Journal article
New insights into mechanism of Eustachian tube ventilation based on cine computed tomography images
European archives of oto-rhino-laryngology, Vol.269(8), pp.1901-1907
08/01/2012
DOI: 10.1007/s00405-011-1829-y
PMCID: PMC3679544
PMID: 22120826
Abstract
There is debate concerning the mechanism of Eustachian tube (ET) ventilation. While a mechanism of complete opening has been advocated previously, sequential contraction of the levator veli palatini and medial pterygoid muscles followed by the tensor veli palatini and lateral pterygoid muscles may produce a transient sequential opening mechanism, allowing an air bolus to traverse the ET. This may explain confusion surrounding sonotubometry reports that not every swallow leads to sound passage in normal subjects. We hypothesize that the ET may not need to open completely when ventilating the middle ear; rather, a discrete air bolus can pass through it. Five normal and five disordered subjects underwent low-radiation dose cine computed tomography (CT) scans of the ET. Sixteen contiguous 2.5 mm slice locations were chosen through a 4 cm area in the nasopharynx that were parallel to and encompassed the entire ET. Twelve images were acquired at each slice over 4.8 s during swallowing and other tasks. Serial images were analyzed. An air bolus was observed passing through the ET in the normal subjects, but not the subject with ET dysfunction. Medial and lateral pterygoid contractions were also observed. A new hypothetical mechanism of transient sequential ET ventilation is presented. This is not a definitive conclusion, as the number of scans taken and maneuvers used was limited. Improved understanding of ET ventilation may facilitate management of middle ear disease as treatment evolves from ventilatory tube placement to ET manipulation.
Details
- Title: Subtitle
- New insights into mechanism of Eustachian tube ventilation based on cine computed tomography images
- Creators
- Michael H. McDonald - University of Wisconsin School of Medicine and Public HealthMatthew R. Hoffman - University of Wisconsin School of Medicine and Public HealthLindell R. Gentry - University of Wisconsin–MadisonJack J. Jiang - University of Wisconsin–Madison
- Resource Type
- Journal article
- Publication Details
- European archives of oto-rhino-laryngology, Vol.269(8), pp.1901-1907
- Publisher
- Springer Nature
- DOI
- 10.1007/s00405-011-1829-y
- PMID
- 22120826
- PMCID
- PMC3679544
- ISSN
- 0937-4477
- eISSN
- 1434-4726
- Number of pages
- 7
- Grant note
- R01 DC008153 / NIH from National Institute on Deafness and other Communicative Disorders R01DC008153 / NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Deafness & Other Communication Disorders (NIDCD)
- Language
- English
- Date published
- 08/01/2012
- Academic Unit
- Otolaryngology
- Record Identifier
- 9984366362002771
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