MIDDLE EAR ANATOMY

Dr. Sriharsha

Development

The tympanic cavity, which originates in the

endoderm, is derived from the first pharyngeal
pouch).
This pouch expands in a lateral direction and comes in
contact with the floor of the first pharyngeal cleft.
The distal part of the pouch, the tubotympanic recess,
widens and gives rise to the primitive tympanic
cavity, and the proximal part remains narrow and
forms the auditory tube, through which the tympanic
cavity communicates with the nasopharynx.

Middle Ear Cleft

Tympanic cavity
Eustachian Tube
Mastoid Air cell system

Tympanic Cavity(Middle Ear)

Mesotympanum
Epitympanum
Hypotympanum

Epitympanum

Part which lies above Pars Tensa

Widest Part (6mm)
Contains

Malleus: Head, Neck, Anterior Process, Lateral

Process
Incus: Body, Short Process

Incudomalleolar Joint
Chorda tympani

Mesotympanum

Part which lies at Pars Tensa

Transvers diameter 2mm
Contains

Malleus : Handle, Long Process

Stapes: Whole structure

Incudo stapedial Joint

Hypotympanum

Part which lies below the level of Pars tensa

Diameter: 4mm
Contains nothing

Prussaks Space

Also called superoir recess of Tympanic

Membrane
Lies between

Neck of Malleus (Medially)

Pars Flacida (Laterally)

It is the most common site of

Cholesteatoma

Boundaries of the tympanic cavity are:

Roof :Tegmen
Floor : Jugular wall and styloid prominence
Posterior : Mastoid, stapedius, pyramidal prominence
Anterior : Carotid wall, eustachian tube, tensor
tympani
Medial : Labyrinthine wall
Lateral : Tympanic membrane, scutum
(laterosuperior)

Lateral Wall

Tympanic Membrane
Scutum : small bone above pars flacida lateral
to attic

Tympanic Membrane

Anterior Wall

Carotid Wall

Thin bone separating the cavity and internal

carotid artery

Above to downwards seen on anterior wall are

Canal for tensor tympani

Opening of Eustachian tube
Internal carotid artery

Floor or Jugular wall

Thin plate of bone separating the tympanic

cavity from the jugular bulb
In the floor close to the medial wall lies a
opening which allows entry of tympanic
branch of glossopharyngeal nerve(Jacobson
nerve)

Roof

Formed by a thin plate of bone called Tegmen

Tympani
Separates tympanic cavity from the middle
cranial fossa
Tegmen tympani is formed by petrous and
squamous part of temporal bone and the
petrosquamous line (Korners septum)

Posterior Wall

Lies close to mastoid air cells

Contains

Aditus
Pyramid
Facial Nerve

Mastoid Antrum

Cancellous or Spongy bone

Numerous air cells, largest of which is mastoid
antrum

Medial Wall

Separates middle ear cavity from inner ear

Features of medial wall are

Promontory
Oval window postero superior to promontory
Round window postero inferior
Facial canal prominence above oval window
Processus cochleaformis- anterior to oval window.
Hook like prominence for tendon of tensor tympani

Ossicles

Development

The malleus and incus are derived from cartilage of

the first pharyngeal arch, and the stapes is derived
from that of the second arch
Although the ossicles appear during the first half of
fetal life, they remain embedded in mesenchyme
until the eighth month when the surrounding tissue
dissolves . The endodermal epithelial lining of the
primitive tympanic cavity then extends along the wall
of the newly developing space. The tympanic cavity is
now at least twice as large as before.

When the ossicles are entirely free of surrounding

mesenchyme, the endodermal epithelium connects
them in a mesentery-like fashion to the wall of the
cavity
The supporting ligaments of the ossicles develop later
within these mesenteries.
Since the malleus is derived from the first pharyngeal
arch, its muscle, the tensor tympani, is innervated by
the mandibular branch of the trigeminal nerve. The
stapedius muscle, which is attached to the stapes, is
innervated by the facial nerve, the nerve to the second
pharyngeal arch.

Malleus

Shaped like a Mallet

Most laterally placed
7-5-9mm long
Parts

Head
Neck
Anteror Process
Lateral Process
Manubrium
Umbo

Incus

Shaped like an Anvil. It articulates with the malleus and

has a body and two processes.
Largest ossicle
Medial to malleus
Parts

Body - Suspended by the superior incudal ligament that is

attached to the tegmen tympani
Short process
Long process
Lenticular process (4th ossicle) - incomplete fusion with the tip of
the long process

Stapes

Shortest bone in the body

Parts

Capitulum
2 Crura
2 foot plate

Foot plate is held on oval window by annular

ligament

Nerve Supply

Tympanic Plexus

Tympanic branch of IX nerve (Jacobson Nerve)

Sympathetic plexus
They form a plexus on promontory and
provide branches to the tympanic cavity,
Eustachian tube, mastoid air cells

Blood Supply

Branches of internal and external carotid

system
Arteries involved are

Anterior tympanic artery

Inferior tympanic artery
Stylomastoid artery