MAURICIO CASTILLO and SURESH K.

MUKHERJI
CONTENTS
32.1 Practi cal Embryology of the Temporal Bones
32.1.1 External Ear
32.1.2 MiddJe Ear
32.1.3 Inner Ear
References
32.1
Practical Embryology of the Temporal Bones
The ear is composed of three separate regions that are
embryologically distinct, i.e., the external, middle,
and inner ear.
32.1.1
External Ear
The external ear is composed of the pinna (auricle)
and the external auditory canal (EAC). The pinna
forms during the fourth week of gestation from the
first branchial groove and the mesoderm of the first
and second branchial arches [1] . By the sixth week of
gestation, the arches have given rise to six outgrowths
termed the hillocks of His. These hillocks fuse to form
the pinna by the third month of gestation.
The EAC derives from the dorsal end of the first
branchial groove [1]. Between the 4th and 5th weeks
of gestation, the ectoderm of the first branchial groove
comes into contact with the endoderm of the first
pharyngeal pouch. At 8 weeks of gestation, the ini-
tial groove formed by the first branchial pouch, also
referred to as the cavum concha, deepens to form a
funnel-shaped tube termed the primary meatus. This
is the precursor of cartilaginous portion of the EAC.
During the 9th week of gestation, the groove deepens
and comes into contact with the epithelium of the
first pharyngeal pouch (tubotympanic recess) [2].
An epidermal plug (meatal plate) subsequently forms
and extends from the primary meatus to the epithe-
lium of the tubotympanic recess (primitive tympanic
cavity) [1, 2]. A core of epithelial cells within the plug
begins to reabsorb during the 28th week of gestation.
This new ectodermal tube is the precursor of the bony
portion of the EAC. The tympanic membrane derives
from the ectoderm of the first branchial groove, the
endoderm of the tubulotympanic recess, and the
mesoderm of the first and second branchial arches.
Except for the tympanic ring, the EAC is not ossified
at birth. Complete ossification of the EAC occurs by
the second year of life. The adult size of the EAC is
M. Castillo and S. K. Mukherji
reached by 9 years of age. Normally, the external one-
third of the external auditory canal is cartilaginous
while the medial two-thirds are bony.
The mastoid antrum is large at birth but poorly
pneumatized. A central mastoid canal is present
at birth. Formation of the mastoid air cells occurs
by progressive pneumatization of the central mas-
toid canal [2]. Pneumatization begins during the
33rd week of gestation. Pneumatization of the petrous
apex is variable and begins during the 28th week of
gestation. Pneumatization is variable and continues
during early childhood.
32.1.2
Middle Ear
The middle ear consists of the tympanic cavity, three
ossicles, the Eustachian tube, and various muscles
and tendons.
The middle ear cavity is formed by expansion of the
endodermal-lined first pharyngeal pouch (the tubo-
tympanic recess). Growth begins during the 3rd week
of gestation. At the 7th week of gestation, there is a
constriction of the mid-portion of the tubotympanic
recess by the second branchial arch, resulting in the
formation of the tympanic cavity laterally and the
Eustachian tube medially. The epitympanum com-
municates with the mastoid antrum via the aditus ad
antrum, which is formed by expansion of the tym-
panic cavity during the 18th week of gestation [1, 2].
The ossicles are the malleus, incus, and stapes,
and arise from mesenchymal tissue adjacent to the
developing middle ear cavity [3]. The ossicles begin
to form during the 4th week of gestation. They origi-
nate as cartilaginous models that reach adult size by
the 18th week of gestation. Ossification of the malleus
begins at 15 weeks gestation, while the stapes begins
to ossify at 18 weeks gestation. At birth, the ossicles
are of nearly adult size. The head of the malleus is
derived from the dorsal end of the mandibular car-
tilage of the first branchial arch (Meckel's cartilage)
[1]. Portions of the first branchial arch cartilage also
give rise to the anterior malleolar ligament and to the
sphenomandibular ligament. The maxillary cartilage
(palatopteryquadrate bar) gives rise to the body and
short process of the incus. The dorsal end of the car-
tilage of the second branchial arch (Reichert's carti-
lage) gives rise to the manubrium of the malleus, long
process of the incus, and the majority of the stapes
(head, neck, crura, and tympanic surface of the foot-
plate) [1, 2]. The medial surface of the stapes footplate
and the stapedial ligament are derived from the otic
capsule [3).
