10/9/2019 Hearing - Outer Ear Development - Embryology

Hearing - Outer Ear Development

Embryology - 8 Oct 2019           Expand to Translate   [Expand]

Contents
1 Introduction
2 Some Recent Findings
3 Pinna- Auricle
3.1 Pharyngeal Contributions
3.2 Human Timeline
4 Auricular Cartilage
5 Human Auricle Development
6 External Auditory Meatus
7 Innervation
8 Postnatal Growth
8.1 Ear Features
9 Lobe Attachment
10 Molecular
11 Abnormalities
11.1 Anotia
11.2 Upper Auricular Detachment
11.3 Microtia
11.4 Cleft Lobule
11.5 Stahl's Ear
11.6 External Auditory Meatus
11.7 Pre-auricular Fistulae and Appendages
11.8 Auricular Pit
12 Additional Images
12.1 Historical Images
13 References
13.1 Reviews
13.2 Articles
13.3 Search PubMed
14 Hearing Terms
15 External Links
16 Glossary Links

Introduction
The outer ear or external ear is derived from 6 surface hillocks (auricular
hillocks), three on each of pharyngeal arch 1 and 2.

The external auditory meatus is derived from the 1st pharyngeal cleft.

The postnatal human outer ear structure also selectively boosts

frequencies around 3 kHz, by a sound pressure level of 30 to 100-fold, that
correspond to frequencies associated with speech. The anatomical
position, on either side of the head, also allows exquisite localization of
sounds in space by neural comparison of signals reaching each ear.

Hearing Links: Introduction | inner ear | middle ear | outer ear | balance | Adult hearing embryonic origins.
placode | hearing neural | Science Lecture | Lecture Movie | Medicine
Lecture | Stage 22 | hearing abnormalities | hearing test | sensory | Student
project

  Categories: Hearing | Outer Ear | Middle Ear | Inner Ear | Balance

Historic Hearing [Expand]

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Some Recent Findings

Movement of the external ear in human embryo[1] "In all, 171 samples between
Carnegie stage (CS) 17 and CS 23 were selected from MR image datasets of human
embryos obtained from the Kyoto Collection of Human Embryos. The three-
dimensional absolute position of 13 representative anatomical landmarks, including
external and internal ears, from MRI data was traced to evaluate the movement
between the different stages with identical magnification. Two different sets of
reference axes were selected for evaluation and comparison of the movements.
...The results indicate that movement of all anatomical landmarks, including external
and internal ears, can be explained by differential growth. Also, when the external Adult external ear
ear is recognized as one of the facial landmarks and having a relative position to
other landmarks such as the eyes and mouth, the external ears seem to move
cranially."

Age- and sex-related changes in the normal human ear[2] "All ear dimensions
were significantly larger in men than in women (p<0.001). A significant effect of age
was found (p<0.001), with larger values in older individuals. The ear width-to-length
ratio and the sagittal angle of the auricle significantly decreased as a function of age
(p<0.001) but without sex-related differences. On average, the three-dimensional
position of ears was symmetric, with symmetry coefficients ranging between 92%
and 96%. Asymmetry was found in the sagittal angle of the auricle (both sexes), in
the ear width-to-length ratio and ear width (men only)."

More recent papers  [Expand]

Pinna- Auricle

Embryonic External Ear

Images of the lateral view of the human embryonic head from week 5 (stage 14) through to week 8 (stage 23) showing development of
the auricular hillocks that will form the external ear. The adult ear is also shown indicating the part of the ear that each hillock
contributes.

develops from six aural hillocks: 3 on first pharyngeal arch and 3 on the second pharyngeal arch.
originally on neck, moves cranially during mandible development

Embryo Embryo Embryo Embryo

6mm 12 mm 14mm 18mm

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Movement of the external ear in human embryo (week 6 to 8)[1]

Pharyngeal Contributions
Pharyngeal Arch Hillock Auricle Component
Arch 1 1 tragus
2 helix
3 cymba concha
Arch 2 4 concha
5 antihelix
6 antitragus
Outer- external auditory meatus

derived from first pharyngeal cleft

ectodermal diverticulum
week 5 - extends inwards to pharynx External ear simplified anatomy
until week 18 has ectodermal plug - plug forms stratified squamous epithelia of canal
and outer eardrum

Human Timeline
Time EAM Appearance

Embryonic period Ectodermal cells proliferate and fill the entire lumen forming a meatal plug

10 weeks Meatal plug extends in a disc-like fashion. In the horizontal plane the meatus is boot-shaped with a narrow
neck and the sole of the meatal plug spreading widely to form the future tympanic membrane medially.
Proximal portion of the neck starts to be resorbed.

