The ear is a sense organ that is specialized for two distinct functions: hearing and

equilibrium. It can be divided into external, middle, and inner sections, with the
neurological elements housed in and protected by structures in the inner ear. The
vestibular complex of the inner ear is the primary sensor for equilibrium. The
remainder of the ear is used for hearing.
The external ear consists of the outer ear, or pinna, and the ear canal ( Gambar. 1).
The pinna is another example of an important accessory structure to sensory system,
and it varies in shape and location from species to species, depending on the animals
survival needs. The ear canal is sealed at its internal end by a thin membranous sheet
of tissue called the tympanic membrane, or eardrum.
The tympanic membrane separates the external ear from the middle ear, an air-filled
cavity hat connects with the pharynx through the Eustachian tube. The Eustachian
tube is normally collapsed, sealing off the middle ear, but it opens transiently to allow
middle ear pressure to equilibrate with atmospheric pressure during chewing,
swallowing, and yawning. Colds or other infections that cause swelling can block the
Eustachian tube and result in fluid buildup in the middle ear. If bacteria are trapped in
the middle ear fluid, the ear infections know as otitis media results.
Three small bones of the middle ear conduct sound from the external environment to
the inner ear: the malleus, the incus, the stapes. The three bones are connected to one
another with the biological equivalent of hinges. One end of the malleus is attached to
the tympanic membrane, and the stirrup end of the stapes is attached to a thin
membrane that separates the middle ear from the inner ear.
The inner ear consists of two major sensory structures. The vestibular apparatus with
its semicircular canals is the sensory transducer for our sense of equilibrium. It will be
described in the following section. The cochlea of the inner ear contains sensory
receptors for hearing. On external view the cochlea is a membranous tube that lies
coiled like a snail shell within a bony cavity called labyrinth. Two membranous disks,
the oval window (to which the stapes is attached) and the round window, separate the
liquid-filled cochlea from the air-filled middle ear. Branches of the cranial nerve VIII,
the vestibulocochlear nerve, lead from the inner ear to the brain.

Gambar 1. Anatomi Telinga

Hearing is our perception of sound
Hearing is our perception of the energy carried by sound waves, which are pressure
waves with alternating peaks of compressed air and valleys in which the air molecules
are farther apart (Gambar. 2a).
Sound is our interpretation of the frequency, amplitude, and duration of the sound
waves that reach our ears. Our brains translate frequency of sound waves (the number
of wave peaks that pass a given point each second) into the pitch of a sound. Low
frequency waves are perceived as low-pitched sounds, such as the rumble of distant
thunder. High-frequency waves create high-pitched sound, such as the screech of
fingernails on a blackboard.
Sound wave frequency (Gambar.2b) is measured in waves per second, or hertz (Hz).
The average human ear can hear sounds over the frequency range of 20-20,000 Hz,
with the most acute hearing between 1000-3000 Hz. Our hearing is not as acute as
that of many other animals, just as our sense of smell is less acute. Bats listen for
ultra-high frequency sound waves (in the kilohertz range) that bounce off objects is
the dark. Elephants and some birds can hear sounds in the infrasound (very low
frequency) range.
Loudness is our interpretation of sound intensity and is influenced by the sensitivity
of an individuals ear. The intensity of a sound wave is a function of the wave
amplitude (Gambar 2b). Intensity is measured on a logarithmic scale in units calls
decibels (dB). Each 10-dB increase represents a 10-fold increase in intensity. Normal
conversation has a typical noise level of about 60 dB. Sounds of 80 dB or more can
damage the sensitive hearing receptors of the ear, resulting hearing loss. A typical
heavy metal rock concert has noise levels around 120 dB, an intensity that put
listeners in immediate danger of damage to their hearing. The amount of damage
depends on the duration and frequency of the noise as well as its intensity.

Gambar 2. Sound Waves

Sound Transduction is a multistep process
Hearing is a complex sense that involves four distinct transductions. Energy from
sound waves in the air first becomes mechanical vibrations, then fluid waves, then
chemical signals, and finally action potentials. This section summarizes the process.
We will then look in detail at signal transduction in the cochlea.
The four transductions steps and sound transmission through the ear are shown in
(Gambar.3). Sound waves striking the outer ear are directed down the ear canal until
they hit the tympanic membrane and are converted into vibrations of the membrane
(first transduction). These vibrations are transferred to the malleus, the incus, and the
stapes, in that order.
The arrangement of the three connected middle ear bones creates a lever that
multiplies the force of the vibration (amplification) so that very little sound energy is
lost due to friction. If noise levels are so high that there is danger of damage to the
inner ear, small muscles in the middle ear can pull on the bones to decrease their
movement and thereby dampen sound transmission to some degree.
As the stapes vibrates, it pulls and pushes on the thin tissue of the oval window, to
which it is attached. Vibrations at the oval window create waves in fluid-filled
channels of the cochlea (second transduction0, but because water is not compressible,
the wave energy dissipates back into the air of the middle ear at the round window.
As waves move through the cochlea, they push on the flexible membranes of the
cochlear duct and bend sensory hair cells inside the duct. The movement causes the
hair cells to release neurotransmitter onto primary sensory neurons (the chemical
signal, third transduction) . neurotransmitters binding to the sensory neuron initiates
action potentials (fourth transduction) that send coded information about sound
through the cochlear nerve to cranial nerve VIII and the brain.