32.1.3
Inner Ear
The inner ear is composed of the membranQ95-laby-
rinth and surrounded by the bony labyrinth. Except
for the endolymphatic sac, the majority of the inner ear
structures are of adult size and configuration at birth.
The membranous labyrinth consists of the utricle,
saccule, semicircular canals, endolymphatic sac and
duct, and cochlear duct. The inner ear develops from
a thickening of the surface ectoderm termed the otic
placode. This occurs on both sides of the developing
rhombencephalon. During the 4th week of life, the
otic placode invaginates into the underlying mes-
enchyme and forms the otic vesicle (otocyst). The
mesenchyme surrounding the otocyst is the precur-
sor of the cartilaginous capsule, and is called the
otic capsule. The otocyst is divided into two sepa-
rate components by three folds. The dorsal utricular
portion gives rise to the utricle, semicircular canals,
and endolymphatic duct, while the ventral saccular
portion forms the saccule and cochlear duct [2]. The
utricle, saccule, and endolymphatic sac form during
the 6th week of gestation and attain an adult configu-
ration by 8 weeks of life. The duct connecting the sac-
cule and utricle (ductus reuniens) develops at 7 weeks
of gestation. The semicircular canals develop from
diverticular outpouchings arising from the utricu-
lar portion of the membranous labyrinth during the
6th week of gestation. The cochlea develops from the
ventral portion of the otocyst. The number of turns
of the cochlea increases with progressive develop-
ment. One turn of the cochlea is present at 7 weeks
of gestation, while the adult configuration of 2 1/2 to
2 3/4 turns is achieved by the 8th week of gestation.
The endolymphatic sac forms from the dorsal compo-
nent of the otocyst at 6 weeks of gestation, and is one
of the few inner ear structures that continue to grow
after birth. The hair cells and auditory sensory net-
work are mostly completed by the 26th-28th weeks of
gestation.
The bony labyrinth encloses the membranous
labyrinth and is formed in three stages. The initial
stage occurs between the 4th and 6th weeks of gesta-
tion and consists of condensation of the mesenchyme
surrounding the membranous labyrinth. The second
stage involves the formation of the bony vestibule
that encloses the perilymphatic spaces surrounding
the utricle, saccule, and part of the cochlear duct.
This stage also includes the development of the peri-
lymph-containing scala tympani and the scala ves-
tibuli, which surround the endolymph-containing
cochlear duct. The third stage involves ossification of
the otic capsule and begins during the 15th week of
gestation. Ossification begins in 14 centers and even-
tually results in formation of the petrous portion of
the temporal bone. Fusion of the ossification centers
is complete by the 23rd week of gestation.
The Temporal Bone
M. Castillo and S. K. Mukherji
References
1. Moore KL. The eye and ear. In: Moore KL (ed) The Devel-
oping Human: Clinically Oriented Embryology, 4th edn.
Philadelphia: WB Saunders, 1988:402-420.
2. Kenna MA. Embryology and developmental anatomy of the
ear.ln: Bluestone CD, Stool SE, Scheetz MD (eds) Pediatric
Otolaryngology. Philadelphia: WB Saunders, 1990:77-87.
3. Swartz JD, Harnsberger HR. Middle ear and mastoid. In:
Swartz JD, Harnsberger HR (eds) Imaging of the Temporal
Bone, 3rd edn. New York: Thieme, 1998:47-169.