1. Anatomy and Physiology of Hearing
© 2013 Pearson Education, Inc.

2. The Ear: Hearing and Balance
Three major areas of ear
External (outer) ear – hearing only
Middle ear (tympanic cavity) – hearing only
Internal (inner) ear – hearing and equilibrium
Receptors for hearing and balance respond to separate stimuli
Are activated independently
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3. The three regions of the ear
Figure 15.24a Structure of the ear.
Middle
ear
Internal ear
(labyrinth)
External
ear
Auricle
(pinna)
Helix
Lobule
External
acoustic
meatus
Tympanic
membrane
Pharyngotympanic
(auditory) tube
The three regions of the ear
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4. Auricle (pinna)Composed of
External Ear
Auricle (pinna)Composed of
Helix (rim); Lobule (earlobe)
Funnels sound waves into auditory canal
External acoustic meatus (auditory canal)
Short, curved tube lined with skin bearing hairs, sebaceous glands, and ceruminous glands
Transmits sound waves to eardrum
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5. Tympanic membrane (eardrum)
External Ear
Tympanic membrane (eardrum)
Boundary between external and middle ears
Connective tissue membrane that vibrates in response to sound
Transfers sound energy to bones of middle ear
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6. Middle Ear (Tympanic Cavity)
A small, air-filled, mucosa-lined cavity in temporal bone
Flanked laterally by eardrum
Flanked medially by bony wall containing oval (vestibular) and round (cochlear) windows
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7. Epitympanic recess—superior portion of middle ear Mastoid antrum
Canal for communication with mastoid air cells
Pharyngotympanic (auditory) tube—connects middle ear to nasopharynx
Equalizes pressure in middle ear cavity with external air pressure
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8. Middle and internal ear
Figure 15.24b Structure of the ear.
Oval window
(deep to stapes)
Entrance to mastoid
antrum in the
epitympanic recess
Semicircular
canals
Malleus
(hammer)
Vestibule
Incus
(anvil)
Auditory
ossicles
Vestibular
nerve
Stapes
(stirrup)
Cochlear
nerve
Tympanic membrane
Cochlea
Round window
Pharyngotympanic
(auditory) tube
Middle and internal ear
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9. Middle ear inflammation
Otitis Media
Middle ear inflammation
Especially in children
Shorter, more horizontal pharyngotympanic tubes
Most frequent cause of hearing loss in children
Most treated with antibiotics
Myringotomy to relieve pressure if severe
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10. Three small bones in tympanic cavity: the malleus, incus, and stapes
Ear Ossicles
Three small bones in tympanic cavity: the malleus, incus, and stapes
Suspended by ligaments and joined by synovial joints
Transmit vibratory motion of eardrum to oval window
Tensor tympani and stapedius muscles contract reflexively in response to loud sounds to prevent damage to hearing receptors
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11. View Superior Malleus Incus Epitympanic recess Lateral Anterior
Figure The three auditory ossicles and associated skeletal muscles.
View
Superior
Malleus
Incus
Epitympanic recess
Lateral
Anterior
Pharyngotym-
panic tube
Tensor
tympani
muscle
Tympanic
membrane
(medial view)
Stapes
Stapedius
muscle
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12. Two Major Divisions of Internal Ear
Bony labyrinth
Tortuous channels in temporal bone
Three regions: vestibule, semicircular canals, and cochlea
Filled with perilymph – similar to CSF
Membranous labyrinth
Series of membranous sacs and ducts
Filled with potassium-rich endolymph
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13. Temporal bone Semicircular ducts in semicircular canals Facial nerve
Figure Membranous labyrinth of the internal ear.
Temporal
bone
Semicircular ducts
in semicircular
canals
Facial nerve
Vestibular nerve
Superior vestibular
ganglion
Anterior
Posterior
Inferior vestibular
ganglion
Lateral
Cristae ampullares
in the membranous
ampullae
Cochlear nerve
Maculae
Spiral organ
Utricle in
vestibule
Cochlear duct
in cochlea
Saccule in
vestibule
Stapes in
oval window
Round window
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14. Central egg-shaped cavity of bony labyrinth
Vestibule
Central egg-shaped cavity of bony labyrinth
Contains two membranous sacs
Saccule is continuous with cochlear duct
Utricle is continuous with semicircular canals
These sacs
House equilibrium receptor regions (maculae)
Respond to gravity and changes in position of head
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15. Semicircular Canals
Three canals (anterior, lateral, and posterior) that each define ⅔ circle
Lie in three planes of space
Membranous semicircular ducts line each canal and communicate with utricle
Ampulla of each canal houses equilibrium receptor region called the crista ampullaris
Receptors respond to angular (rotational) movements of the head
© 2013 Pearson Education, Inc.

