Head and Neck

Head and Neck

Embryology
Embryology
Prepared by :Wiam Khader
Supervised by : Dr Omar Ghannam
Head & Neck Embryology
Head & Neck Embryology

Branchial
Branchial
Apparatus
Apparatus

Thyroid Gland
Thyroid Gland

Tongue
Tongue

Development of the face
Development of the face

Nose
Nose

Palate
Palate

Ear
Ear
Branchial
Branchial
Apparatus
Apparatus
4 arches are well developed by 4 4 arches are well developed by 4
th th
week of gestation week of gestation
5 5
th th
and 6 and 6
th th
arches are still rudimentary arches are still rudimentary
Development takes place over weeks 4 to 7 Development takes place over weeks 4 to 7
Contribute mostly to neck development but the first Contribute mostly to neck development but the first
arch contributes to facial development arch contributes to facial development
Branchial
Branchial
Apparatus
Apparatus
Branchial
Branchial
Apparatus
Apparatus

Arches
Arches
mesenchymal mesenchymal tissue surrounded by ectoderm tissue surrounded by ectoderm
and endoderm and endoderm

Clefts (or grooves)
Clefts (or grooves)
Separate adjacent arches along Separate adjacent arches along ectodermal ectodermal
surface surface

Pouches
Pouches
Outpouching Outpouching of endoderm from foregut of endoderm from foregut
Penetrate adjacent Penetrate adjacent mesenchyme mesenchyme
Branchial
Branchial
Apparatus
Apparatus
Branchial
Branchial
Apparatus
Apparatus
Branchial
Branchial
Arches
Arches
Each arch contains:
Each arch contains:
A A cartilagenous cartilagenous component component
A muscular component A muscular component
An aortic arch (artery) An aortic arch (artery)
A nerve A nerve
First
First
Branchial
Branchial
Arch
Arch
Divides early into 2 portions Divides early into 2 portions
Maxillary Maxillary process dorsally (maxilla, process dorsally (maxilla, zygoma zygoma, , squamous squamous
temporal bone) temporal bone)
Mandibular Mandibular process ventrally process ventrally
First
First
Branchial
Branchial
Arch
Arch
Cartilage (
Cartilage (
Meckel
Meckel

s
s
Cartilage)
Cartilage)
Dorsal end becomes the Dorsal end becomes the malleus malleus and and incus incus
Intermediate portion regresses, but the Intermediate portion regresses, but the perichondrium perichondrium
forms: forms:
Anterior ligament of the Anterior ligament of the malleus malleus
Sphenomandibular Sphenomandibular ligament ligament
Ventral portion forms the mandible Ventral portion forms the mandible
**Patiente with hypoplasia of the mandible are suspected to
have anomalies in the mallelous and incus
First
First
Branchial
Branchial
Arch
Arch
Muscular component
Muscular component
Muscles of mastication ( Muscles of mastication (temporalis temporalis, , masseter masseter, med & lat , med & lat
pterygoids pterygoids) )
Accessorymuscles Accessorymuscles of mastication ( of mastication (mylohyoid mylohyoid, ant belly of , ant belly of
digastric digastric) )
Tensor tympani Tensor tympani
Tensor Tensor veli veli palatini palatini
First
First
Branchial
Branchial
Arch
Arch
Aortic arch
Aortic arch
Maxillary artery Maxillary artery
Nerve
Nerve
Trigeminal nerve (CN V) Trigeminal nerve (CN V)
Second
Second
Branchial
Branchial
Arch
Arch
Cartilage (Reichert
Cartilage (Reichert

