIAL WALL
Consist of the oval window, Promontory and round window.
The horizontal part of the facial nerve lies just above the
oval window and horizontal semicircular canal above the
facial nerve.
Medial wall separates middle ear from inner ear.
 POSTERIOR WALL
Contains the aditus ad antum
It also contains a bony pyramid from which the stapedius
tendon arises just below the aditus.
Lateral to the pyramid is the entrance of chorda tympani.
 ANTERIOR WALL
A narrow wall with four openings
(i) Canal of Hunguier (chorda tympani)
(ii) Canal of the tensor tympani muscle
(iii) Eustachian tube orifice
(iv) Glaserian fissure containing the tympanic artery
 THE ROOF
A thin plate of bone (tegmen tympani).
Separate the middle ear from middle cranial fossa.
The floor
• The bone plate which separates tympanic cavity from the jugular bulb

• Near the madial border of the floor is a small aperture through which
the tympanic branch from the glossopharngeal nerve enters the
middle ear
 CONTENTS OF THE MIDDLE EAR
(a) Air
(b) Chorda tympani (chief nerve of taste –VII)
(c) Tympanic plexus of nerves
(d) The auditory ossicles.
(i) The malleus: The largest ossicle
(ii)The incus
(iii)The stapes the smallest bone in the body
 THE MALLEUS
The malleus has a head, neck and handle.
The handle is attached to the drum.
The head articulates with the body of the incus
 THE INCUS
The incus has a body, a long process and a lenticular
process at the end of the long process that articulates
with the head of the stapes.
 THE STAPES
The stapes has a head, a neck, a posterior and
anterior crura and a foot plate.
The foot plate is in contact with the oval window
membrane.
 BLOOD SUPPLY OF THE MIDDLE EAR

(i) Anterior tympanic branch of maxillary artery

(ii) stylomastoid branch of posterior auricular artery
 NERVE SUPPLY OF THE MIDDLE EAR
(i) Nerve of Arnold (x)
(ii) Nerve of Jacobson (ix)
 ADITUS AD ANTRUM
• An opening from the middle ear attic into the mastoid
antrum.
• The facial nerve lies just below the aditus.
 THE MASTOID ANTRUM
• An air chamber situated in the mastoid bone
• It measures about 14 mm (anterior posterior)
9mm(superior-interior) 7 mm (medial – Lateral).
 THE INNER EAR
The inner ear is the innermost part of the ear,called the labyrinth and is
concerned with hearing and balance.
it consists of bony labyrinth and membranous labyrinth
The bony labyrinth contained within the petrous part of temporal bone and is
divided into three chambers;
the vestibule,
the semicircular canals and
the bony cochlea
 INNER EAR .....
The membranous labyrinth is a series of communicating
membranous sac and ducts, contained within the bony cavities.
it consists of
cochlear duct
utricule and saccule
semicircular ducts
endolymphatic duct and sac
 THE VESTIBULE
The vestibule lies between the middle ear medial wall and the
outer part of the internal acoustic meatus.
The three bony semi circular canals open on the posterior
aspect of the vestibule.
The bony cochlear lies anterior to the vestibule towards the
Internal acoustic meatus.
vestibule has 5 opening of 3 semicircular canal
 (It is rolled into 2 .5 turns and is about 35mm long)
 THE COCHLEA

A spiral shaped fluid filled structure

It is rolled into 2 .5 turns and is about 35mm long
around a central pyramid of bone called modiolus
The cochlear is divided into three compartments
(1) Scala vestibule (vestibular duct)
(2) Scala media (cochlea duct)
(3) Scala tympani (tympanic duct)
 SCALA MEDIA
This chamber contains the organ of hearing the so called the organ
of corti
It contains Endolymph
The sensory cells of the organ of corti are hair cells.
These cells are set along the length of the cochlear; and are
supported by supporting cells.
The hairs of the hair cells are in contact with a gelatinous
membrane, known as the tectorial membrane.
 Stria vascularis is also contained in the scala media.
ORGAN OF CORTI
 ORGAN OF CORTI
The organ of Corti is the auditory receptor organ.
It is found in the scala media resting on the basilar membrane.
It contain hair cells that respond to different sound frequencies
HAIR CELLS--These convert mechanical into electrical energy.
TECTORIAL MEMBRANE:--Transmits sound vibrations into the
hair cells by deformation of the hairs of the hair cells.
BASILAR MEMBRANE.--Supports the nerve fiber of the hair cells.
The stria vascularis is a highly vascular tissue which
supplies oxygen and nutrients to the organ of corti.
It is known as the battery of the cochlear.
 INNER EAR FLUIDS

Perilymph – Between bony and membranous labyrinth

Endolymph-Fills the entire membranous labyrinth

 SCALA VESTIBULE
The scala vestibule communicates functionally with the middle ear
through the oval window, while the scala tympani communicates
with the middle ear through the round window.