16. Temporal bone Semicircular ducts in semicircular canals Facial nerve
Figure Membranous labyrinth of the internal ear.
Temporal
bone
Semicircular ducts
in semicircular
canals
Facial nerve
Vestibular nerve
Superior vestibular
ganglion
Anterior
Posterior
Inferior vestibular
ganglion
Lateral
Cristae ampullares
in the membranous
ampullae
Cochlear nerve
Maculae
Spiral organ
Utricle in
vestibule
Cochlear duct
in cochlea
Saccule in
vestibule
Stapes in
oval window
Round window
© 2013 Pearson Education, Inc.

17. A spiral, conical, bony chamber
The Cochlea
A spiral, conical, bony chamber
Size of split pea
Extends from vestibule
Coils around bony pillar (modiolus)
Contains cochlear duct, which houses spiral organ (organ of Corti) and ends at cochlear apex
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18. Cavity of cochlea divided into three chambers
The Cochlea
Cavity of cochlea divided into three chambers
Scala vestibuli—abuts oval window, contains perilymph
Scala media (cochlear duct)—contains endolymph
Scala tympani—terminates at round window; contains perilymph
Scalae tympani and vestibuli are continuous with each other at helicotrema (apex)
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19. The "roof" of cochlear duct is vestibular membrane
The Cochlea
The "roof" of cochlear duct is vestibular membrane
External wall is stria vascularis – secretes endolymph
"Floor" of cochlear duct composed of
Bony spiral lamina
Basilar membrane, which supports spiral organ
The cochlear branch of nerve VIII runs from spiral organ to brain
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20. Modiolus Spiral ganglion Osseous spiral lamina Vestibular membrane
Figure 15.27a Anatomy of the cochlea.
Helicotrema
at apex
Modiolus
Cochlear nerve,
division of the
vestibulocochlear
nerve (VIII)
Spiral ganglion
Osseous spiral lamina
Vestibular membrane
Cochlear duct
(scala media)
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21. Vestibular membrane Osseous spiral lamina Tectorial membrane Spiral
Figure 15.27b Anatomy of the cochlea.
Vestibular membrane
Osseous spiral lamina
Tectorial membrane
Spiral
ganglion
Scala
vestibuli
(contains
perilymph)
Cochlear duct
(scala media;
contains
endolymph)
Stria
vascularis
Spiral organ
Scala
tympani
(contains
perilymph)
Basilar
membrane
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22. Hairs (stereocilia) Supporting cells
Figure 15.27c Anatomy of the cochlea.
Tectorial membrane
Inner hair cell
Hairs (stereocilia)
Afferent nerve
fibers
Outer hair cells
Supporting cells
Fibers of
cochlear
nerve
Basilar
membrane
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23. Inner hair cell Outer hair cell Figure 15.27d Anatomy of the cochlea.
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24. Properties of Sound Sound is Sound wave
Pressure disturbance (alternating areas of high and low pressure) produced by vibrating object
Sound wave
Moves outward in all directions
Illustrated as an S-shaped curve or sine wave
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25. Wavelength Crest Trough Amplitude
Figure Sound: Source and propagation.
Area of
high pressure
(compressed
molecules)
Area of
low pressure
(rarefaction)
Wavelength
Crest
Air pressure
Trough
Distance
Amplitude
A struck tuning fork alternately compresses
and rarefies the air molecules around it, creating
alternate zones of high and low pressure.
Sound waves radiate
outward in all
directions.
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26. Properties of Sound Waves
Frequency
Number of waves that pass given point in given time
Pure tone has repeating crests and troughs
Wavelength
Distance between two consecutive crests
Shorter wavelength = higher frequency of sound
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27. Properties of Sound Pitch Quality Perception of different frequencies
Normal range 20–20,000 hertz (Hz)
Higher frequency = higher pitch
Quality
Most sounds mixtures of different frequencies
Richness and complexity of sounds (music)
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28. Amplitude perceived as loudness
Properties of Sound
Amplitude
Height of crests
Amplitude perceived as loudness
Subjective interpretation of sound intensity
Normal range is 0–120 decibels (dB)
Severe hearing loss with prolonged exposure above 90 dB
Amplified rock music is 120 dB or more
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29. High frequency (short wavelength) = high pitch
Figure Frequency and amplitude of sound waves.
High frequency (short wavelength) = high pitch
Low frequency (long wavelength) = low pitch
Pressure
0.01
0.02
0.03
Time (s)
Frequency is perceived as pitch.
High amplitude = loud
Low amplitude = soft
Pressure
0.01
0.02
0.03
Time (s)
Amplitude (size or intensity) is perceived as loudness.
© 2013 Pearson Education, Inc.