13 weeks Disc-like plug innermost surface in contact with the primordial malleus, contributes to the formation of the
tympanic membrane.

16.5 week Meatus is fully patent throughout its length, lumen is still narrow and curved.

18 week Meatus is already fully expanded to its complete form.

Based on data from[3]

Auricular Cartilage
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Image shows the embryonic and fetal growth of the auricular

cartilage within the pinna.[4]

Fig. 6. Lateral views of left auricular cartilage, taken from

reconstructions of human embryos of the Carnegie Collection:
No. 460 (21 mm.), No. 417 (32 mm.), No. 886 (43 mm.). X14.

Fig. 7. Reconstruction of left auricular cartilage of a 50 mm. fetus

(No. 84, Carnegie Collection). X 14. A model of the external form
of the auricle was made, in conjunction with the cartilage, to give
the topographical relations. The edge of the helix in contact with
the ectoderm is indicated by cross-lines.

Human Auricle Development

Stage 12 - otic Stage 13 - first and Ventrolateral view Region first cleft Disappearance of Month 3 - Fetus
placode second pharyngeal head of human hillocks
arches, otic vesicle embryos

Month 4 - Fetus Month 5 - Fetus Embryo ear cartilage

21 - 50 mmm CRL

External Auditory Meatus

At Birth Adult

External Auditory Meatus

Development of the human external auditory meatus (EAM) begins in the late embryo and continues through the fetal second trimester.
The period the "metal plug" is present has been variously described. The best EAM developmental time course is described in two
studies.[5][3]

Period Week Description

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Embryo
Fetus (first trimester)
Fetus (first trimester)
Fetus (second trimester)
Fetus (second trimester)
Fetus (second trimester)
Fetus (second trimester)
Links: outer ear | hearing | timeline     Reference[3]
week 8 Funnel-shaped tube continues medially into mesenchymal tissue, forms a curved path.
week 9 Ectodermal cells proliferate, fill the meatus lumen and form the "meatal plug".
Meatal plug bottom extends in a disc-like fashion, so that in the horizontal plane the
meatus is boot-shaped with a narrow neck and the sole of the meatal plug spreading
week 10
widely to form the future tympanic membrane medially. At the same time, the plug in the
proximal portion of the neck starts to be resorbed.
Meatal plug disc-like, innermost surface in contact with the primordial malleus, contributes
week 13
to formation of tympanic membrane.
Meatal plug innermost portion splits, leaving a thin ectodermal cell layer of immature
week 15 tympanic membrane. The neck of the boot forms the border between the primary and
secondary meatus, and is the last part to split.
The meatus is fully patent throughout entire length. Lumen is still narrow and curved.
week 16.5
Epithelium cornification commences.
week 18 The meatus is now fully expanded to its complete form.

External Auditory Meatus Timeline

Fetal epithelium[5]

1. originates as a tube derived from the epithelium of the fundus of the primary external canal
2. composed of a thin, flat epithelium on the medial side
3. continuous with a thicker epithelium on the lateral side
4. then merges with the external epithelium of the primary external canal

Epithelium cornification begins in the second trimester, at week 16 (GA week 18), and is followed by clearing of keratinous debris to the
exterior.

The adult stratified squamous epithelium lines the external auditory meatus and covers tympanic membrane.

Innervation
The auriculotemporal nerve supplies a large part of the pinna, some innervation may also arise from the trigeminus.

Postnatal Growth
Postnatally, human ears continue to grow throughout the entire lifetime and have a sexually dimorphic pattern, described in a large
study.[6] Three anatomical features of the ear were found to not grow at all after birth; Concha auriculae width, Incisura intertragica
width, and the helical brim diameter of the auricle.

birth - external ear bigger than the large head in proportion to the body
childhood - large yearly increases decrease by 8 or 10 years of age.
adult - male increases in all parameters were greater than for female ears.

Age Female Male

Birth 52 (4.3) 52 (4.1)
20 yrs 61 (3.9) 65 (4.0)
Older than 70
72 (4.6) 78 (4.8)
yrs

Ear Length (mm +/-SD) Data[6]

Ear Features
Darwin's tubercle - (Woolnerian tip) is a tubercle is seen along the upper, posterior portion of the helix (upper and middle thirds).
"railroad track" - associated with fatal alcohol syndrome, the curve at top part of outer ear is underdeveloped and folded over
parallel to curve beneath.

Lobe Attachment
In the normal population, free earlobes have been described as dominant.[7] With some researchers suggesting that "attached" would be
better described as "lobeless". There have been several historic studies identifying attached ear lobes in some population groups
(Indian[8], Malaysian). There are a number of syndromes and genetic disorders associated with variation in lobe attachment.

