Blood Supply of the
Blood supply of the Auricle: Ear
From External Carotid Artery branches:
1. The Posterior Auricular Artery (Dominant Artery), supplies:
Medial surface (except the lobule)
Concha
Middle and lower portions of the helix
lower part of the antihelix
2. Anterior Auricular Artery of the Superficial Temporal Artery, supply:
Lobule
Triangular Fossa
Upper portions of the helix
Upper portion of the Antihelix
Tragus
3. The Superior Auricular Artery
It has a constant course
It connects the Superficial Temporal Artery and the Posterior Auricular artery network.
This branch can provide a reliable vascular pedicle for retroauricular flaps.
4. A small auricular branch from the occipital artery:
May assist the posterior auricular in supplying the medial surface.
Venous Drainage of the Auricle:
1. Superficial temporal vein
2. Retro-mandibular vein
3. Post auricular vein
4. External jugular vein
Lymphatic drainage of the auricle and EAC:
posterior surface: the lymph nodes at the mastoid tip
tragus and upper part of the anterior surface: preauricular nodes
Rest of the auricle drains to the upper deep cervical nodes.
Blood supply of the external auditory canal
External Carotid Artery
Venous drainage of the EAC:
Posterior Auricular superficial temporal
Maxillary Artery
Artery artery External Jugular Vein
Maxillary veins
Pterygoid plexus
deep auricular artery
(behind TMJ) through
anterior auricular
Tympanosquamous
artery
fissure P493 NETTER
anterior meatal
Posterior wall of the anterior wall + roof of surface
EUC EUC epidermal surface of
tympanic membrane
Blood Supply of the Middle Ear Cavity
External
Carotid Artery
Posterior Ascending Internal
Auricular Pharyngeal Maxillary
Artery Artery Artery
Stylomastoid Inferior Tympanic
Artery Middle Meningeal Anterior
Artery
Artery Tympanic Artery
Stylomastoid jugulocarotid
ridge Foramen Petrotympanic
foramen
Spinosum fissure
Posterior Stapedius mastoid mesotym superior Superior
Tympanic Artery branch panum petrosal Tympanic Anterior wall
Artery artery Artery
mucosal
mastoid surface of
Stapedius
cavity facial superior tympanic
posterior muscle
hiatus tympanic membrane
part of the canaliculus in the
tympanic Malleus
petrosquamous
membrane fissure/canal of Incus
Roof of Mastoid, tensor tympani
Epitympanum, Facial nerve, muscle
Genigulate ganglion
Incus
Maellus
Tensor Tympani muscle
Facial Nerve
Vidian Artery supplies the meso & hypotympanum
The superior petrosal artery continues on within the fallopian canal and forms a vascular plexus with the stylomastoid
artery in the mastoid portion of the facial nerve.
Internal carotidcorticotympanic artery anstamosis with branches from stylomastoid, internal maxillary, ascending
pharyngeal
The long process of the incus receive the least blood supply which makes it the most frequently necrosed
Eustachian tube blood supply
By the superior and inferior tympanic blood supply
Blood supply of the tympanic membrane
Epidermal vessels (from the auditory canal):
External carotid Internal maxillary deep auricular .A
Mucosal vessels (from middle ear):
External carotid Internal maxillary Ant tympanic .A
External carotid Post auricular A stylomastoid A post tympanic artery
Probably from:
Ext carotid Internal maxillary Middle meningeal A superior tympanic a
In summary ant +post +sup blood supply of the tympanic cavity also supply the internal surface of the T.M
The blood supply of the long process of the inus is the least this is why it is frequently necrotized
Note: the anterior tympanic and Stylomastoid arteries are the biggest.
Ossicles: ant +sup tympanic artery
ET: sup + inf tympani artery
Mastoid air cells : mastoid branch of post tympanic a
Stapedius muscle: Stapedius branch of post tympanic a
Tensor tympani muscle : sup tympanic
Roof of Epitymanuam+roof of masoid: superficial petrosal nerve
Hypotympanum: vidian artery +tympanic arches of internal carotid artery
Mesotympanum: inf tympanic artery, vidian artery +tympanic arches of internal carotid artery
Anterior tympanic artery Posterior tympanic artery
Origin Maxillary artery Post auricular a: stylomastoid a
Entrance Petrotympanic fissure ( Glaserian iter chordæ posterius: junction
fissure ): junction between the ant& between the lateral & post wall
lateral wall
Supply The lateral wall Lateral wall
Tympanic membrane + Ant part Post part
Ossicles Malleus + incus Malleus
Cavity Ant part Post part
Other structures Mastoid antrum Facial nerve
Anterior tympanic artery supply the epitympanum + ant part of middle ear cavity
Deep auricular Inferior tympanic
Origin Maxillary artery Ascending pharyngeal artery
Entrance Squamotympanic fissure Inferior tympanic canaliculus
Supply Floor of tympanic cavity Floor of tympanic cavity
T.M Promontory
Cavity Hypo+ Mesotympanum
Caroticotympanic artery/ramus Stylomastoid artery
tympanici
Origin Internal carotid artery Post auricular artery
Entrance Perforations in the ant wall Stylomastoid foramen
Supply Anterior wall Post wall
Eustachian tube Stapedius
Mastoid air cells
External carotid artery: post auricular artery: stylomastoid artery
Branches of stylomastoid artery:
1. Post auricular artery : enters the middle ear with the chorda tympani
post part of T.M+ Cavity +malleus
2. Stapedius: stapedius muscle
3. Mastoid: mastoid air cells
External carotid artery: maxillary artery: middle meningeal artery
Branches of middle meningeal artery:
1. Superior tympanic artery: maellus,incus,tensor tympani muscle
2. Petrosal artery: roof of the epitympanum + roof of the mastoid +facial nerve
Note the superior petrosal nerve+stylomastoid artery runs in the fallopian canal & supply facial nerve
Blood supply of the inner ear:
Internal Auditory Artery (labrynthin artery)is the principle arterial blood supply of the inner ear
It is a branch from:
The anterior Inferior cerebellar artery 85%
the basilar artery 15%
ant inf cerebellar artery gives
a. internal auditory artery:
1. VIII
2. scarpa's ganglion
3. inner ear
b. recurrent penetrating artery:
1. middle cerebellar peduncle
2. dorsal lateral pons
paramedian pontine reticular formation is supplied by the perforating arteries arising from the basilar artery directly
internal auditory
artery/labrinthin artery
common cochlear artery
anterior vestibular artery
posterior vestibular
proper cochlear artery
artery
inferior part of the utricle superior part of saccule &
& saccule utricle
cochlea
posterior semicircular superior & horizontal
canal semicircular canal
stria vascularis
Cochlear proper artery ultimately forms the stria vascularis
Spiral modiolar artery is an end artery & obstruction to its blood flow is a potential cause of sudden sensory hearing
loss
