Anatomy of Middle Ear MCQs

Processus cochleariformis is a hook like process on the medial wall of middle ear which marks the first genu of facial nerve. Tendon of tensor tympani takes a turn here to attach to malleus. Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8th Edition, Page - 5,6, 9

Hyrtl's fissure connects middle ear to middle cranial fossa. Canal of Huguier is the exit point of chorda tympani nerve from middle ear Vestibular aqueduct is the bony cover of Endolymphatic duct Aqueduct of cochlea connects inner ear to CSF in subarachnoid space of brain(not middle ear) Reference : Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8th Edition, Chapter name: Some Memorable Nuggets for Rapid Review, Page number: 547

Explanation: Middle ear ossicles begin forming around 6 weeks of development as cartilaginous structures . Malleus and Incus: Derived from mesoderm of the first pharyngeal arch . Stapes: Suprastructure: From mesoderm of the second pharyngeal arch . Footplate: From the otic capsule , which is derived from neural crest cells .

Branches of maxillary artery: The maxillary artery consists of three parts; mandibular part, pterygoid part, pterygopalatine part. Branches of mandibular part: Inferior alveolar artery Middle meningeal artery Deep auricular artery Anterior tympanic artery Occasionally an accessory meningeal branch. Branches of pterygoid part: Masseteric artery Deep temporal branches Pterygoid branches Buccal artery Branches of pterygopalatine part: Posterior superior alveolar artery Infraorbital artery Descending palatine artery Greater palatine artery Lesser palatine artery Sphenopalatine artery Lateral posterior nasal arteries Posterior septal branches

Tubercular otitis media Clinical features: Painless otorrhoea - The ear discharge is foul smelling due to underlying bone destruction. Pale granulations in middle ear and mastoid. It does not have blood stained discharge. Multiple perforations in pars tensa of tympanic membrane. Facial palsy → most common complication. Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, Page - 88, 89.

Pyramid lies on the posterior wall. Tendon of Stapedius muscle arises from it. The medial wall of middle ear has – Promontary - a bulge on medial wall due to the basal coil of cochlea Lateral semicircular canal bulge Tympanic plexus (IXth N) - lies on promontory Oval window - into which footplate of stapes is fixed Round window - covered by secondary tympanic membrane Processus cochleariformis - hook like process which marks the first genu of facial nerve Ponticulus, Subiculum and Sinus tympani in between these two bony spicules Horizontal segment of Facial nerve canal Reference : Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8th Edition, Chapter name: Anatomy of Ear, Page number: 6

Meatoplasty is a surgical procedure that involves the reconstruction or enlargement of the cartilaginous part of the external auditory canal. It is performed to improve access, drainage, and ventilation of the ear canal.It is the last step of modified radical mastoidectomy. Other options: A. Canaloplasty: Canaloplasty is a surgical procedure used to treat glaucoma by enlarging and restructuring the eye's drainage canal. B. Myringoplasty: Myringoplasty is a surgical procedure to repair a perforated tympanic membrane (eardrum), not involving the cartilaginous part of the external auditory canal. C. Tympanoplasty: Tympanoplasty is a surgical procedure to repair or reconstruct the middle ear, including the tympanic membrane and ossicles, but not specifically the cartilaginous part of the external auditory canal.