s Cartilage)
s Cartilage)
Dorsal end becomes stapes (except footplate) and Dorsal end becomes stapes (except footplate) and styloid styloid
process process
Intermediate portion regresses and Intermediate portion regresses and perichondrium perichondriumforms forms
the the stylohyoid stylohyoid ligament ligament
Ventral end forms the lesser Ventral end forms the lesser cornu cornu of the hyoid and the of the hyoid and the
upper half of the hyoid bone upper half of the hyoid bone
Second
Second
Branchial
Branchial
Arch
Arch
Muscular Component
Muscular Component
Migrates over superficial face to form the muscles of facial Migrates over superficial face to form the muscles of facial
expression expression
Stapedius Stapedius muscle muscle
Stylohyoid Stylohyoid muscle muscle
Posterior belly of Posterior belly of digastric digastric
Aortic Arch
Aortic Arch
Hyoid artery Hyoid artery
Stapedial Stapedial artery artery
Second
Second
Branchial
Branchial
Arch
Arch
Nerve
Nerve
Facial Nerve (CN VII) Facial Nerve (CN VII)
Third
Third
Branchial
Branchial
Arch
Arch
Cartilage
Cartilage
Located ventrally and forms the lower half of the body of Located ventrally and forms the lower half of the body of
the hyoid and the greater the hyoid and the greater cornu cornu
Muscular Component
Muscular Component
Only one muscle: Only one muscle: stylopharyngeus stylopharyngeus
Aortic Arch
Aortic Arch
Common carotid, external carotid, proximal internal Common carotid, external carotid, proximal internal
carotid carotid
Third
Third
Branchial
Branchial
Arch
Arch
Nerve
Nerve
Glossopharyngeal Glossopharyngeal (CN IX) (CN IX)
Fourth
Fourth
Branchial
Branchial
Arch
Arch
Cartilage
Cartilage
Thyroid cartilage Thyroid cartilage
Muscular Component
Muscular Component
The 3 pharyngeal constrictors The 3 pharyngeal constrictors
Cricothyroid Cricothyroid muscle muscle
Aortic Arch
Aortic Arch
Left: Aortic arch Left: Aortic arch
Right: Right Right: Right subclavian subclavian
Nerve
Nerve
Superior laryngeal branch of Superior laryngeal branch of vagus vagus (CN X) (CN X)
Sixth
Sixth
Branchial
Branchial
Arch
Arch
Cartilage
Cartilage
Cricoid Cricoid cartilage, cartilage, arytenoid arytenoid, , corniculate corniculate and cuneiform and cuneiform
Muscular Component
Muscular Component
Intrinsic muscles of larynx Intrinsic muscles of larynx
Aortic Arch
Aortic Arch
Left: pulmonary artery, Left: pulmonary artery, ductus ductus arteriosus arteriosus
Right: pulmonary artery, distal end degenerates Right: pulmonary artery, distal end degenerates
Nerve
Nerve
Recurrent laryngeal nerve of Recurrent laryngeal nerve of vagus vagus (CN X) (CN X)
Branchial
Branchial
Arches
Arches
Summary
Summary
Branchial
Branchial
Clefts
Clefts
(or grooves)
(or grooves)
4 clefts 4 clefts
The 2 The 2
nd nd
to 4 to 4
th th
clefts become buried by the clefts become buried by the
overgrowth of the 2 overgrowth of the 2
nd nd
arch to form the cervical arch to form the cervical
sinus sinus
Cervical sinus has Cervical sinus has dissapeared dissapeared by week 7 by week 7
The first cleft persists and invades the The first cleft persists and invades the mesenchyme mesenchyme
opposite the first pouch opposite the first pouch
This becomes the EAC and ectoderm of the TM This becomes the EAC and ectoderm of the TM
Branchial
Branchial
Clefts
Clefts
Pharyngeal Pouches
Pharyngeal Pouches
1
1
st
st
Pharyngeal Pouch
Pharyngeal Pouch
Elongates into the Elongates into the tubotympanic tubotympanic recess recess
The distal part contacts the 1 The distal part contacts the 1
st st
pharyngeal cleft and pharyngeal cleft and
forms the inner lining of the TM forms the inner lining of the TM
The The tubotympanic tubotympanic recess becomes the tympanic recess becomes the tympanic
cavity and mastoid cavity and mastoid antrum antrum
Connection of the recess with the pharynx becomes Connection of the recess with the pharynx becomes
the the eustachian eustachian tube tube
2
2
nd
nd
Pharyngeal Pouch
Pharyngeal Pouch
Forms the Forms the tonsillar tonsillar fossa fossa
Endoderm forms the surface epithelium and lining Endoderm forms the surface epithelium and lining
of of tonsillar tonsillar crypts crypts
At 20 weeks lymphoid tissue invades the endoderm At 20 weeks lymphoid tissue invades the endoderm
and forms the palatine tonsils and forms the palatine tonsils
3
3
rd
rd
Pharyngeal Pouch
Pharyngeal Pouch
Forms 2 Forms 2 diverticula diverticula: dorsal and ventral : dorsal and ventral
Endoderm of Endoderm of dorsal dorsal diverticula diverticula: : inf inf parathyroid parathyroid
Endoderm of Endoderm of ventra ventral l diverticula diverticula: lobule of thymus : lobule of thymus
These These diverticula diverticula become detached from the wall become detached from the wall
and migrate caudally. and migrate caudally.
Thymus comes to lie in the superior Thymus comes to lie in the superior mediastinum mediastinum
Pharyngeal Pouches
Pharyngeal Pouches
Pharyngeal Pouches
Pharyngeal Pouches
4
4
th
th
Pharyngeal Pouch
Pharyngeal Pouch
Also develops dorsal and ventral Also develops dorsal and ventral diverticula diverticula
The The dorsal dorsal bud becomes the sup. parathyroid bud becomes the sup. parathyroid
The The ventral ventral bud becomes the bud becomes the Ultimobranchial Ultimobranchial
body body
The The ultimobranchial ultimobranchial body fuses with the thyroid body fuses with the thyroid
gland and disseminates within it to give the gland and disseminates within it to give the
parafollicular parafollicular C cells which produce C cells which produce calcitonin calcitonin
Pharyngeal Pouches
Pharyngeal Pouches
Pharyngeal Pouches
Pharyngeal Pouches