30. Transmission of Sound to the Internal Ear
Sound waves vibrate tympanic membrane
Ossicles vibrate and amplify pressure at oval window
Cochlear fluid set into wave motion
Pressure waves move through perilymph of scala vestibuli
© 2013 Pearson Education, Inc.

31. Transmission of Sound to the Internal Ear
Waves with frequencies below threshold of hearing travel through helicotrema and scali tympani to round window
Sounds in hearing range go through cochlear duct, vibrating basilar membrane at specific location, according to frequency of sound
© 2013 Pearson Education, Inc.

32. Route of sound waves through the ear
Figure 15.30a Pathway of sound waves and resonance of the basilar membrane.
Slide 1
Auditory ossicles
Malleus
Incus
Stapes
Cochlear nerve
Scala vestibuli
Oval
window
Helicotrema 4a
Scala tympani
Cochlear duct 2 3
Basilar
membrane 4b 1
Sounds with frequencies below hearing travel through the
helicotrema and do not excite hair cells. 4a
Tympanic
membrane
Round
window
Route of sound waves through the ear
Sound waves vibrate the tympanic membrane. 1
Auditory ossicles vibrate. Pressure is amplified. 2
Pressure waves created by the stapes pushing on the oval window move through fluid in the scala vestibuli. 3
Sounds in the hearing range go through the cochlear duct, vibrating the basilar membrane and
deflecting hairs on inner hair cells. 4b
© 2013 Pearson Education, Inc.

33. Route of sound waves through the ear
Figure 15.30a Pathway of sound waves and resonance of the basilar membrane.
Slide 2
Auditory ossicles
Malleus
Incus
Stapes
Cochlear nerve
Scala vestibuli
Oval
window
Helicotrema
Scala tympani
Cochlear duct
Basilar
membrane 1
Tympanic
membrane
Round
window
Route of sound waves through the ear
Sound waves vibrate the tympanic membrane. 1
© 2013 Pearson Education, Inc.

34. Route of sound waves through the ear
Figure 15.30a Pathway of sound waves and resonance of the basilar membrane.
Slide 3
Auditory ossicles
Malleus
Incus
Stapes
Cochlear nerve
Scala vestibuli
Oval
window
Helicotrema
Scala tympani
Cochlear duct 2
Basilar
membrane 1
Tympanic
membrane
Round
window
Route of sound waves through the ear
Sound waves vibrate the tympanic membrane. 1
Auditory ossicles vibrate. Pressure is amplified. 2
© 2013 Pearson Education, Inc.

35. Route of sound waves through the ear
Figure 15.30a Pathway of sound waves and resonance of the basilar membrane.
Slide 4
Auditory ossicles
Malleus
Incus
Stapes
Cochlear nerve
Scala vestibuli
Oval
window
Helicotrema
Scala tympani
Cochlear duct 2 3
Basilar
membrane 1
Tympanic
membrane
Round
window
Route of sound waves through the ear
Sound waves vibrate the tympanic membrane. 1
Auditory ossicles vibrate. Pressure is amplified. 2
Pressure waves created by the stapes pushing on the oval window move through fluid in the scala vestibuli. 3
© 2013 Pearson Education, Inc.

36. Route of sound waves through the ear
Figure 15.30a Pathway of sound waves and resonance of the basilar membrane.
Slide 5
Auditory ossicles
Malleus
Incus
Stapes
Cochlear nerve
Scala vestibuli
Oval
window
Helicotrema 4a
Scala tympani
Cochlear duct 2 3
Basilar
membrane 1
Sounds with frequencies below hearing travel through the
helicotrema and do not excite hair cells. 4a
Tympanic
membrane
Round
window
Route of sound waves through the ear
Sound waves vibrate the tympanic membrane. 1
Auditory ossicles vibrate. Pressure is amplified. 2
Pressure waves created by the stapes pushing on the oval window move through fluid in the scala vestibuli. 3
© 2013 Pearson Education, Inc.

