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Chapter 371
The External Ear
The external ear (Auris externa) comprises (1) the auricula, a funnel-like organ which collects the sound waves, together with its muscles, and (2) the external auditory canal, which conveys these waves to the tympanic membrane, the partition which separates the canal from the cavity of the middle ear.
The auricula or pinna is attached by its base around the external auditory canal in such a manner as to be freely movable. In the following description it will be assumed that the opening is directed outward and that the long axis is practically vertical. It has two surfaces, two borders, a base, and an apex. The convex surface or dorsum (Dorsum auriculæ) faces inward and is widest in its middle part; its lower part is almost circular in curvature, while above it narrows and flattens. The concave surface (Scapha) is the reverse of the dorsum; it presents several ridges which subside toward the apex. The anterior border is sinuous; it is largely convex, but becomes concave near the apex. It divides below into two diverging parts (crura helicis). The posterior border is convex. The apex is flattened, pointed, and curved a little forward. The base is strongly convex. It is attached to the external auditory process of the petrous temporal bone, and around this there is a quantity of fat. The parotid gland overlaps it below and externally. The structure of the external ear comprises a framework of cartilages (which are chiefly elastic), the integument, and a complicated arrangement of muscles.
The conchal or auricular cartilage (Cartilago auriculæ) determines the shape of the ear; its form can be made out without dissection, except below, where it is concealed by the muscles and the parotid gland. The basal part is coiled to form a tube, which incloses the cavity of the concha (Cavum conchæ). This part is funnel-shaped and curves outward and a little backward. Its internal (medial) surface is strongly convex, forming a prominence termed the eminentia conchæ. The lowest part of the internal margin bears a narrow, pointed prolongation, the styloid process. This process is about an inch long and projects downward externally over the annular cartilage; the guttural pouch is attached to its free end. Behind its base there is a foramen through which the auricular branch of the vagus passes.
The basal part of the posterior border is cut into by a notch, which separates two irregular quadrilateral plates. The upper plate (Tragus) is overlapped by the anterior border, and is separated from the adjacent part of the posterior border (Antitragus) by a notch (Incisura intertragica). The lower plate is curved to form a half ring and partly overlaps the anterior border and the annular cartilage. Behind the notch there is a foramen, which transmits the internal auricular artery and internal auricular branch of the facial nerve.
The annular cartilage (Cartilago annularis) is a quadrilateral plate, curved to form about three-fourths of a ring; its ends are a little less than half an inch (ca. 1 cm.) apart internally and are united by elastic tissue. It embraces the external auditory process and forms with the lower part of the conchal cartilage the cartilaginous part of the external auditory canal.
The scutiform cartilage (Cartilago scutiformis s. scutulum) is an irregular quadrilateral plate which lies on the temporal muscle in front of the base of the conchal cartilage. Its superficial face is slightly convex from side to side and its deep face is correspondingly concave. The anterior end is thin and rounded; the posterior part or base is wider and thicker, and its inner angle is prolonged by a pointed process half an inch or more in length. The cartilage moves very freely over the underlying parts.
The external auditory canal or meatus leads from the cavum conchæ to the tympanic membrane. It does not continue the general direction of the cavity of the concha, but extends inward, downward, and slightly forward. It consists of a cartilaginous part formed by the lower part of the conchal cartilage and the annular cartilage, and an osseous part formed by the external auditory process of the temporal bone. These are united by elastic membranes to form a complete tube. Its caliber diminishes from without inward, so that the lumen of the inner end is about half of that of the outer end.
The skin on the convex surface of the concha presents no special features; it is attached to the cartilage by a considerable amount of subcutaneous tissue except at the apex. The integument which lines the concave surface is intimately adherent to the cartilage and is relatively dark in color. There are three or four cutaneous ridges which run about parallel with the borders of the conchal cartilage, but do not extend to the apex or the cavum conchæ. The upper and marginal parts and the ridges are covered with long hairs, but between the ridges and below it is thin, covered sparsely with very fine hairs, and supplied with numerous sebaceous glands. In the external auditory canal the skin becomes thinner; in the cartilaginous part it is supplied with numerous large, coiled, ceruminous glands (Glandulæ ceruminosæ) and is sparsely covered with very fine hairs; in the osseous part the glands are small and few or absent and there are no hairs.