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Tympanic Membrane 1 Tympanic Membrane infant adult • EAM terminates at the tympanic membrane TM. • In newborns the TM is horizontal • In adults , the TM sits at a 55 degree angle. • Ossification of EAM causes changes in angle of TM until about age 5 when it reaches adult position. 2 Tympanic Membrane • Very thin and translucent (wax paper). • Average thickness is 0.74 mm (.003 inches). • Elliptically shaped – Vertically .9 cm – Horizontally .8 cm 3 Tympanic Membrane • Three Layers of TM – Ectoderm (cutaneous) - continuous with EAM – Mesoderm (fibrous) • Radial Fibers • Concentric Fibers – Endoderm (mucous) - continuous with Tympanic Cavity. • Pars Tensa contains all three layers. • Pars Flacida DOES NOT contain fibrous layer. 4 Tympanic Membrane 5 6 Middle Ear • • • • Tympanic Cavity Ossicles Eustachian Tube Middle Ear Muscles 7 Tympanic Cavity • About same size/shape as an aspirin tablet. – – – – 15 mm (superior to inferior) 15 mm (anterior to posterior) 5 mm (lateral to medial) For descriptive purposes the TC has been compared to a six-sided room (4 walls + ceiling + floor). 8 Tympanic Cavity 9 Tympanic Wall 10 Medial Wall 11 Posterior Wall 12 Aditus and Pyramidal Eminence 13 Anterior Wall 14 Tegmen • Also known as the superior wall. • Paper thin. • Separates the tympanic cavity from the posterior cranial fossa which houses the temporal lobe. • Inflamatory conditions of middle ear can pass through the petrous-squamosal suture in children directly to the meninges of temporal lobe of cortex. 15 Jugular Wall • No landmarks. • Jugular vein is found inferior to this wall. • Glomus bodies can push up through this wall from jugular vein causing glomus jugularis. 16 Ossicles 17 Ossicles • Connects tympanic membrane with the oval window. • Smallest bones in the human body • Connected via a series of joints. • Held in place by a series of ligaments, tendons, and joints (see p. 455 of Zemlin). 18 Ossicular Chain • Function – Sound transmission to oval window – Protect cochlea from intense vibrations by changing axis of rotation of stapes. 19 Malleus 20 Incus 21 Stapes 22 Eustachian Tube • Function – Pressure equalization – Drainage • Description – 35 mm and drops at about a 40 degree angle. – Cartilaginous portion is 2/3, osseous portion is 1/3 – Osseous portion is open, Cartilaginous portion is usually closed. – Begins at tympanic cavity and terminates in nasopharynx. 23 Eustachian Tube 24 Eustachian Tube • Function – Tensor palatini definitely involved in opening ET. – Levator palatini role is not clear. – Opening has been described as a milking action and also been described as the tensor palatini pulling on side of ET, opening the tube. 25 Eustachian Tube • Differences between adults and infants – Angle of ET • Adults - about 40 degrees • Children - more horizontal – Length • Adults - about 35 mm • Children - shorter – Flaccidity • More flaccid in children 26 Eustachian Tube • Cleft Palate – Normally fibers from tensor palatini and levator palatini insert into the velum. – In cleft palate fibers from these two muscles insert into the levator palatini may insert into hard palate and tensor palatini may insert into lateral portions of velum. – Number of fibers for these two muscles is often reduced in people with cleft palate. 27 Middle Ear Muscles 28 Tensor Tympani Muscle 29 Stapedius Muscle 30 Function of the middle ear • The middle ear system that includes the tympanic membrane and the ossicles, acts as an impedance matching device between the air-borne sound waves and the fluids of the inner ear. 31 Function of the middle ear • Must consider tympanic membrane • Impedance … opposition to the flow of energy. • Impedance mismatch… occurs when you have two mediums of differing impedances. • Impedance mismatch occurs between gas (air) in environment and fluid of inner ear. 32 Example of impedance mismatch 33 Areal Advantage • 17:1 (55:3) areal advantage between tympanic membrane and oval window and yields 34 Lever Advantage • 1.3:1 lever advantage QuickTime™ and a Animation decompressor are needed to see this picture. 35 Resonance of the Middle Ear • The middle ear ear system creates a gain of nearly 30 dB between 1000 and 2000 Hz. 36 Resonance of the Middle Ear • Effects of increased mass and stiffness. – increase in mass causes downward shift of resonant frequency. – increase in stiffness causes upward shift in resonant frequency. 37 Summary 38