37. Route of sound waves through the ear
Figure 15.30a Pathway of sound waves and resonance of the basilar membrane.
Slide 6
Auditory ossicles
Malleus
Incus
Stapes
Cochlear nerve
Scala vestibuli
Oval
window
Helicotrema 4a
Scala tympani
Cochlear duct 2 3
Basilar
membrane 4b 1
Sounds with frequencies below hearing travel through the
helicotrema and do not excite hair cells. 4a
Tympanic
membrane
Round
window
Route of sound waves through the ear
Sound waves vibrate the tympanic membrane. 1
Auditory ossicles vibrate. Pressure is amplified. 2
Pressure waves created by the stapes pushing on the oval window move through fluid in the scala vestibuli. 3
Sounds in the hearing range go through the cochlear duct, vibrating the basilar membrane and
deflecting hairs on inner hair cells. 4b
© 2013 Pearson Education, Inc.

38. Resonance of the Basilar Membrane
Fibers near oval window short and stiff
Resonate with high-frequency pressure waves
Fibers near cochlear apex longer, more floppy
Resonate with lower-frequency pressure waves
This mechanically processes sound before signals reach receptors
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39. High-frequency sounds displace the basilar membrane near the base.
Figure 15.30b Pathway of sound waves and resonance of the basilar membrane.
Basilar membrane
High-frequency sounds displace the
basilar membrane near the base.
Medium-frequency sounds displace the
basilar membrane near the middle.
Low-frequency sounds displace the
basilar membrane near the apex.
Fibers of basilar membrane
Apex
(long,
floppy
fibers)
Base (short,
stiff fibers)
20,000
2000
200 20
Frequency (Hz)
Different sound frequencies cross the basilar membrane at different locations.
© 2013 Pearson Education, Inc.

40. Excitation of Hair Cells in the Spiral Organ
Cells of spiral organ
Supporting cells
Cochlear hair cells
One row of inner hair cells
Three rows of outer hair cells
Have many stereocilia and one kinocilium
Afferent fibers of cochlear nerve coil about bases of hair cells
© 2013 Pearson Education, Inc.

41. Hairs (stereocilia) Supporting cells
Figure 15.27c Anatomy of the cochlea.
Tectorial membrane
Inner hair cell
Hairs (stereocilia)
Afferent nerve
fibers
Outer hair cells
Supporting cells
Fibers of
cochlear
nerve
Basilar
membrane
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42. Excitation of Hair Cells in the Spiral Organ
Stereocilia
Protrude into endolymph
Longest enmeshed in gel-like tectorial membrane
Sound bending these toward kinocilium
Opens mechanically gated ion channels
Inward K+ and Ca2+ current causes graded potential and release of neurotransmitter glutamate
Cochlear fibers transmit impulses to brain
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43. Auditory Pathways to the Brain
Impulses from cochlea pass via spiral ganglion to cochlear nuclei of medulla
From there, impulses sent
To superior olivary nucleus
Via lateral lemniscus to Inferior colliculus (auditory reflex center)
From there, impulses pass to medial geniculate nucleus of thalamus, then to primary auditory cortex
Auditory pathways decussate so that both cortices receive input from both ears
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44. cortex in temporal lobe
Figure The auditory pathway.
Medial geniculate
nucleus of thalamus
Primary auditory
cortex in temporal lobe
Inferior colliculus
Lateral lemniscus
Superior olivary
nucleus (pons-
medulla junction)
Midbrain
Cochlear nuclei
Medulla
Vibrations
Vestibulocochlear
nerve
Vibrations
Spiral ganglion
of cochlear nerve
Bipolar cell
Spiral organ
© 2013 Pearson Education, Inc.

45. Auditory Processing
Pitch perceived by impulses from specific hair cells in different positions along basilar membrane
Loudness detected by increased numbers of action potentials that result when hair cells experience larger deflections
Localization of sound depends on relative intensity and relative timing of sound waves reaching both ears
© 2013 Pearson Education, Inc.

