Anatomy of the Ear

The ear consists of three sections: the outer ear, middle ear, and inner ear. Each plays a vital role in hearing. Here is what they do and how they work:

The Outer Ear is the visible portion on the side of your head (called the auricle or pinna) down the external auditory canal to the tympanic membrane (eardrum).

  • How it works: the pinna provides the necessary anatomical structure to “catch” and funnel sound waves down the external auditory canal to the tympanic membrane (eardrum).

This Middle Ear is the area from the inner portion of the eardrum to the oval window. This includes the middle ear cavity, trio of tiny bones, and the Eustachian tube (the tube that opens to unplug your ears when you drive into higher elevations).

  • How it works: when sound hits the eardrum it turns into a vibration that pushes the eardrum into a trio of tiny bones called ossicles. The ossicles consist of the malleus (hammer), incus (anvil), and the stapes (stirrup). The stapes attach to the oval window, which connects the middle and inner ear.

The Inner Ear contains the cochlea (organ of hearing), vestibular system (organ of balance), and the nerves that feed the brain information.

  • How it works: The cochlea is a fluid-filled structure where vibrations transmitted from the eardrum turn into electric impulses. This causes hair cells in the cochlea to move. This movement is converted to electrical impulses that traverse the auditory nerve to the brain. There, they are interpreted as a sound that we associate meaning with, and the hearing process is complete.

Hearing or Understanding?

Both are important, but they are different.

  • Hearing is processing that there are sounds happening around you.
  • Understanding is processing that those sounds have meaning.
Hearing happens with our ears. Understanding happens with our brains.
When patients come into my office, they often tell me their goal is to hear better. But when I start learning more about their unique struggles, goals tend to shift. Instead, many hope to understand better.
Most patients hear—they know people are talking quietly, but with the presence of background noise, it can be more difficult.
Patients know that there is speech happening, but they aren’t processing the clarity of the signal. For example, it’s difficult to catch the difference in the speech pattern to know if it is the word /cheese/ or /chief/.
People with hearing loss need to hear the difference between the sounds to clearly distinguish the signal. To hear the signal clearly is to be able to understand speech.

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