Pathology of the Eustachian Tube in Chronic Otitis Media Acute otitis media causes edema of the membrane lining, the Eustachian tube, and the middle ear. This edema may be maintained as long as there is infection in the ear spaces, and it produces the simplest form of Eustachian tube blockage.
In this type of case, it may be possible to inflate the tube by the. The Function of the Eustachian Tube. AMA Arch Otolaryngol. Coronavirus Resource Center.
Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy Continue. Twitter Facebook. This Issue. The pharyngeal two-thirds of the Eustachian tube is closed at rest and opens during swallowing, sneezing or performance of a valsalva maneuver.
At the nasopharyngeal end, a ring of lymphoid tissue known as the tubal tonsil of Gerlach surrounds the orifice. The Eustachian tube in infancy differs anatomically and physiologically from that of the adolescent. The shorter tube during infancy and early childhood facilitates reflux of bacteria-laden secretions from the nasopharynx. In addition, the isthmus constricted zone is not angulated in infants as it is in adolescents and adults.
This reduces the protective function of the Eustachian tube. Infants also are less able to actively open the Eustachian tube that accounts in part for their susceptibility to middle-ear disease. The Eustachian tube has three primary functions: 1 ventilation of the middle ear so that ambient pressure and middle ear pressure are similar; 2 protection of the middle ear from reflux of nasopharyngeal secretions and bacterial flora; and 3 drainage of secretions from the middle ear into the nasopharynx.
Optimum function of the Eustachian tube depends on a number of factors, including its length and angulation with the horizontal plane, the function and angulation of the tensor veli palatini muscle that opens up the pharyngeal end of the tube levator palatini assumes a role in late childhood , the amount of surfactant produced by the pharyngeal zone, and the viscosity of liquid in the middle ear.
The consequences of Eustachian tube dysfunction decrease with age. Dysfunction of the Eustachian tube can occur from anatomical causes, such as lymphoid tissue, edema, inflammation, and viscosity and amount of mucoid effusion or physiological causes, such as barotrauma, middle ear atelectesis, deficiency of surfactant production, ciliary dysfunction and abnormal patency of the pharyngeal tubal orifice. In the meantime, it may be necessary to reestablish Eustachian tube patency.
Here are some techniques I use and situations where they would be appropriate. The Politzer technique is a simple method of introducing positive pressure into one nostril with the goal of aeration of the middle ear via the Eustachian tube.
A 30 cc rubber bulb with a conical shaped plastic tip can be purchased inexpensively infant nasal aspirator, many dollar stores or most pharmacies.
Secretions are removed from both nasal passages by suction or by simply having the older child blow his nose. It may be necessary to instill one or two sprays of phenylephrine 0. The act of deglutition activates the tensor veli palatini muscle that opens up the Eustachian tube orifice. The bolus of air further distends the Eustachian tube and the air bolus is forced into the middle ear cleft neutralizes any negative pressure and ventilating the middle ear.
For chronic problems of Eustachian tube dysfunction, the accompanying parent is told to purchase an infant nasal syringe for home use. The Otovent is a balloon that fits over a flanged end of a similar conical plastic nasal occluder.
It controls the pressure within the middle ear, making it equal with the air pressure outside the body. Most of the time the eustachian tube is closed, opening only during activities such as yawning, swallowing, and chewing, to allow air through the passage between the middle ear and nasopharynx. When atmospheric pressure changes rapidly, causing a sudden feeling of blockage in the ear such as during airplane travel , these activities can be done on purpose to open the tube and equalize the pressure within the middle ear.
When the eustachian tube will not open enough to equalize pressure, symptoms such as discomfort, dizziness, or ringing in the ear may result. Visual examination of the eardrum with a lighted scope helps to determine if the cause is inflammation, swelling, or fluid in the ear. Conditions such as nasal congestion, infection of the ear or sinus, or allergies may cause these symptoms and lead to eustachian tube problems.
These causes can often be treated with decongestant medication or antibiotics, but in severe cases, surgery may be necessary. The nasopharynx is, by definition, the upper part of the throat behind the nose. It is a part of the pharynx, which comprises three separate segments…. The jejunum is one of three sections that make up the small intestine. Learn about its function and anatomy, as well as the conditions that can affect….
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