Scala vestibule and scala tympani communicate to each other at

the apex of the cochlear through the opening known as
helicotremas
 SCALA TYMPANI
• Scala tympani is the lower compartment of the cochlea and contains the
perilymph.
• It is separated from cochlear duct (scala media) by the basilar membrane.
• It extends from the round window to the helicotrema where it continues as
vestibular duct (scala vestibuli).
• The scala tympani and the scala vestibuli are continuous at the apex
(helicotrema) of the cochlear duct.
• scala tympani also communicates with the sub arachnoid space through
the cochlear aqueduct.
 INNER EAR FLUIDS
PERILYMPH ENDOLYMPH
• Resembles ECF • Resembles ICF
• Rich in sodium ions • Rich in potassium ions
• SOURCE:2 theories • SOURCE:
• 1)filtrate of serum from 1) Stria vascularis
capillaries of spiral ligament. 2) Dark cells of utricle &
• 2)CSF reaching labyrinth ampullated ends of
via aqueduct of cochlea. semicircular canals.
 THE VESTIBULAR RECEPTOR ORGANS
This is the organ of balance.
Contain special sensory epithelium, the crista
ampularis is found on each ampulla, and is supplied
by fibres of the vestibular division of the 8th cranial
nerve.
In the utricle and saccule there is also a patch of
specialized sensory cells known as macula.
The vestibular receptor organs consists of three
basic structures;
(a) Sensory cells containing hairs on their free surface.
(Hair cells)
(b) Supporting Cells
(c) A gelatinous mucopolysaccharide substance
 THE MACULA
These are hair cells contained in the saccule and utricle.
These hair cells are responsible for static equilibrium and linear
acceleration
The macula of the utricle is in the horizontal plane and that of the
saccule in the vertical plane
The maculae consists of an otolithic membrane resting on a layer
of columnar cells
These otolithic membrane contains minute crystals of calcium
carbonate known as otoliths/statoconia.
 Contn…The hair cell of a maculae
The hair consist of a cilium and many stereocilia.
The hair cells are surrounded by the dendritic processes of afferent
neurons which form the vestibular division of the vestibulocochlear
nerve.
THE AMPULLA
In the ampulla, the gelatinous substance is known as
cupula.
The hairs of the hair cell just freely into it
THE UTRICLE AND SACCULE
In the utricle and saccule, the gelatinous substance is
studded with crystals known as statoconia.
The membrane is known as statoconial membrane.
 Utricle and Saccule
When the head moves, the hairs of the hair cells are
deformed by the mechanical force of the gelatinous
membranes.
 This event is transformed into action potentials in the
hair cell and the their vestibular nerve fibres.
 VESTIBULAR HAIR CELLS
The vestibular hair cells are of two types;
(a) Type 1: Flask shaped
(b) Type 2: Cylindrical shaped
 SEMICIRCULAR CANALS
The semicircular canals are three in number and are continuous with the
utricle.
lateral/horizontal
posterior
superior
lies at right angel to each other
Each semicircular canal has an ampullated end and non ampullated end
Non ampullate ends of PSCC and SSCC unite to form a common channel
called crus commune
The ampulla is lined by non-keratinised
stratified squamous epithelium resting
on connective tissue.
A crista ampullaris is a mound
consisting of a central core of
connective tissue covered by a layer
sensory and supporting cells.
Overlying the epithelium should be a
cone-shaped gelatinous mass known as
the cupula--This is a gelatinous
membrane covering the hair cells of the
crista
Contn….
The sensory cells send sensory
hairs into the cupula.
The sensory hairs are similar to
those in the macula and contain
cilia and microvilli.
There are no otoliths in cupula.
Dentritic processes of the
vestibular nerve surround the
sensory cells.
 BLOOD SUPPLY OF THE INNER EAR
Blood supply of the inner ear is derived from the
labyrinthine artery which is a branch of the anterior
inferior cerebellar artery of the basilar artery.

VENOUS DRAINAGE OF THE INNER EAR

Goes into the jugular bulb via the petrosal and
sigmoid sinuses.
 NERVE SUPPLY OF THE INNER
The vestibular nerve supplies the utricle, the saccule,
and the ampulla of the semicircular ducts.
THE END