Anatomy and development of the mammalian external auditory canal: implications for understanding canal disease and deformity
Open accessAbstract
The mammalian ear is made up of three parts (the outer, middle, and inner ear), which work together to transmit sound waves into neuronal signals perceived by our auditory cortex as sound. This review focuses on the often-neglected outer ear, specifically the external auditory meatus (EAM), or ear canal. Within our complex hearing pathway, the ear canal is responsible for funneling sound waves toward the tympanic membrane (ear drum) and into the middle ear, and as such is a physical link between the tympanic membrane and the outside world. Unique anatomical adaptations, such as its migrating epithelium and cerumen glands, equip the ear canal for its function as both a conduit and a cul-de-sac. Defects in development, or later blockages in the canal, lead to congenital or acquired conductive hearing loss. Recent studies have built on decades-old knowledge of ear canal development and suggest a novel multi-stage, complex and integrated system of development, helping to explain the mechanisms underlying congenital canal atresia and stenosis. Here we review our current understanding of ear canal development; how this biological lumen is made; what determines its location; and how its structure is maintained throughout life. Together this knowledge allows clinical questions to be approached from a developmental biology perspective.
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The ear localizes, amplifies, transmits, and codes sound into neuronal signals which the auditory cortex in the brain discerns.
“Functionally, the ear localizes, amplifies, transmits, and codes sound into neuronal signals which the auditory cortex in the brain discerns.1”
From Ear Reconstruction following Mohs Micrographic Surgery (2024) · cites this paper as [1]
The Introduction describes sound passing through the outer and middle ear, cochlear hair cells generating neural signals, and those signals reaching the auditory cortex. It also describes a middle-ear leverage mechanism, but neither the Introduction nor the retrieved Ear Canal Anatomy and Function passage says that the ear localizes sound; amplification is not stated explicitly. (LLM, conf=0.84)
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Casselman, J. W., Bossche, S. V., Foer, B. D., Bernaerts, A., & Dekeyzer, S. (2022) · Springer eBooks · doi:10.1007/978-3-319-61423-6_90-1
The External Auditory Canal Should Not Be, but Is, Often Overlooked
Chandrasekhar, S. S. (2023) · Otolaryngologic Clinics of North America · doi:10.1016/j.otc.2023.06.014
Zhang, X., Yang, L., Chen, P., Liu, Y., Yang, J., Li, Y. Z., & Zhao, S. (2023) · Clinical Otolaryngology · doi:10.1111/coa.14124
Otorrinolaringología General Vol. 6
Illapa, K. L. R., Manssur, Y. F. R., Bravo, A. V. M., Villavicencio, J. V., Castro, M. A. M., Montenegro, P. M. G., Fuentes, J. N. I., Piguave, M. C. A., Jácome, D. A. V., & Fajardo, J. M. B. (2024) · Juan Cuevas eBooks · doi:10.56470/978-9942-660-21-3
The feasibility of endoscopic stapes surgery: A three‐dimensional planning method
Jellema, M., Buter, M., Blijleven, E. E., Willemsen, K., Nguyen, H. C., Stokroos, R. J., Wegner, I., & Thomeer, H. G. X. M. (2025) · Laryngoscope Investigative Otolaryngology · doi:10.1002/lio2.70057
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Ear-Rational Behavior: A Survey Study of Q-tip (Cotton Swab) Habits and Health Perceptions
Weissman, B., Chowdhury, S., Mattin, M. D., Viola, F. C., & Flanagan, O. L. (2025) · Cureus · doi:10.7759/cureus.92402
Gigov, K., Kavradzhieva, P., Ginev, I., & Bogdanova, M. (2026) · Clinics and Practice · doi:10.3390/clinpract16020027
Otitis externa: What clinicians need to hear: pathophysiology, management and treatment
Balmith, M., & Moonsamy, S. (2026) · SA pharmaceutical journal. · doi:10.36303/sapj.3896
PaW-ViT: A Patch-based Warping Vision Transformer for Robust Ear Verification
Arun, D., Bowyer, K. W., & Flynn, P. J. (2026) · International Conference on Automatic Face and Gesture Recognition · doi:10.1109/fg67764.2026.11556519
Qiu, J., Shen, C., Wang, Y., Lai, X., Mu, Y., Zhao, F., Liu, W., & Jiang, W. (2026) · Journal of Otology · doi:10.26599/joto.2026.9540071
Bossche, S. V., Casselman, J. W., Foer, B. D., Bernaerts, A., & Dekeyzer, S. (2026) · Springer eBooks · doi:10.1007/978-3-319-61423-6_90-2
- Authors
- Mozaffari, M., Nash, R., & Tucker, A. S.
- Affiliations
- Guy's Hospital (GB)
- Great Ormond Street Hospital (GB)
- Corresponding author
- Mozaffari, Mona
- Venue
- Frontiers in Cell and Developmental Biology
- Publisher
- Frontiers Media SA
- Published
- 2021-01-08
- Volume
- 8
- Pages
- 617354-617354
- ISSN
- 2296-634X (ISSN-L)
- PMC
- PMC7857502
- OpenAlex
- W3118614055
- Cited by
- 27
- References
- 82
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 7 · 2023: 3 · 2022: 4 · 2021: 2
- FWCI
- 0.57
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Cell and Developmental Biology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Research Portal (King's College London) (submittedVersion, cc-by)
- Funders
- Wellcome Trust (102889/Z/13/Z, 102889)
- University of Cambridge
- Medical Research Council (MR/P019730/1)
- Topics
- Health Sciences › Medicine › Genetics › Congenital Ear and Nasal Anomalies
- Life Sciences › Neuroscience › Sensory Systems › Hearing, Cochlea, Tinnitus, Genetics
- Health Sciences › Medicine › Otorhinolaryngology › Ear Surgery and Otitis Media
- Keywords
- external auditory canal, canal stenosis, conductive hearing loss, tympanic membrane
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