Eustachian tubes

[Guest guest]

Jim asked me to forward this note about Eustachian tubes...

EUSTACHIAN TUBES

Eustachian tubes connect the middle ear to the back of the throat and are

supposed to open with jaw movement to equalize pressure between the middle

ear and the environment and to let fluid that might be present drain from

the middle ear. In newborns they are at an angle of 11 degrees from

horizontal and they often don't open very well on their own (which causes

negative pressure to form in the middle ear, accumulation of clear fluid in

the middle ear, and possibly infection of the fluid which can turn to

pus.). The Eustachian tube is essentially a passive device that opens and

closes with jaw movement; it has one muscle that helps, but not very much.

If there is any inflammation that cause it to swell, tonsils and adenoids

that block its motion, or deformation due familial differences (like in my

family) or craniofacial anomaly, the Eustachian tube can open very poorly or

close completely causing the cycle of events described above. PE tubes are

bobbins or grommets placed in a hole that is cut in the eardrum to keep the

hole open so that the middle ear will be ventilated and negative pressure

does not form. In most cases, the PE tube is designed so that the eardrum

grows behind it and pushes into the ear canal. By age 10-11 years, after the

skull has matured, the Eustachian tubes move up to angle of 45 degrees and

normally open well on their own and middle ear problems and infections go

away. However, if the Eustachian tube is structurally abnormal or if there

are allergies (second hand cigarette smoke is a big one and many allergens

as well) and chronic infections in the throat, the person may end up having

middle ear problems caused by Eustachian tube dysfunction into adulthood.

Thirty years ago, someone told me of an attempt to improve Eustachian tube

function in which a very narrow soft tube was inserted into the Eustachian

tube to keep it open. The result was that the thin tube irritated the

Eustachian tube and caused it to function more poorly; ultimately the thin

tube worked its way up to the middle ear and pierced the eardrum. That

solution was abandoned quickly. I know of no other attempts to surgically

treat or re-construct this delicate and vital structure. If your child has

had chronic Eustachian problems and they go away, consider yourself

fortunate and try to identify your guardian angel.

Jim Thelin, audiologist, father of two boys who each had 3 sets of PE tubes

--

" It is far better to grasp the universe as it really is than to persist in

delusion, however satisfying and reassuring. " --Carl Sagan