Links: OMIM 128900 (http://omim.org/entry/128900) | PMID 14277139

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Molecular
Outer Ear Genes

controlled by genes that regulate arch 1 and 2 development

related to hindbrain segmentation (rhombomere 4)
Mouse - Hoxa1/Hoxb1, goosecoid, Endothelin1, dHAND

Abnormalities
There are a range of external ear abnormalities relate to final structure, size and position.
In some cases these abnormalities relate directly to pharyngeal arch development or
may be part of a wider spectrum of abnormalities associated with a genetic or
environmental (fetal alcohol syndrome) disorders. Some known abnormalities include:
anotia, microtia, prominent ear, lop ear, cup ear, cryptotia and Stahl's ear. Other
associated external ear abnormalities include the formation of the external auditory
meatus (canal) and pre-auricular fistulae (pits) and appendages. Finally, a range of
abnormalities can be found associated with the overlying skin of both the external ear
and the ear canal.{#pmid:18261212|PMID18261212}}

Minor structural anomalies have been shown to be corrected by appropriate splinting in

the early neonatal period.{#pmid:18490209|PMID18490209}}

Links: Sensory - Hearing Abnormalities

Facial appearance of fetal alcohol syndrome. Ear
Anotia curve at top part of outer ear is underdeveloped
and folded over parallel to curve beneath and
gives the appearance of a "railroad track"

Upper Auricular Detachment

Microtia

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Microtia (autosomal-recessive) - A mutation has been identified in HoxA2 (https://www.omim.org/entry/604685 HOXA2] 7p15.2)
{#pmid:18394579|PMID18394579}}

Links: Hox

Cleft Lobule
Oculo-auricular syndrome - A mutation in the NKX5-3 (HMX3 (https://www.omim.org/entry/613380) 10q26.13) human homeobox
gene.{#pmid:18423520|PMID18423520}}

Stahl's Ear
A rare ear abnormality, where the rim of the ear is flattened and the upper portions deformed. More common in Oriental background
and can occur from mild to severe. The skin and cartilage are both folded to different degrees that can result in a pointed upper edge.
This pointed ear has been said to resemble the Star Trek television character "Vulcan" ear shape.

External Auditory Meatus

The external auditory meatus (canal) can also fail to canalise leading to a range of malformation including membranous and/or bony
atresia and stenosis.

External Auditory Meatus Stenosis[9]

Type A - a marked narrowing of the canal with an intact skin layer.

Type B - a partial development of the canal with an atresia plate at the medial part.
Type C - a complete bony canal atresia.

Pre-auricular Fistulae and Appendages

There are also a range of pre-auricular fistulae (pits) and appendages that generally
occur in a specific region beside the tragus and crus helicis.

Preauricular sinus

Preauricular tag

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Preauricular tag

Auricular Pit

Posterior helix pit associated with Beckwith-Wiedemann syndrome.

Links: Sensory - Hearing Abnormalities

Additional Images
Historical Images

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Fig. 35. Diagrammatic Fig. 36 A. Section of Fig. 36 B. A Section of Fig. 37. Showing the Fig. 38. Showing the (1922) Embryo 18 mm
Section through the the External Auditory the External Auditory Tubercles which arise part of the Adult Ear reconstruction model,
Cephalic region of an Meatus of the Adult. Meatus at Birth. (After round the First formed by each Carnegie Collection
embryo, showing the Symington.) Visceral Cleft to form Tubercle. No. 1390
origin of the Auditory the External Ear.
System.