5
5
th th
pouch never develops
pouch never develops

Controversy re:
Controversy re:
originof
originof
ultimobranchial
ultimobranchial
body
body
Thyroid
Thyroid
In 4 In 4
th th
week begins as week begins as endodermal endodermal thickening in floor of thickening in floor of
primitive pharynx primitive pharynx
The thickening becomes an The thickening becomes an outpouching outpouching: thyroid : thyroid diverticulum diverticulum
Thyroid descends anterior to hyoid and thyroid cartilage Thyroid descends anterior to hyoid and thyroid cartilage
Connected to tongue by Connected to tongue by thyroglossal thyroglossal duct duct
Week 7: Thyroid reaches final position Week 7: Thyroid reaches final position
Thyroglossal Thyroglossal duct has degenerated duct has degenerated
Pyramidal lobe: Persistence of distal end of Pyramidal lobe: Persistence of distal end of thyroglossal thyroglossal duct duct
Present in 50% of people Present in 50% of people
Thyroid
Thyroid
Tongue
Tongue
4 4
th th
week: elevation on floor of week: elevation on floor of
pharynx, just pharynx, just rostral rostral to foramen to foramen
cecum cecum: : Median Tongue Bud Median Tongue Bud
( (Tuberculum Tuberculumimpar impar) )
Distal Tongue Buds Distal Tongue Buds develop develop
just lateral to median tongue bud just lateral to median tongue bud
Both of the above originate in Both of the above originate in
mesenchyme mesenchyme of first of first branchial branchial
arch arch
Tongue
Tongue
Distal tongue buds overgrow the Distal tongue buds overgrow the
median tongue bud and merge with median tongue bud and merge with
each other each other
These form the ant 2/3 of the tongue These form the ant 2/3 of the tongue
Median tongue bud forms no adult Median tongue bud forms no adult
structure structure
Tongue
Tongue
At same time 2 elevations develop caudal At same time 2 elevations develop caudal
to foramen to foramen cecum cecum: :
1. Copula: from 2 1. Copula: from 2
nd nd
arch arch
2. 2. Hypobranchial Hypobranchial emminence emminence: :
from 3 from 3
rd rd
& 4 & 4
th th
arches arches
The The hypobranchial hypobranchial emminence emminence
overgrows the copula which disappears overgrows the copula which disappears
The post 1/3 of the tongue is formed by The post 1/3 of the tongue is formed by
the the rostral rostral part of the part of the hypobranchial hypobranchial
emminence emminence (Arch 3) (Arch 3)
Caudal part of Caudal part of hypobranchial hypobranchial emminence emminence
(Arch 4) forms the epiglottis (Arch 4) forms the epiglottis
Tongue
Tongue
Branchial Branchial mesenchyme mesenchyme
forms the soft tissue, forms the soft tissue,
vascular and vascular and lymphatics lymphatics
of the tongue. of the tongue.
Tongue muscles Tongue muscles
originate from the originate from the
occipital occipital somites somites which which
bring with them bring with them
innervation innervation (CN XII) (CN XII)
Tongue
Tongue
Innervation Innervation to tongue: to tongue:
Ant 2/3: CN V Ant 2/3: CN V
Post 1/3: CN IX Post 1/3: CN IX
Development of the Face
Development of the Face
Five facial Five facial primordia primordia contribute to development of the face: contribute to development of the face:
The The frontonasal frontonasal prominence prominence
Paired Maxillary prominences Paired Maxillary prominences
Paired Paired Mandibular Mandibular prominences prominences
Development of the Face
Development of the Face
4 4
th th
week: thickening of ectoderm in the week: thickening of ectoderm in the ventrolateral ventrolateral parts of parts of
the FNP: the FNP: Nasal Nasal Placodes Placodes
Mesenchyme Mesenchyme on the edges of the on the edges of the placodes placodes proliferates to proliferates to
form: form: medial and lateral nasal prominences medial and lateral nasal prominences
As a result the nasal As a result the nasal placodes placodes now lie in a depression called now lie in a depression called
nasal pits nasal pits which enlarge dorsally to form the nasal cavities. which enlarge dorsally to form the nasal cavities.
These nasal cavities are separated from the oral cavity by the These nasal cavities are separated from the oral cavity by the
oronasal oronasal membranes membranes which rupture to form the primitive which rupture to form the primitive
choana choana
Development of the Face
Development of the Face