Gambar 3. Lokalisasi Suara

Sounds are processed first in the cochlea
The auditory system process sound waves so that they can be discriminated by
location, pitch, and loudness. Localization of sound is complex process that requires
sensory input from both ears coupled with sophisticated computation by the brain
(Gambar. 3). In contrasts , the initial processing for pitch and loudness takes place in
the cochlea of each ear.
Coding sound for pitch is primarily a function of the basilar membrane. The
membrane is stiff and narrow near its attachment between the round and oval
windows but widens and becomes more flexible near its distal end (Gambar 4a). High
frequency waves entering a vestibular duct create maximum displacement of the
portion of basilar membrane close to the oval window and consequently are not
transmitted very far along the cochlea. Low-frequency waves travel along the length
of the basilar membrane and create their maximum displacement near the flexible
distal end. This differential response to frequency transforms the temporal aspect of
frequency (number of sound waves per second) into spatial coding by location along
the basilar membrane (Gambar . 4b). the spatial coding is preserved in the auditory
cortex as neurons project from hair cells along the basilar membrane to corresponding
regions in the brain.
Loudness is coded by the ear in the same way that signal strength is coded in somatic
receptions. The louder the noise, the more rapidly action potentials fire in the sensory
neuron.

Gambar 4. Sensory coding for pitch

Auditory Pathways Project to the auditory cortex

Once the cochlea transforms sound waves into electrical signals, primary sensory
neurons transfer this information to the brain. The cochlear nerve become part of
cranial nerve VIII, and its neuron project to nuclei in the medulla oblongata. AT that
point, sound from each ear is projected to both ipsilateral (same side) and contralateral
( opposite side) nuclei. As a result, each side of the brain gets information from both
ears. Ascending tracts from the medulla divide and go in three directions. The main
auditory pathway synapses in nuclei in the midbrain and thalamus before projecting to
the auditory cortex (Gambar 3). Collateral pathways take information to the reticular
formation and the cerebellum.
The localization of a sound source is an integrative task that requires simultaneous
input from both ears. Unless sound s coming from directly in front of a person, it will
not reach both ears at the same time ( Gambar 3). The brain records the time
differential for sound arriving at the ears and uses a complex computation to create a
three-dimensional representation of the sound source.

Hearing loss may result from mechanical of neural damage

There are three forms of hearing loss: conductive, central, and sensorineural. In
conductive hearing loss, sound cannot be transmitted through either the external ear or
the middle ear. The causes of conductive hearing loss range from an ear canal plugged
with ear wax (cerumen), to fluid in the middle ear from am infection, to diseases or
trauma that impede vibration of the malleus, incus, or stapes. Correction of
conductive hearing loss includes microsurgical techniques in which the bones of the
middle ear can be reconstructed.
Central hearing loss results either from damage to the neural pathways between the
ear and cerebral cortex or from damage to the cortex itself, as might occur from
stroke. This form of hearing loss in relatively uncommon.
Sensorineural hearing loss arises from damage to the structures of the inner ear,
including death of hair cells as a result of loud noises. The loss of hair cells in
mammals is currently irreversible. Birds and lower vertebrates, however, are able to
regenerate hair cells to replace those that die. This discovery has researches exploring
strategies to duplicate the process in mammals, including transplantation of neural
stem cells and gene therapy to induce nonsensory cells to differentiate into hair cells.
A therapy that replaces hair cells would be an important advance because the
incidence of hearing loss in younger people is increasing due to prolonged exposure
to rock music and environmental noises. Ninety percent of hearing loss in the elderlycalled presbycusis is sensorineural. Currently the primary treatment for sensorineural
hearing loss is the use of hearing aids, but amazing results have been obtained with
cochlear implants attached to tiny computers. Hearing is probably our most important
social sense. Suicide rated are higher among deaf people than m=among those who
have lost their sight. More than any other sense, hearing connects us to other people
and to the world around us.
Equilibrium pathways project primarily to the cerebellum
The hair cells of the vestibular apparatus stimulate primary sensory neurons in the
vestibular nerve. Those neurons either synapse in the vestibular nuclei of the medulla
or run without synapsing to the cerebellum (Gambar 5). Collateral pathways run from
the medulla to the cerebellum or upward through the reticular formation and
thalamus. There are some poorly defined pathways to the cerebral cortex, but most
integration for equilibrium comes from the cerebellum. Descending pathways from
the vestibular nuclei go to certain motor neurons involved in eye movement. These
pathways help keep the eyes locked on an object as the head turns.

Gambar 5. Central nervous system pathways for equilibrium