46. Equilibrium and Orientation
Vestibular apparatus
Equilibrium receptors in semicircular canals and vestibule
Vestibular receptors monitor static equilibrium
Semicircular canal receptors monitor dynamic equilibrium
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47. Maculae Sensory receptors for static equilibrium
One in each saccule wall and one in each utricle wall
Monitor the position of head in space, necessary for control of posture
Respond to linear acceleration forces, but not rotation
Contain supporting cells and hair cells
Stereocilia and kinocilia are embedded in the otolith membrane studded with otoliths (tiny CaCO3 stones)
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48. Kinocilium Otoliths Stereocilia Hair bundle Hair cells
Figure Structure of a macula.
Macula of
utricle
Macula of
saccule
Kinocilium
Otolith
membrane
Otoliths
Stereocilia
Hair bundle
Hair cells
Supporting
cells
Vestibular
nerve fibers
© 2013 Pearson Education, Inc.

49. Maculae in saccule respond to vertical movements
Maculae in utricle respond to horizontal movements and tilting head side to side
Maculae in saccule respond to vertical movements
Hair cells synapse with vestibular nerve fibers
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50. Activating Maculae Receptors
Hair cells release neurotransmitter continuously
Movement modifies amount they release
Bending of hairs in direction of kinocilia
Depolarizes hair cells
Increases amount of neurotransmitter release
More impulses travel up vestibular nerve to brain
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51. Activating Maculae Receptors
Bending away from kinocilium
Hyperpolarizes receptors
Less neurotransmitter released
Reduces rate of impulse generation
Thus brain informed of changing position of head
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52. Figure 15.34 The effect of gravitational pull on a macula receptor cell in the utricle.
Otolith
membrane
Kinocilium
Stereocilia
Receptor potential
Depolarization
Hyperpolarization
Nerve impulses generated
in vestibular fiber
When hairs bend toward
the kinocilium, the hair cell
depolarizes, exciting the
nerve fiber, which generates
more frequent action potentials.
When hairs bend away
from the kinocilium, the hair cell
hyperpolarizes, inhibiting the nerve
fiber, and decreasing the action
potential frequency.
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53. The Crista Ampullares (Crista)
Sensory receptor for rotational acceleration
One in ampulla of each semicircular canal
Major stimuli are rotational movements
Each crista has supporting cells and hair cells that extend into gel-like mass called ampullary cupula
Dendrites of vestibular nerve fibers encircle base of hair cells
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54. Anatomy of a crista ampullaris in a semicircular canal
Figure 15.35a–b Location, structure, and function of a crista ampullaris in the internal ear.
Ampullary cupula
Crista
ampullaris
Endolymph
Hair bundle
(kinocilium
plus stereocilia)
Crista
ampullaris
Hair cell
Membranous
labyrinth
Supporting
cell
Fibers of vestibular nerve
Anatomy of a crista ampullaris in a semicircular canal
Scanning electron micrograph
of a crista ampullaris (200x)
Section of
ampulla,
filled with
endolymph
Cupula
Fibers of
vestibular
nerve
Flow of endolymph
At rest, the cupula stands upright.
During rotational acceleration, endolymph moves inside the semicircular canals in the direction opposite the rotation (it lags behind due to inertia). Endolymph flow bends the cupula and excites the hair cells.
As rotational movement slows, endolymph keeps moving in the direction of rotation. Endolymph flow bends the cupula in the opposite direction from acceleration and inhibits the hair cells.
Movement of the ampullary cupula during rotational acceleration and deceleration
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55. Activating Crista Ampullaris Receptors
Cristae respond to changes in velocity of rotational movements of the head
Bending of hairs in cristae causes
Depolarizations, and rapid impulses reach brain at faster rate
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56. Activating Crista Ampullaris Receptors
Bending of hairs in the opposite direction causes
Hyperpolarizations, and fewer impulses reach the brain
Thus brain informed of rotational movements of head
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57. Figure 15.35c Location, structure, and function of a crista ampullaris in the internal ear.
Section of
ampulla,
filled with
endolymph
Cupula
Fibers of
vestibular
nerve
Flow of endolymph
At rest, the cupula stands upright.
During rotational acceleration, endolymph moves inside the semicircular canals in the direction opposite the rotation (it lags behind due to inertia). Endolymph flow bends the cupula and excites the hair cells.
As rotational movement slows, endolymph keeps moving in the direction of rotation. Endolymph flow bends the cupula in the opposite direction from acceleration and inhibits the hair cells.
Movement of the ampullary cupula during rotational acceleration and deceleration
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58. Strange eye movements during and immediately after rotation
Vestibular Nystagmus
Strange eye movements during and immediately after rotation
Often accompanied by vertigo
As rotation begins eyes drift in direction opposite to rotation, then CNS compensation causes rapid jump toward direction of rotation
As rotation ends eyes continue in direction of spin then jerk rapidly in opposite direction
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59. Equilibrium Pathway to the Brain
Equilibrium information goes to reflex centers in brain stem
Allows fast, reflexive responses to imbalance
Impulses travel to vestibular nuclei in brain stem or cerebellum, both of which receive other input
Three modes of input for balance and orientation:
Vestibular receptors
Visual receptors
Somatic receptors
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60. (cranial nerve XI nuclei and vestibulospinal tracts)
Figure Neural pathways of the balance and orientation system.
Input: Information about the body’s position in space comes from
three main sources and is fed into two major processing areas in the
central nervous system.
Somatic receptors
(skin, muscle
and joints)
Vestibular
receptors
Visual
receptors
Vestibular
nuclei
(brain stem)
Cerebellum
Central nervous
system processing
Oculomotor control
(cranial nerve nuclei
III, IV, VI)
(eye movements)
Spinal motor control
(cranial nerve XI nuclei
and vestibulospinal tracts)
(neck, limb, and trunk
movements)
Output: Responses by the central nervous system provide fast
reflexive control of the muscles serving the eyes, neck, limbs, and
trunk.
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61. Sensory input mismatches
Motion Sickness
Sensory input mismatches
Visual input differs from equilibrium input
Conflicting information causes motion sickness
Warning signs are excess salivation, pallor, rapid deep breathing, profuse sweating
Treatment with antimotion drugs that depress vestibular input such as meclizine and scopolamine
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62. Homeostatic Imbalances of Hearing
Conduction deafness
Blocked sound conduction to fluids of internal ear
Impacted earwax, perforated eardrum, otitis media, otosclerosis of the ossicles
Sensorineural deafness
Damage to neural structures at any point from cochlear hair cells to auditory cortical cells
Typically from gradual hair cell loss
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63. Cochlear implants for congenital or age/noise cochlear damage
Treating Deafness
Research trying to prod supporting cell differentiation into hair cells to treat sensorineural deafness
Cochlear implants for congenital or age/noise cochlear damage
Convert sound energy into electrical signals
Inserted into drilled recess in temporal bone
So effective that deaf children can learn to speak
© 2013 Pearson Education, Inc.

