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Embrology of The Ear - Development of The Ear : An Overview

 EMBRYOLOGY OF THE EAR

 Embryology -


 Introduction : •

 The word embryo has been come from a Greek word meaning “to swell”.
 • Study of embryo is known as Embryology.
 • A developing baby during its 1st 8 week of gestation is known as embryo.
 Relevance to audiology : •
 An understanding of embryologic development & its relationship helps to the audiologist/physician for early identification, intervention & for prevention. 
• The timetable of prenatal development & the association of the various structures with each other helps to the audiologist/physician for any kind of suspicion of deafness, its subsequent diagnosis & management.

 • Development : •


 Major changes in the development of the ear takes place in the mother’s womb, first as an embryo and later as a fetus. 
• However development of auditory structure doesn’t stop nor it is totally completed at the time of birth.
 • Knowledge of the origins of auditory structures can be diagnostically significant to the clinician.
 Eg: An infant presents with a congenital skin disorder, as the skin and otocyst both originate from the structure called ectoderm. 
Hence anomalies of the cochlear structures could have link contiguously with the skin disorder.
 • The timing of development of the various organs system guides the clinician about the occurrence of HL.
 • Eg: A noxious influence occurs at 2 months of gestation may result in malformation of pinna that is developing at that time.
 • However, the pinna malformation doesn’t necessarily imply malformation of the middle ear ossicles, although they are also developing at the same time but the origins of the structures are different.
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 • Prognosis of auditory function can be estimated from the origin & the expected pathology. • All growth is the the result of cell division of the pre-existing cell called zygote.
 • A zygote is a cell which is an ovum fertilized by sperm. (Ovum + Sperm cell = zygote)
 • This zygote/pre-existence cell get divided into 2 main cells through the process called mitosis .
 • Thus mitosis results in the changes in the nucleus of a cell which produces a specific no. of double structures i.e the cell & nucleus then subdivided into 2 identical daughter cells.  (Mitosis)
 • Organization in the embryo stimulate development of associated areas & create specific differentiation of cells during the developmental process.
 • One of the earliest organizational developments of embryo is the formation of 3 super-imposed cellular plates known as ‘germ layers’. 
• However each of these layer is also a key structure for development of the various portions & part of the ear & the auditory system.
 
 • The ear begins its development during the early life of embryo. 
• Ear begins its development at about 25 hours of the embryonic development, when embryonic disc split & leads to the formation of a structure called primitive groove.
 • Primitive groove is underlined by ectoderm layer. 
• This primitive groove then further develops into a structure called ‘primitive pit’ which ultimately results to form the ‘neural groove’ & ‘neural fold
 • This neural fold along with the neural grooves come together to form a structure called ‘neural tube’.
 • This neural tube remarks the beginning of the ear development.

 Development of the inner ear :

 • The earliest demarcation of the ear in the human embryo occurs as early as in the 3 rd week of gestation.
 • -At this time there is thickening of the superficial ectoderm on the either side of the ‘open neural plate’.
 • Each thickening are known as auditory/otic placodes which are the obvious by middle of 3 rd week of gestation.
 • Around 23 rd day of gestation, the auditory placodes get mixed with the surface ectoderm & forms auditory/otic pits.
 • Around 30th day of gestation the mouth of each auditory pit closes off & forms a structure called auditory vesicle and otocyst which remarks the development of the inner ear
. • The auditory vesicle takes elongated shape which is divided into 2 parts i.e. 
 1. Utricular-saccule area 
 2. Tubular extension / Endolymphatic duct
 • By 4½ weeks of gestation, the portion of auditory vesicle get connected to the endolymphatic duct which is the future vestibular apparatus of membranous labyrinth, whereas there is more slender portion of the auditory vesicle begins to form the future cochlea which is originated from the saccular area. 
 • At the end of 6 th week of gestation, 3 arch like pockets are visible which are destined to form future of 3 semicircular canal.
 • At the same time, utricle and saccule are developed as a part of vestibular portion of the auditory system.
 • By the end of the 7 th week of gestation, the elongated portion of the saccule of the auditory vesicle completes one turn / one coil of the future cochlea.
 • -The 2½ turns / 2¾ turns of cochlea get completed from 8-11 th week of gestation. 
• At this time, the cochlear duct gets attached to vestibular portion by means of narrow tube called ‘ductus reuniens’. 
 • During 8-11 weeks of gestation, the cochlear division of the 8 th nerve follows the coiling of the cochlear duct i.e. it supplies its fiber to the cochlear duct. 
• During the 7 th week of gestation the bony labyrinth continue to developed into sensory end organs with the appearance of localized thickening of epithelium layers in the utricle & saccule.
 • Similar localized epithelial thickening in the ampullated ends of the semicircular canals during the 8 th week of gestation. 
• These epithelium thickening shows the differentiation into 2 types of cell .i.e.
 1. Sensory cells with bristle like hairs (OHC & IHC)
 2. Supporting cells (dieter cells) • However complete maturation of these cells in cochlea doesn’t occur until 5 th month of gestation when entire cochlear duct results considerable growth & expansion
. • The membranous labyrinth of the inner ear reaches its full adult configuration by the early part of the 3 rd month of gestation.
 • At this time the otic capsule / bony labyrinth gets started / begins to ossify.
 • Thus the inner ear is the only sense organ in the entire human body to reach full adult size & differentiation by fetal midterm means 5 months of pregnancy
 • However it should be noted that, the cochlear portion of the inner ear is the last inner ear end organ to differentiate and mature. 
• Thus the cochlea may be subject to more possible developmental deviations, malformations, acquired disease than the vestibular end organs.

