In the

anatomy Anatomy () is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old science, having i ...

of humans and various other

tetrapod Tetrapods (; ) are four-limbed vertebrate animals constituting the superclass Tetrapoda (). It includes extant and extinct amphibians, sauropsids ( reptiles, including dinosaurs and therefore birds) and synapsids ( pelycosaurs, extinct t ...

s, the eardrum, also called the tympanic membrane or myringa, is a thin, cone-shaped

membrane A membrane is a selective barrier; it allows some things to pass through but stops others. Such things may be molecules, ions, or other small particles. Membranes can be generally classified into synthetic membranes and biological membranes. ...

that separates the external ear from the middle ear. Its function is to transmit

sound In physics, sound is a vibration that propagates as an acoustic wave, through a transmission medium such as a gas, liquid or solid. In human physiology and psychology, sound is the ''reception'' of such waves and their ''perception'' by ...

from the air to the

ossicles The ossicles (also called auditory ossicles) are three bones in either middle ear that are among the smallest bones in the human body. They serve to transmit sounds from the air to the fluid-filled labyrinth (cochlea). The absence of the auditor ...

inside the middle ear, and then to the

oval window The oval window (or ''fenestra vestibuli'' or ''fenestra ovalis'') is a membrane-covered opening from the middle ear to the cochlea of the inner ear. Vibrations that contact the tympanic membrane travel through the three ossicles and into the in ...

in the fluid-filled

cochlea The cochlea is the part of the inner ear involved in hearing. It is a spiral-shaped cavity in the bony labyrinth, in humans making 2.75 turns around its axis, the modiolus. A core component of the cochlea is the Organ of Corti, the sensory o ...

. Hence, it ultimately converts and amplifies vibration in the air to vibration in cochlear fluid. The malleus bone bridges the gap between the eardrum and the other ossicles. Rupture or

perforation of the eardrum A perforated eardrum (tympanic membrane perforation) is a hole in the eardrum. It can be caused by infection (otitis media), trauma, overpressure (loud noise), inappropriate ear clearing, and changes in middle ear pressure. An otoscope can be ...

can lead to conductive hearing loss. Collapse or retraction of the eardrum can cause conductive hearing loss or cholesteatoma.

Structure

Orientation and relations

The tympanic membrane is oriented obliquely in the anteroposterior, mediolateral, and superoinferior planes. Consequently, its superoposterior end lies lateral to its anteroinferior end. Anatomically, it relates superiorly to the middle cranial fossa, posteriorly to the ossicles and

facial nerve The facial nerve, also known as the seventh cranial nerve, cranial nerve VII, or simply CN VII, is a cranial nerve that emerges from the pons of the brainstem, controls the muscles of facial expression, and functions in the conveyance of taste ...

, inferiorly to the parotid gland, and anteriorly to the temporomandibular joint.

Regions

The eardrum is divided into two general regions: the

pars flaccida In human anatomy, the pars flaccida of tympanic membrane or Shrapnell's membrane (also known as Rivinus' ligament) is the small, triangular, flaccid portion of the tympanic membrane, or eardrum. It lies above the malleolar folds attached directly ...

and the

pars tensa In the anatomy of humans and various other tetrapods, the eardrum, also called the tympanic membrane or myringa, is a thin, cone-shaped membrane that separates the external ear from the middle ear. Its function is to transmit sound from the ai ...

. The relatively fragile pars flaccida lies above the lateral process of the malleus between the notch of Rivinus and the anterior and posterior malleal folds. Consisting of two layers and appearing slightly pinkish in hue, it is associated with

Eustachian tube In anatomy, the Eustachian tube, also known as the auditory tube or pharyngotympanic tube, is a tube that links the nasopharynx to the middle ear, of which it is also a part. In adult humans, the Eustachian tube is approximately long and in d ...

dysfunction and cholesteatomas. The larger pars tensa consists of three layers:

skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other animal coverings, such as the arthropod exoskeleton, have different ...

, fibrous tissue, and

mucosa A mucous membrane or mucosa is a membrane that lines various cavities in the body of an organism and covers the surface of internal organs. It consists of one or more layers of epithelial cells overlying a layer of loose connective tissue. It i ...

. Its thick periphery forms a fibrocartilaginous ring called the annulus tympanicus or Gerlach's ligament. while the central umbo tents inward at the level of the tip of malleus. The middle fibrous layer, containing radial, circular, and parabolic fibers, encloses the handle of malleus. Though comparatively robust, the pars tensa is the region more commonly associated with perforations.

Umbo

The manubrium ( la, handle) of the malleus is firmly attached to the medial surface of the membrane as far as its center, drawing it toward the

tympanic cavity The tympanic cavity is a small cavity surrounding the bones of the middle ear. Within it sit the ossicles, three small bones that transmit vibrations used in the detection of sound. Structure On its lateral surface, it abuts the external auditor ...

. The lateral surface of the membrane is thus concave. The most depressed aspect of this concavity is termed the umbo ( la, shield boss).

Nerve supply

Sensation of the outer surface of the tympanic membrane is supplied mainly by the auriculotemporal nerve, a branch of the

mandibular nerve In neuroanatomy, the mandibular nerve (V) is the largest of the three divisions of the trigeminal nerve, the fifth cranial nerve (CN V). Unlike the other divisions of the trigeminal nerve ( ophthalmic nerve, maxillary nerve) which contain only ...

(

cranial nerve Cranial nerves are the nerves that emerge directly from the brain (including the brainstem), of which there are conventionally considered twelve pairs. Cranial nerves relay information between the brain and parts of the body, primarily to and ...

