ANATOMY OF EAR

Organ of hearing and equilibrium

External ear – tympanic membrane – middle ear – pharyngotympanic tube – nasopharynx

1. External ear
a. Pinna/auricle
 Irregular plate of ELASTIC CARTILLAGE with various depressions and elevations
 Deepest compression: concha of pinna
 Elevated margin: helix
 Fat, fibrous tissue, blood vessels; lobule: gapunya cartillage
 Arterial supply; superior auricle and auricotemporal arteries
  Innervation; great auricular (medial/back and lateral ear/front) and auricotemporal nerve (branch
V3, skin of auricle anterior to external acoustic meatus
 Lymphatic drainage; laterosuperior half of auricle to superficial parotid lymph node; cranial superior
half of auricle to mastoid and deep cervical lymph nodes, the rest is to superficial cervical lymph
node.

b. External Acoustic Meatus/ear canal

 Leads inward to tympanic membrane
 S-shaped, lateral (front) third is cartilaginous while 2/3 is lined by thin, bony skin continuous
with skin auricle
 Cartilaginous part has sebaceous and ceruminous gland; makes cerumen

c. Tympanic Membrane
 Diameter +- 1 cm; an oval semitransparent membrane at medal end of external acoustic meatus
 Ext layer : skin, int layer: mucous membrane
 Concave + ada cone-like central depression yang ujungnya bernama umbo (bentuknya kyk
parabola)
 Pars flaccida: thin membrane, superior to lateral process of malleus
 Pars tensa: radial and circular fibers di sisa bagian membrane
 Tympanic membrane moves in response to air vibration; dideteks CN X di bbrp tempat, CN IX di
internal surface

2. Middle ear
a. Tympanic cavity
 Air-filled chamber in petrous part of the temporal bone; part of cranial floor
 Connected anteromedially by pharyngotympanic tube to nasopharnyx
 Connected posterosuperiorly to mastoid cells through mastoid antrum
 2 part: tympanic cavity proper (directly setelah tympanic membrane) dan epitympanic process
(superior to membrane)
 Lined with mucous membrane
 Contents: auditory ossicles, stapedius and tensor tympani muscles, chorda tympani (branch of CN
VII), and tympanic plexus of nerve
Walls of tympanic cavity:
1. Tegmental (roof) dari tegmen tympani, separates cavity from duramater
2. Jugular (floor) dari bone, separates tympanic cavity dari bulb of internal jugular vein
3. Membranous wall (lateral) dari peaked convexity of tympanic membrane, superior dar lateral
bony wall of eptympanic recess
4. Labyrinthe (medial wall) separates tympanic cavity from internal ear
- Promontory of labyrinth wall dari basal turn of cochlea
- Oval and round windows; communicates w internal ear adjacent to cranium
5. Mastoid wall (posterior) ada aditus (opening to mastoid antrum) to connect mastoid cells dan
tympanic cavity
6. Anterior carotid wall: separates cavity dgn carotid canal. Superior: punya opening dari
pharyngotympanic tube dan canal buat tensor tympani
b. Pharyngotympanic Tube
 Opens posterolaterally to inferior nasal meatus
 Dilapisi oleh mucous membrane
 1/3 posterolateral bony, sisanya cartilaginous
 Function: menyeimbangkan pressure di middle ear dengan pressure atmosfer; kalo seimbang,
tympanic membrane bisa bergerak dgn leluasa jadi bisa denger
 Tube harus selalu terbuka; dibantu oleh levator veli palatini dan tensor veli palatini
 Vascularization: internal carotid artery -> ascending pharyngeal artery dan maxillary artery-> middle
meningeal artery dan artery of pterygoid canal
 Nerve: tympanic plexus dari CN IX
 Venous drainage: to pterygoid venous plexus