 • Development of middle ear : 


• During the period time when the inner ear developing, at the same time the transmission portion of the auditory mechanism is developed as the middle ear. 
• Middle ear develops from endodermal structure
. • Middle ear cavity begins its development during the 3 rd week of gestation, when the auditory pit is sinking into neural plate to become the auditory vesicle.

 • The tympanic cavity & auditory tube originate from an elongation of the lateral superior edge of the 1 st pharyngeal pouch known as ‘tubotympanic recess’.
 • By that time, the human embryo is in its 4 th week of gestation when a series of 5 branchial grooves known as “gill slits” have appeared.
 • These grooves are in the lower head & neck region on the outside of the embryo.

 Pharyngeal pouches :


 • At the same time, on the inside of embryo a corresponding series of 5 phryngeal pouches develops & these structures collectively identified as ‘arches’.
 • In fish, these grooves are ultimately meets the corresponding pouches to form gills as a part of their respiratory mechanism whereas in humans one of the gill pouches does actually become perforated forming a passage way which becomes the external ear canal & the eustachian tube.
 • The tympanic membrane forms a barrier between these 2 portions of the passage-way. • .Occasionally , an additional opening will occur forming a structure called ‘cervical fistula’ or ‘branchial cyst’ which an opening on the throat between pharynx & the surface of the neck.
 • During the 2 nd month, the tubo-tympanic recess approaches the embryo, surface between the 1 st & 2 nd branchial arches known as Meckel’s / Mandibular and Reichert’s /Hyoid cartilages, respectively
• By the 8 th week of gestation the tympanic cavity is developed in the lower half of the future middle ear, while the upper half is filled with ‘cellular mesenchyme’.
 • According to the classical theory of ossicles origin, malleus & incus develops from Meckel’s cartilage while stapes developed from Reichert’s cartilage.
 • According to Pearson et al (1970) suggests the most of the part of malleus & incus are originated from the 1 st branchial arch while the lenticular process of the incus, the handle of malleus & the stapes originates from 2 nd branchial arch.
 • Thus the middle ear cavity has a dual origin with the anterior area developing from the 1 st arch while the posterior area from the 2 nd arch.
 • The incus & malleus have attained a complete cartilaginous form like an adult by 8½ weeks, whereas stapes attained the same by 15 th week of gestation.
 • The ossification of malleus & incus begins by end of the 15 th week of gestation & reach its completion by 32 nd week of gestation. 
• However, the ossification of stapes begins by 18 th week & it continue to develop further during the life
. • As the ossicles begin to ossify, the surrounding mesenchymal tissue becomes loose, less cellular, & connects each ossicle to the walls of the middle ear cavity.
 • While the 30 th week of gestation the development of the tympanum proper is almost complete
. • The middle ear cavity with antrum is pneumatized during the last 34 th to 35 th week of gestation. • While the epitympanum is pneumatized during the last fetal month 36 th to 38 th week of gestation.

Development of the outer ear :


 • 2 main parts of outer ear i.e. 
 1. Auricle / pinna
 2. External Auditory Meatus (EAM) 

1. Auricle : 

• Auricle develops from the 1 st & 2 nd branchial arches during the 3 rd or 4 th week of gestation.
 • However, the auricle actually derived primarily from 2 nd branchial arch while only tragus seems to originate from the 1 st branchial arch.
 • This is occurring at the same time, when auditory vesicle is formed in the development of inner ear. 
 • During the 6 th week of gestation 6 hillocks or tissue thickenings form on both sides of the 1 st branchial groove.
 • They are arranged as 3 hillocks on each facing border. • The ultimate shape & configuration of the adult auricle depends on the development of these 6 th growth centers / hillocks
. • During the 6 th week of gestation, the ‘mesenchymal folds’ of the auricle are beginning to become cartilage.
 • From the 7 th to 20 th week of gestation, the auricle moves from its original ventro-medial position to be slowly displaced laterally, so as get match to growth of mandible & face.
 • At the 20 th week of gestation, the auricle attains an adult shape but continues to growth until the individual becomes 9 years of age.
 

2. External auditory meatus (EAM) :

 • The EAM is derived from the 1 st branchial groove during 4 th to 5 th week of gestation.
 • At this time the ectodermal lining of the 1 st branchial groove is in brief contact with the endodermal lining of the 1 st pharyngeal pouch. 
• Mesodermal tissue grows between this 2 layers & separate the pharyngeal pouch from that of branchial groove. Pharyngeal pouches 
• In the 8 th week of gestation, the primary auditory meatus sinks towards the middle ear cavity & forms outer 1/3 rd of auditory canal which is surrounded ultimately by cartilage.
 • The ectodermal groove continues to deepen toward the tympanic cavity from the external surface until it meets a thickening of epithelial cells known as the meatal plug which is developed from surface ectoderm.
 • Mesenchyme grows between the meatal plug and the epithelial cells of the tympanic cavity. 
• Thus 3 layers of tissues are formed which are combined to form the tympanic membrane. These 3 layer includes ;
 1. The inner circular fiber layer 
 2. Fibrous middle layer of tissue
 3. Outer radial fiber layer
 • These entire development occurred before 9 th week of gestation.
 • The solid meatal plug keeps the external auditory canal closed until 21 st week of gestation.
 • By this time the inner & middle ear structures are well formed & ossified. 
• The meatal plug disintegrates & forms a canal, with the inner most layer of epithelium which becomes the squamous epithelial layer of the tympanic membrane.
 • The EAM, continues to grow until the 9 year of age.
 • At birth the floor of the external auditory canal has no bony portion which develops after the birth till the age of 9 years.
 • Hence the EAC is short & straight in infants while in adult it is longer & curved

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