Chapter 174. The Vestibulocochlear System: The Middle Ear - Review of Medical Embryology Book

The tympanic cavity of the middle ear is of entodermal origin and is derived from the first pharyngeal pouch, an outpocketing of the pharynx, which grows laterally in the direction of the external acoustic meatus. The pouch, lined with epithelium of entodermal origin, appears in embryos at about week 4.

THE POUCH GROWS RAPIDLY in a lateral direction and at about the end of month 6 of gestation, its external wall comes into contact with the floor of the first ectodermal cleft (deep end of the external auditory meatus)

A thin mesodermal plate persists between the ectodermal and entodermal epithelial structures, and the combination of all 3 layers forms the tympanic membrane or eardrum

THE DISTAL PART of the pharyngeal pouch, the tubotympanic recess, widens and gives rise to the primitive tympanic cavity. The proximal portion remaining narrows and forms the auditory or Eustachian tube

The tube's pharyngeal orifice is surrounded by a considerable amount of lymphoid tissue, the tubal or pharyngeal tonsil (adenoids)

Nasal inflammations associated with the tubal tonsillar swelling often result in occlusion of the tube and inflammation of the tympanic cavity resulting in otitis media (seen in young children quite frequently)

DURING LATE FETAL LIFE, the tympanic cavity expands dorsally and posteriorly to form the tympanic antrum

AFTER BIRTH, the bone of the developing mastoid process is invaded by the epithelium of the tympanic cavity and epithelial-lined air sacs are created (pneumatization)

BY THE END OFWEEK 7, the mesenchyme above the primitive tympanic cavity demonstrates a number of condensations caused by proliferation of the dorsal tips of pharyngeal arches I and II

The condensations become the cartilaginous precursors of the auditory ossicles, the malleus, the incus, and the stapes

The malleus and incus are derived from pharyngeal arch I (Meckel's cartilage) and the stapes is derived from arch II (Reichert's cartilage)

THE OSSICLES appear during the first half of fetal life but remain embedded in mesenchyme until month 8, when the surrounding tissue dissolves
THE ENTODERMAL LINING of the primitive tympanic cavity gradually extends along the wall of the newly developed space, and the tympanic cavity becomes almost twice as large as originally
WHEN THE OSSICLES are entirely free from the surrounding mesenchyme, the entodermal epithelium connects them in a mesenterylike manner to the cavity wall. The supporting ligaments of the ossicles develop in these mesenteries
SINCE THE MALLEUS IS DERIVED from pharyngeal arch I, its muscle, the tensor tympani, is innervated by the mandibular branch of the trigeminal (V) nerve
SINCE THE STAPES is of pharyngeal arch II, its muscle, the stapedius, is innervated by the facial (VII) nerve

Further development: at birth, the cavities of the middle ear fill with air via the eustachian tube. With the ossicles, they form the system used for transmitting vibrations to the inner ear

THE PART OF THE OSSEOUS LABYRINTH opposite the stapes remains thin and becomes the oval window (fenestra vestibuli) which opens into the vestibule; below this, another thinning of the bony labyrinth forms the round window (fenestra cochleae) which opens into the scala tympani. Both are closed by membranes