References
1. Kagurasho M, Yamada S, Uwabe C, Kose K & Takakuwa T. (2012). Movement of the external ear in human embryo. Head Face Med , 8,
2. PMID: 22296782 (https://www.ncbi.nlm.nih.gov/pubmed/22296782) DOI (https://dx.doi.org/10.1186/1746-160X-8-2).
2. Sforza C, Grandi G, Binelli M, Tommasi DG, Rosati R & Ferrario VF. (2009). Age- and sex-related changes in the normal human ear.
Forensic Sci. Int. , 187, 110.e1-7. PMID: 19356871 (https://www.ncbi.nlm.nih.gov/pubmed/19356871) DOI (https://dx.doi.org/10.1016/
j.forsciint.2009.02.019).
3. Nishimura Y & Kumoi T. (1992). The embryologic development of the human external auditory meatus. Preliminary report. Acta
Otolaryngol. , 112, 496-503. PMID: 1441991 (https://www.ncbi.nlm.nih.gov/pubmed/1441991)
4. Streeter GL. Development of the auricle in the human embryo. (1922) Carnegie Instn. Wash. Publ. 277, Contrib. Embryol., 14: 111-
138.
5. Michaels L & Soucek S. (1989). Development of the stratified squamous epithelium of the human tympanic membrane and external
canal: the origin of auditory epithelial migration. Am. J. Anat. , 184, 334-44. PMID: 2756906 (https://www.ncbi.nlm.nih.gov/pubmed/2
756906) DOI (https://dx.doi.org/10.1002/aja.1001840408).
6. Niemitz C, Nibbrig M & Zacher V. (2007). Human ears grow throughout the entire lifetime according to complicated and sexually
dimorphic patterns--conclusions from a cross-sectional analysis. Anthropol Anz , 65, 391-413. PMID: 18196763 (https://www.ncbi.nl
m.nih.gov/pubmed/18196763)
7. DUTTA P & GANGULY P. (1965). FURTHER OBSERVATIONS ON EAR LOBE ATTACHMENT. Acta Genet Stat Med , 15, 77-86. PMID:
14277139 (https://www.ncbi.nlm.nih.gov/pubmed/14277139)
8. Sharma A, Sidhu NK, Sharma MK, Kapoor K & Singh B. (2007). Morphometric study of ear lobule in northwest Indian male subjects.
Anat Sci Int , 82, 98-104. PMID: 17585565 (https://www.ncbi.nlm.nih.gov/pubmed/17585565) DOI (https://dx.doi.org/10.1111/j.1447-
073X.2007.00166.x).
9. Kösling S, Omenzetter M & Bartel-Friedrich S. (2009). Congenital malformations of the external and middle ear. Eur J Radiol , 69,
269-79. PMID: 18054456 (https://www.ncbi.nlm.nih.gov/pubmed/18054456) DOI (https://dx.doi.org/10.1016/j.ejrad.2007.10.019).

Reviews
Anthwal N & Thompson H. (2016). The development of the mammalian outer and middle ear. J. Anat. , 228, 217-32. PMID: 26227955 (htt
ps://www.ncbi.nlm.nih.gov/pubmed/26227955) DOI (https://dx.doi.org/10.1111/joa.12344).

Alasti F & Van Camp G. (2009). Genetics of microtia and associated syndromes. J. Med. Genet. , 46, 361-9. PMID: 19293168 (https://www.
ncbi.nlm.nih.gov/pubmed/19293168) DOI (https://dx.doi.org/10.1136/jmg.2008.062158).

Torban E & Goodyer P. (2009). The kidney and ear: emerging parallel functions. Annu. Rev. Med. , 60, 339-53. PMID: 18976115 (https://w
ww.ncbi.nlm.nih.gov/pubmed/18976115) DOI (https://dx.doi.org/10.1146/annurev.med.60.052307.120752).

Wood-Jones F & I-Chuan W. (1934). The Development of the External Ear. J. Anat. , 68, 525-33. PMID: 17104502 (https://www.ncbi.nlm.ni
h.gov/pubmed/17104502)

Articles
Michaels L & Soucek S. (1989). Development of the stratified squamous epithelium of the human tympanic membrane and external
canal: the origin of auditory epithelial migration. Am. J. Anat. , 184, 334-44. PMID: 2756906 (https://www.ncbi.nlm.nih.gov/pubmed/2756
906) DOI (https://dx.doi.org/10.1002/aja.1001840408).

Sforza C, Grandi G, Binelli M, Tommasi DG, Rosati R & Ferrario VF. (2009). Age- and sex-related changes in the normal human ear.
Forensic Sci. Int. , 187, 110.e1-7. PMID: 19356871 (https://www.ncbi.nlm.nih.gov/pubmed/19356871) DOI (https://dx.doi.org/10.1016/j.for
sciint.2009.02.019).

Nishimura Y & Kumoi T. (1992). The embryologic development of the human external auditory meatus. Preliminary report. Acta
Otolaryngol. , 112, 496-503. PMID: 1441991 (https://www.ncbi.nlm.nih.gov/pubmed/1441991)

Search PubMed
May 2010 "Outer Ear Development" All (1478) Review (120) Free Full Text (215)

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Search Pubmed: Outer Ear Development (http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=search&term=Outer+Ear+Deve

lopment) | Pinna Development (http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=search&term=pinna+Development)

Hearing Terms
Hearing Terms  [Expand]

External Links
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longer works search the web with the link text or name. Links to any external commercial sites are provided for information purposes
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information or commercial affiliation.

Neuroscience Neuroscience - The External Ear (http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=neurosci.section.891)

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