1 Anatomy of The Ear
1 Anatomy of The Ear
1 Anatomy of The Ear
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2- The floor is formed by the upper aspect of the fossa for the superior bulb of the
internal jugular vein.
3- Anterior wall: The lower half of the anterior wall is related to the internal carotid
artery in the carotid canal and is perforated by the caroticotympanic arteries. In its upper
half, it has two openings. The upper opening is the opening of the canal for tensor
tympani muscle. The lower opening is the tympanic orifice of the auditory tube.
4- Posterior wall: separates the middle ear from the mastoid bone. It contains the aditus
which leads to the mastoid antrum.
5- Medial wall: In it there are two openings, the upper of which is the oval window and
the lower is the round window which is closed by the secondary tympanic membrane. In
front of and between these two windows lies the promontory (basal turn of the cochlea).
The surface of it is grooved for the nerve fibers of the tympanic plexus. The horizontal
portion of the facial nerve is enclosed in a bony canal (Fallopian canal), which is
sometimes deficient, and which crosses the medial wall above the oval window. Situated
just above the bend of this canal is the eminence of the lateral semicircular canal.
6- Lateral wall: is the partly membranous (tympanic membrane) and partly bony which
is the outer attic wall.
The tympanic membrane represents the first closing membrane of the embryo. It
separates the external auditory canal from the middle ear cleft. The tympanic membrane
is thin and when examined with an auriscope has a pearly grey colour with a triangular
bright area, the cone of light, extending from the center (umbo) downwards and forwards.
It is placed obliquely so much so that it makes an angle of 45 degree with the floor of the
external auditory canal. Short process of the malleus is a small knuckle in the middle of
the upper part of the ear drum. Anterior and posterior malleolar folds run forwards &
backwards from it. Handle of the malleus descends downwards and backwards from it.
That part of the tympanic membrane which is situated above the two malleolar folds is
flaccid and called the pars flaccida. The rest of the ear drum is tense and known as pars
tensa. The ear drum is made of three layers
1- Outer layer of squamous epithelium continuous with that of the meatus.
2- Middle fibrous layer which is absent in pars flaccida.
3- Inner layer of mucous membrane continuous with the lining of the tympanic cavity.
The middle ear contains
1- Air
2- Muscles (tensor tympani and stapedius)
3- Bones (ossicles): a- Malleus b- Incus c- stapes
Blood Supply: The middle ear is supplied by the deep auricular branch of the maxillary
artery, branches from stylomastoid, middle meningeal, ascending pharyngeal and internal
carotid arteries. The veins drain into the pterygoid plexus and the superior petrosal sinus.
Lymph Drainage: drain into the retropharyngeal and parotid glands.
Nerve Supply: The main sensory nerve of the middle ear is the tympanic branch of
the glossopharyngeal nerve.
Eustachian tube (auditory tube)
It is 36 mm long, divided into an outer bony third and an inner cartilaginous two thirds. It
extends from the anterior wall of the middle ear to the lateral wall of the nasopharynx. Its
only function is to equalize the air pressure on the two sides of the ear drum.
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Mastoid Air Cells: Are tiny air containing compartments in the mastoid temporal bone.
These are divided into a number of topographical groups, such as
1- Antrum
2- Mastoid tip cells
3- Zygomatic cells
4- Squamous cells
5- Petrous apex cells
6- Perisinus cells
7- Perilabyrinthine cells
8- Retrofacial cells
9- Subdural cells
Inner Ear
The inner ear lies in the temporal bone. It is called the labyrinth (from its complexity) and
consist of:
Osseous labyrinth
A series of cavities in the petrous part of the temporal bone. There are three main parts:
1- Vestibule
Placed between the medial wall of the middle ear and the lateral end of the internal
auditory canal. A small aperture in the posterior part of the medial wall of the vestibule
leads into the aqueduct of the vestibule, a canal which passes backwards to the posterior
surface of the petrous bone, where it opens under the dura. The fenestra ovali, in the
lateral wall of the vestibule, is closed to the middle ear by the footplate of the stapes and
its annular ligament.