64. Homeostatic Imbalances of Hearing
Tinnitus
Ringing or clicking sound in ears in absence of auditory stimuli
Due to cochlear nerve degeneration, inflammation of middle or internal ears, side effects of aspirin
Ménière's syndrome: labyrinth disorder that affects cochlea and semicircular canals
Causes vertigo, nausea, and vomiting
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65. Developmental Aspects
All special senses are functional at birth
Chemical senses—few problems occur until fourth decade, when these senses begin to decline
Odor and taste detection poor after 65
Vision—optic vesicles protrude from diencephalon during fourth week of development
Vesicles indent to form optic cups; their stalks form optic nerves
Later, lens forms from ectoderm
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66. Developmental Aspects
Vision not fully functional at birth
Babies hyperopic, see only gray tones, eye movements uncoordinated, tearless for 2 weeks
Depth perception, color vision well developed by age three; emmetropic eyes developed by year six
With age, lens loses clarity, dilator muscles less efficient, visual acuity drastically decreased by age 70 and lacrimal glands less active so eyes dry, more prone to infection
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67. Developmental Aspects
Ear development begins in three-week embryo
Inner ears develop from otic placodes, which invaginate into otic pit and otic vesicle
Otic vesicle becomes membranous labyrinth, and surrounding mesenchyme becomes bony labyrinth
Middle ear structures develop from pharyngeal pouches
Branchial groove develops into outer ear structures
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68. Developmental Aspects
Newborns can hear but early responses reflexive
Language skills tied to ability to hear well
Congenital abnormalities common
Missing pinnae, closed or absent external acoustic meatuses
Maternal rubella causes sensorineural deafness
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69. Developmental Aspects
Few ear problems until 60s when deterioration of spiral organ noticeable
Hair cell numbers decline with age
Presbycusis occurs first
Loss of high pitch perception
Type of sensorineural deafness
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