Eustachian tube

The Eustachian tube, also known as the auditory tube or pharyngotympanic tube, is a tube that links the nasopharynx to the middle ear. It is a part of the middle ear. In adult humans the Eustachian tube is approximately 35 mm (1.4 in) long and 3 mm (0.12 in) in diameter. It is named after the sixteenth-century Italian anatomist Bartolomeo Eustachi.Frontal section through left ear; upper half of sectionView of the inner wall of the tympanum (enlarged)The right membrana tympani with the hammer and the chorda tympani, viewed from within, from behind, and from above The Eustachian tube, also known as the auditory tube or pharyngotympanic tube, is a tube that links the nasopharynx to the middle ear. It is a part of the middle ear. In adult humans the Eustachian tube is approximately 35 mm (1.4 in) long and 3 mm (0.12 in) in diameter. It is named after the sixteenth-century Italian anatomist Bartolomeo Eustachi. In humans and other land animals the middle ear (like the ear canal) is normally filled with air. Unlike the open ear canal, however, the air of the middle ear is not in direct contact with the atmosphere outside the body. The Eustachian tube connects from the chamber of the middle ear to the back of the nasopharynx. Normally, the Eustachian tube is collapsed, but it gapes open both with swallowing and with positive pressure. When taking off in an airplane, the surrounding air pressure goes from higher (on the ground) to lower (in the sky). The air in the middle ear expands as the plane gains altitude, and pushes its way into the back of the nose and mouth. On the way down, the volume of air in the middle ear shrinks, and a slight vacuum is produced. Active opening of the Eustachian tube is required to equalize the pressure between the middle ear and the surrounding atmosphere as the plane descends. A diver also experiences this change in pressure, but with greater rates of pressure change; active opening of the Eustachian tube is required more frequently as the diver goes deeper into higher pressure. The Eustachian tube extends from the anterior wall of the middle ear to the lateral wall of the nasopharynx, approximately at the level of the inferior nasal concha. It consists of a bony part and a cartilaginous part. The bony part (1/3) nearest to the middle ear is made of bone and is about 12 mm in length. It begins in the anterior wall of the tympanic cavity, below the septum canalis musculotubarii, and, gradually narrowing, ends at the angle of junction of the squamous and the petrous parts of the temporal bone, its extremity presenting a jagged margin which serves for the attachment of the cartilaginous part. The cartilaginous part of the Eustachian tube is about 24 mm in length and is formed of a triangular plate of elastic fibrocartilage, the apex of which is attached to the margin of the medial end of the bony part of the tube, while its base lies directly under the mucous membrane of the nasal part of the pharynx, where it forms an elevation, the torus tubarius or cushion, behind the pharyngeal opening of the auditory tube. The upper edge of the cartilage is curled upon itself, being bent laterally so as to present on transverse section the appearance of a hook; a groove or furrow is thus produced, which is open below and laterally, and this part of the canal is completed by fibrous membrane. The cartilage lies in a groove between the petrous part of the temporal bone and the great wing of the sphenoid; this groove ends opposite the middle of the medial pterygoid plate. The cartilaginous and bony portions of the tube are not in the same plane, the former inclining downward a little more than the latter. The diameter of the tube is not uniform throughout, being greatest at the pharyngeal opening, least at the junction of the bony and cartilaginous portions, and again increased toward the tympanic cavity; the narrowest part of the tube is termed the isthmus. The position and relations of the pharyngeal opening are described with the nasal part of the pharynx. The mucous membrane of the tube is continuous in front with that of the nasal part of the pharynx, and behind with that of the tympanic cavity; it is covered with ciliated pseudostratified columnar epithelia and is thin in the osseous portion, while in the cartilaginous portion it contains many mucous glands and near the pharyngeal orifice a considerable amount of adenoid tissue, which has been named by Gerlach the tube tonsil.