V₃), with contributions from the auricular branch of the vagus nerve ( cranial nerve X), the

(cranial nerve VII), and possibly the

glossopharyngeal nerve The glossopharyngeal nerve (), also known as the ninth cranial nerve, cranial nerve IX, or simply CN IX, is a cranial nerve that exits the brainstem from the sides of the upper medulla, just anterior (closer to the nose) to the vagus nerve. ...

(cranial nerve IX). The inner surface of the tympanic membrane is innervated by the glossopharyngeal nerve.

Clinical significance

Examination

When the eardrum is illuminated during a

medical examination In a physical examination, medical examination, or clinical examination, a medical practitioner examines a patient for any possible medical signs or symptoms of a medical condition. It generally consists of a series of questions about the pat ...

, a cone of light radiates from the tip of the malleus to the periphery in the anteroinferior quadrant, this is what is known clinically as 5 o'clock.

Rupture

Unintentional perforation (rupture) has been described in

blast injuries A blast injury is a complex type of physical trauma resulting from direct or indirect exposure to an explosion. Blast injuries occur with the detonation of high-order explosives as well as the deflagration of low order explosives. These injur ...

and air travel, typically in patients experiencing upper respiratory congestion that prevents equalization of pressure in the middle ear. It is also known to occur in swimming, diving (including

scuba diving Scuba diving is a mode of underwater diving whereby divers use breathing equipment that is completely independent of a surface air supply. The name "scuba", an acronym for " Self-Contained Underwater Breathing Apparatus", was coined by Chr ...

), and

martial arts Martial arts are codified systems and traditions of combat practiced for a number of reasons such as self-defense; military and law enforcement applications; competition; physical, mental, and spiritual development; entertainment; and the preser ...

. Patients with tympanic membrane rupture may experience bleeding, tinnitus,

hearing loss Hearing loss is a partial or total inability to hear. Hearing loss may be present at birth or acquired at any time afterwards. Hearing loss may occur in one or both ears. In children, hearing problems can affect the ability to acquire spoken l ...

, or disequilibrium (

vertigo Vertigo is a condition where a person has the sensation of movement or of surrounding objects moving when they are not. Often it feels like a spinning or swaying movement. This may be associated with nausea, vomiting, sweating, or difficulties w ...

). However, they rarely require medical intervention, as between 80 and 95 percent of ruptures recover completely within two to four weeks. The prognosis becomes more guarded as the force of injury increases.

Surgical puncture for treatment of middle ear infections

The pressure of fluid in an infected middle ear onto the eardrum may cause it to rupture. Usually, this consists of a small hole (perforation), which allows fluid to drain out. If this does not occur naturally, a myringotomy (tympanotomy, tympanostomy) can be performed. A myringotomy is a surgical procedure in which a tiny incision is created in the eardrum to relieve pressure caused by excessive buildup of fluid, or to drain pus from the middle ear. The fluid or pus comes from a middle ear infection (

otitis media Otitis media is a group of inflammatory diseases of the middle ear. One of the two main types is acute otitis media (AOM), an infection of rapid onset that usually presents with ear pain. In young children this may result in pulling at the ear, ...

), which is a common problem in children. A tympanostomy tube is inserted into the eardrum to keep the middle ear aerated for a prolonged time and to prevent reaccumulation of fluid. Without the insertion of a tube, the incision usually heals spontaneously in two to three weeks. Depending on the type, the tube is either naturally extruded in 6 to 12 months or removed during a minor procedure. Those requiring myringotomy usually have an obstructed or dysfunctional

eustachian tube In anatomy, the Eustachian tube, also known as the auditory tube or pharyngotympanic tube, is a tube that links the nasopharynx to the middle ear, of which it is also a part. In adult humans, the Eustachian tube is approximately long and in d ...

that is unable to perform drainage or ventilation in its usual fashion. Before the invention of antibiotics, myringotomy without tube placement was also used as a major treatment of severe acute otitis media. In some cases, the pressure of fluid in an infected middle ear is great enough to cause the eardrum to rupture naturally. Usually, this consists of a small hole (perforation), from which fluid can drain.

Society and culture

The Bajau people of the Pacific intentionally rupture their eardrums at an early age to facilitate diving and hunting at sea. Many older Bajau therefore have difficulties hearing.

Additional images

File:Anatomy of the Human Ear en.svg, Anatomy of the human right ear. File:Gray907.png, External and middle ear, right side, opened from the front (coronal section) File:Gray908.png, Horizontal section through left ear; upper half of section File:Gray912.png, The right membrana tympani with the hammer and the chorda tympani, viewed from within, from behind, and from above File:Gray915.png, Auditory tube, laid open by a cut in its long axis File:Gray919.png, Chain of ossicles and their ligaments, seen from the front in a vertical, transverse section of the tympanum ympanic cavityFile:Gray909.png, Right eardrum as seen through a speculum File:Normal Left Tympanic Membrane.jpg, This is a normal left eardrum. File:Tympanic membrane viewed by otoscope.png, Tympanic membrane viewed by otoscope File:Traumatic Perforation of the Tympanic Membrane.jpg, The oval perforation in this left tympanic membrane was the result of a slap on the ear File:Subtotal Perforation of the right tympanic membrane.tif, A subtotal perforation of the right tympanic membrane resulting from a previous severe otitis media File:TM RIGHT NORMAL.jpg, A normal human right tympanic membrane (eardrum) File:Frog on leaf with eardrum.jpg, Frog on leaf showing eardrum

References

External links

Diagram at Georgia State University

{{Authority control Auditory system Ear