c. Auditory Ossicles
 mobile small bones crossng to the oval window (fenestrae vestibularis) dari tympanic membrane
 tulang2 yang pertama kali matur saat lahir dan paling cepet untuk ossifikasi
 tipe tulang keras, gapunya osteogenic periosteum
I. malleus/hammer
- nempel ke tympanic membrane
- bagian head ada di tympanic recess; neck nempel ke pars flaccida; handle tertanam di
tympanic membrane
- malleus bergerak bersamaan dgn tympanic membrane
II. incus/anvil
- antara maleus dan stapes; one body and two limbs
- long limb; paralel sama handle of malleus
- short limb; nempel ke bagian posterior dr tympanic cavity
III. stapes/stirrup
- paling kecil
- head articulates dgn incus
- base; seukuran dgn oval window, vibratory forcenya 10x lbh besar dari tympanic
membrane, tapi nurunin amplitudo
 d. Muscles
 to dampen movement dan vibration
 by tensor tympani dari superior cartilaginous part of pharyngotympanic membrane; narik handle
maleus scr medial, tympanic membrane jadi tense/lebih mengeras; untuk mengurangi amplitudo jd
melindungi telinga dari loud sounds. Supplied by CN V3
 stapedius di dalam pyramidal eminence (ada gambarnya di wall tympanic cavity) mencegah
excessive movements dari stapes; inervasi CN VII

3. Internal Ear
 Vestibulocochlear organ: untuk hearing dan balance
 Terdapat membranous labyrinth berisi endolymph
 Ditahan oleh bony labyrinth yang berisi perilymph
 Gak ngambang, krn fluidnya buat stimulasi hearing dan balance

a. Bony labyrinth
 Ruang2 di dalam otic capsule; tulangnya lebih keras drpd jaringan sekitar
 Berisi fluid
b. Cochlea
 Berisi cochlear duct
 Spiral canal berputar 2,5 rotasi sekitar bony cone yg bernama modiolus (spongy bone, cone
shaped, contains blood vessels and nerve)
  Di bagian basal turn, bony labyrinth communicates dengan subarachnod space melalui cochlear
aqueduct
 Ada round window; berhubungan dgn secondary tympanic membrane

c. Vestibule of Bony Labyrinth

 Oval chamber, contains utricle and saccule + vestibular labyrinth
 Lateral: oval window, base of stapes; anterior: bony cochlea; posterior: semicircular canal and
posterior cranial fossa by vestibular aqueduct which opens to internal acoustic meatus to transmit
endolymphatic duct
 Semicircular circles: ant, post, lat; at right angles with each other, posterosuperior to vestibules
5 openings to vestibule: ant and post punya satu common limb

d. Membranous Labyrinth
 Filled with endolymph (intracell fluid)
 Consists of vestibular labyrinth, 3 semicicular ducts, cochlear albyrinth
 + spiral ligament: penebalan dari periosteal lining di cochlear canal, nempelin cochlear duct ke
spiral canal of cochlea
  Sisanya di suspend oleh transverse filaments dari perilymph
 Semicircular ducts open to utricle dari 5 openings
Utricle -> utriculosaccular duct -> saccule -> ductus reuniens -> cochlear duct
 Utricle dan saccule punya sensory epthelium yang bernama maculae; di base utricle dan medial
wall of saccule
 Maculae innervated by vestbulocochlear ganglia dari internal acoustic meatus
 Endolymphatic duct transverses vesitubular aqueduct and expands to blind pouch called
endolymphatic sac buat naro excess endolymph

e. Semicircular ducts
 Punya ampulla di setiap ujung sbg sensory area (ampullary crest)
 Crest untuk record movements dari endolymph -> hasil rotasi dari head @ plane of the dduct
 Hair cells of crest: stimulates primary sensor neurons, badan sel di vestibular ganglia

f. Cochlear duct
 Memisahkan perilymph into two channels di helicotrema
 Vibration ascends to cochlea dari scala vestibuli -> helicotrema -> balik ke basal turn of
cochlea lewat scala tympani -> vibrations akhirnya ke tympanic cavity lg lewat round
window
 Roof: vestibular membrane, floor: basillar membrane, receptor: spiral organ/organ of Corti,
overlaid by tectorial membrane

g. Internal acoustic meatus

 Runs lateral +- 1 cm within petrous part of temporal bone
 Opening: di bgn posteromedial, in line with external acoustic meatus
 Dilewati oleh CN VII, CN VIII