title: Analysis of eustachian tube function by video endoscopy.
abstract: OBJECTIVE
  Human eustachian tubes (ET) were inspected in vivo endoscopically, and video recordings were made for careful slow-motion analysis of normal physiologic function.
  
  
  METHODS
  Ambulatory office in a tertiary referral center.
  
  
  METHODS
  Thirty-four adults, 17 with no history of ET dysfunction (2 of whom had tympanic membrane perforations), 17 with known ET dysfunction.
  
  
  METHODS
  Transnasal endoscopic examination of the nasopharyngeal opening of the eustachian tube during rest, swallowing, and yawning.
  
  
  METHODS
  Video analysis of ET opening movements.
  
  
  RESULTS
  Normal ETs had four consistent sequential movements: (1) palatal elevation causing passive, then active, rotation of the medial cartilaginous lamina; (2) lateral excursion of the lateral pharyngeal wall; (3) dilation of the lumen, caused primarily by tensor veli palatini muscle movement beginning distally and inferiorly, then opening proximally and superiorly; and (4) opening of the tubal valve at the isthmus caused by dilator tubae muscle contraction. Dysfunctional ETs had intraluminal edema, polyps, or minimal muscle movement.
  
  
  CONCLUSIONS
  Slow-motion endoscopic video analysis may be a useful new technique for the study of eustachian tube physiology. Consistent muscle movement patterns were demonstrated in normal subjects but were absent in abnormal subjects. More studies of normal and abnormal patterns are needed to establish useful clinical correlates.
authors.affiliation: Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, USA.
authors.forename: D S
authors.initials: DS
authors.lastname: Poe
authors.forename: I
authors.initials: I
authors.lastname: Pyykkö
authors.forename: H
authors.initials: H
authors.lastname: Valtonen
authors.forename: J
authors.initials: J
authors.lastname: Silvola
mesh_terms: D000328:