Development of the Face
Development of the Face
Growth of maxillary Growth of maxillary
prominences pushes medial prominences pushes medial
nasal prominences medially nasal prominences medially
These fuse to form the These fuse to form the
nasal bulb, the nasal bulb, the philtrum philtrum, ,
the the premaxillary premaxillary segment of segment of
the maxilla and the the maxilla and the
primitive palate primitive palate
Development of the Face
Development of the Face
The lateral nasal prominences, which become the ala are The lateral nasal prominences, which become the ala are
separated from the maxillary prominences by the separated from the maxillary prominences by the
n nasolacrimal asolacrimal grooves grooves which become the which become the nasolacrimal nasolacrimal
ducts. ducts.
The sinuses form as The sinuses form as outpouchings outpouchings of the ectoderm of lateral of the ectoderm of lateral
nasal walls nasal walls
The olfactory epithelium develops from ectoderm The olfactory epithelium develops from ectoderm
Palate
Palate
Primary and Secondary Palate Primary and Secondary Palate
Primary Palate
Primary Palate
Develops from the fusion of the medial nasal prominences Develops from the fusion of the medial nasal prominences
between the maxillary prominences between the maxillary prominences
Forms the adult portion of the palate which is anterior to the Forms the adult portion of the palate which is anterior to the
incisive foramen incisive foramen
Palate
Palate
Secondary Palate
Secondary Palate
Origin of the hard and soft palate Origin of the hard and soft palate
Develops from internal projections of the maxillary Develops from internal projections of the maxillary
prominences called the prominences called the lateral palatine processes lateral palatine processes
As mandible develops, the tongue drops and the palatine As mandible develops, the tongue drops and the palatine
processes grow medially and fuse in the midline. processes grow medially and fuse in the midline.
They also fuse with the nasal septum and the primary palate. They also fuse with the nasal septum and the primary palate.
Ossification occurs in an Ossification occurs in an antero antero- -posterior direction posterior direction
The Ear
The Ear
Inner Ear
Inner Ear
4 4
th th
week: thickening in surface ectoderm called week: thickening in surface ectoderm called otic otic placode placode
Invaginates Invaginates into underlying into underlying mesenchyme mesenchyme and detaches from and detaches from
ectoderm: now called ectoderm: now called otic otic vesicle vesicle
Otic Otic vesicle divides into 2 regions: vesicle divides into 2 regions: utricular utricular portion and portion and
saccular saccular portion portion
Utricular Utricular portion portion
Utricle, semicircular canals and Utricle, semicircular canals and endolymphatic endolymphatic duct duct
Saccular Saccular portion portion
Saccule Saccule and cochlear duct (becomes cochlea) and cochlear duct (becomes cochlea)
Inner Ear
Inner Ear
Middle Ear
Middle Ear
External Ear
External Ear
Develops from 6 Develops from 6 mesenchymal mesenchymal swellings, called swellings, called auricular auricular
hillocks hillocks, which develop around the first , which develop around the first branchial branchial cleft cleft
The The mesenchyme mesenchyme is derived from mesoderm in the first and is derived from mesoderm in the first and
2 2
nd nd
branchial branchial arches. As the ear grows, arches. As the ear grows, contrbutions contrbutions of the of the
first first branchial branchial arch become reduced. arch become reduced.
The The pinna pinna initially develops in the neck. As the mandible initially develops in the neck. As the mandible
grows, it moves up to the level of the eyes. grows, it moves up to the level of the eyes.
Part of the auricle originating from the first Part of the auricle originating from the first branchial branchial arch is arch is
innervated by CN V innervated by CN V
The part originating from the 2 The part originating from the 2
nd nd
arch is innervated by the arch is innervated by the
cervical plexus (namely the lesser occipital and greater cervical plexus (namely the lesser occipital and greater
auricular nerves) auricular nerves)
External Ear
External Ear
External Ear
External Ear
Thank You
Thank You