2- Bony Semicircular Canals
Three in number on each side.
a- Superior Canal. Lies almost transverse to the long axis of the petrous. b- Posterior
Canal. Lies in a plane parallel to the posterior surface of the petrous. c- Horizontal or
lateral Canal. Lies in the angle between the superior and posterior canals.
3- Bony Cochlea
Lies in front of the vestibule. It resembles a snail shell in shape, and has 2.5 turns in the
human. It has a central axis, the modiolus, which forms the inner wall of the bony canal
of the cochlea, which is wound spirally round it. The osseous spiral lamina projects from
the modiolus into the canal.
The osseous labyrinth contains perilymph in which the membranous labyrinth is situated.
The composition of the perilymph is very similar to that of extracellular fluids.
Membranous Labyrinth
A continuous series of communicating sacs and ducts within the bony cavities. It consists
of:
1- Saccule & Utricle, in the vestibule.
2- Membranous Semicircular ducts, in the bony semicircular canals.
3- Cochlear Duct (scala media) in the bony cochlea.
The membranous labyrinth contains endolymph fluid. The endolymph contains a very
high concentration of potassium and a low sodium content, similar to that of intracellular
fluids.
The basilar membrane stretches from the free border of the osseous spiral lamina to the
outer wall of the bony canal of the cochlea.
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Reissner’s membrane extends diagonally from the osseous spiral lamina to the outer wall
of the bony cochlea.
Sensory cells concerned with hearing are contained in the cochlear duct (scala media), a
portion of the membranous labyrinth which lies between Reissner’s membrane and the
basilar membrane and ends blindly at the helicotrema. The scala media contains
endolymph.
The scala vestibule and scala tympani lie above the scala media respectively and both
contain perilymph. They communicate with each other at the helicotrema.
The scala vestibuli communicates functionally with the middle ear through the oval
window, the scala tympani through the round window.
Organ of Corti
Consists of a series of epithelial structures arranged along the inner edge of the basilar
Membrane. A tunnel, composed of two rows of rods of Corti, and forming a triangle with
the basilar membrane, divides the organ into inner and outer portions. The tunnel
contains a fluid called cortilymph.
On the inner side of the inner rod there is a single row of hair cells, the hair of each cell
consisting of 120 sterocilia. On the outer side of the outer rod there are 3-4 rows of hair
cells, the outer hair cell contains 46-148 stereocilia.
The Tectorial membrane overhangs the organ of Corti. Outside the outer hair cells are the
cells of Hensen (supporting cells). Lining the outside of the scala media is the stria
vascularis. Thickened endosteum lining the outer wall of the bony canal of the cochlea is
called the spiral ligament.
Cochlear Division of the Eighth Cranial Nerve
The terminal fibers end in contact with the hair cells. These fibers are of two types: type l
fibers, sparsely granulated and probably afferent: and type 2 fibers, richly granulated and
probably efferent. The fibers pass in the spiral lamina to the spiral ganglion in the
modiolus, to become the auditory branch of the eighth cranial nerve.
Anatomy of the Vestibular Labyrinth
The vestibular labyrinth is situated behind the cochlea within the petrous bone. It consists
of a system of membranous sacs and ducts within the bony vestibule and semicircular
canals. The three semicircular ducts open into the utricle by five separate openings .
Membranous semicircular ducts open into the posterior part of the utricle, which
communicates indirectly with the saccule through the endolymphatic duct. This duct
occupies the bony aqueduct of the vestibule and divides into two branches, which
separate to open into the saccule and utricle. The endolymphatic duct has an initial
dilatation, the sinus before it narrows at the isthmus, to enter the bony aqueduct.
Vestibular Division of Eighth Cranial nerve
Vestibular Receptor Organs. These are the ampullary crista & utricular maculae (otolith
organ). The axis cylinders of the nerve fibers ramify round the hair cells of the receptor
organs. The fibers are gathered together to form the vestibular nerve, which passes
through the internal auditory canal.
Blood Supply of the Labyrinth
The blood supply of the labyrinth is derived principally from the internal auditory artery,
which arises usually from the anterior inferior cerebellar artery, sometimes directly from
the basilar artery.
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