- What is the function of the Eustachian tube?
- The Eustachian tube - what pathologies can it meet?
- How can I examine the Eustachian tube?
- Diseases of the trumpetauditory - treatment
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The Eustachian tube, also known as the Eustachian tube or tube, is the structure that connects the middle ear to the throat. It is about 3-4 centimeters long and plays an important role in equalizing the pressure between the middle ear and the external environment.
The Eustachian tube( Eustachian tube ,Eustachian tube ) consists of a cartilage and bone marrow. The cartilaginous portion of the Eustachian tube is normally flattened. As a result, no air passes through it and therefore does not participate in pressure equalization. It is only when the muscle of the soft palate is working that the cartilage part expands and the pressures are equalized. Tension of this muscle occurs, for example, as a result of yawning or swallowing saliva, and sudden changes in height. The Eustachian tube is covered with a monolayer snapper epithelium, which contains goblet cells and glands.
What is the function of the Eustachian tube?
The Eustachian tube is normally closed. This prevents the discharge from the nasopharynx into the middle ear from refluxing and protects it from excessively loud sounds. The Eustachian tube opens in situations such as sneezing, yawning and swallowing. Then, it is possible to equalize the pressure on both sides of the tympanic membrane, as mentioned above, and to drain unnecessary secretions from the middle ear.
The Eustachian tube - what pathologies can it meet?
Your Eustachian tube has an outlet at the top of your throat. Under physiological conditions, its patency is ensured by the correct operation of the soft palate tensioner muscle. For various reasons, this patency may be impaired, leading to the development of inflammation of the Eustachian tube first, and eventually also the middle ear. Conditions that can restrict the patency of the Eustachian tube include, for example:
- inflammatory processes in the nose and / or throat
- sudden changes in pressure, for example during a dive or an airplane take-off
- neoplasms of the nose or throat
- pharyngeal hypertrophy
In children, the anatomy of the Eustachian tube is slightly different than that of adults, which promotes inflammation.
As beforementioned, inflammation of the Eustachian tube most often leads to acute otitis media. In what mechanism? The inflammatory process leads to the formation of swelling within the Eustachian tube. This, in turn, impairs its patency, making it difficult to equalize the pressure. A negative pressure builds up in the middle ear, which is manifested by retraction of the tympanic membrane on an otoscopic examination. Negative pressure disturbs the hydrostatic balance between blood vessels and perivascular tissues within the Eustachian tube. This results in an exudate and then an exudate. It gives the ear a feeling of blockage, possible hearing impairment, and tinnitus may also appear.
Eustachianitisviral or bacterial in origin is probably the most common cause of acute otitis media. However, it should be remembered that each of the above-mentioned causes that impede the patency of the Eustachian tube leads to otitis through the same mechanism. In children with recurrent episodes of acute, exudative otitis, it is important to remember about the possible hypertrophy of the adenoid, as it is a relatively common cause of this disease. Then adenoidectomy should be considered as it is the only causal treatment.
How can I examine the Eustachian tube?
The Eustachian tube itself is not available in an ordinary clinical trial. Its course can only be traced on more detailed, imaging examinations of the head. In otoscopy, however, we can assess the appearance of the eardrum, which indirectly shows us the pressure behind it. When examining the throat, we can use a mirror to observe any swelling within the mouth of the Eustachian tube. The patency of the Eustachian tube can also be assessed using the Valsalva maneuver. Catheterization of the Eustachian tube is also often performed.
Depending on the cause of the obstruction of the Eustachian tube, catheterization can be both a diagnostic and a therapeutic method, because if the examination shows that there is liquid content in its lumen, it can be sucked out immediately. The catheter is inserted through the nose or throat into the area of the Eustachian tube. A so-called Politzer balloon is attached to one end of the catheter. On the one hand, the doctor pushes air into the ear, and on the other hand, he listens to the accompanying sound. Humming indicates complete patency of the Eustachian tube. If your doctor hears a gurgling sound, there is fluid in the middle ear. If no noise is heard during this examination, it is either a complete obstruction of the Eustachian tube or a poorly positioned catheter.
Diseases of the trumpetauditory - treatment
Treatment of diseases of the Eustachian tube should always be causal treatment. If there is any obstacle that restricts its permeability, it should be removed as far as possible. The infectious etiology is usually treated conservatively, by instilling the nose, and then laying on the "sick side", so that the drops from the nose reach the area of the Eustachian tube, thus reducing inflammation and swelling in its vicinity. The infection is most often viral, therefore nasopharyngeal infections should not be treated immediately with an antibiotic, as it will not be effective, and may only contribute to the development of drug resistance in bacteria. A few years ago, another method of treating diseases of the Eustachian tube was started, in the form of ballooning. It is a minimally invasive method and is generally considered safe, unfortunately it is only performed in specialized centers.