ear, nose, and throat disorders
Ears
Middle Ear
The middle ear consists of the eardrum and a small air-filled chamber containing a chain of three tiny bones (ossicles) that connect the eardrum to the inner ear. The ossicles are named for their shapes. The hammer (malleus) is attached to the eardrum. The anvil (incus) is the middle bone between the hammer and the stirrup (stapes), which sits in the oval window. The stapes sits in the oval window and seals it. Vibrations of the eardrum are amplified mechanically by the ossicles and transmitted to the oval window. The middle ear also contains two tiny muscles. The tensor tympani muscle is attached to the hammer and helps tune and protect the ear. The stapedius muscle is attached to the stirrup. This muscle contracts in response to a loud noise, making the chain of ossicles more rigid so that less sound is transmitted. This response, called the acoustic reflex, helps protect the delicate inner ear from sound damage. is a small tube that connects the middle ear to the airway in the back of the nose (nasopharynx). This tube allows outside air to enter the middle ear (behind the eardrum). The eustachian tube, which opens when a person swallows, helps maintain equal air pressure on both sides of the eardrum and prevents fluid from accumulating in the middle ear. If air pressure is not equal, the eardrum may bulge or retract, which can be uncomfortable and distort hearing. Swallowing or voluntary "popping" of the ears can relieve pressure on the eardrum caused by sudden changes in air pressure, as often occurs when flying in an airplane. The eustachian tube's connection with the middle ear explains why upper respiratory infections (such as the Common Cold ), which inflame and block the eustachian tube, can lead to middle ear infections or changes in middle ear pressure, resulting in pain. 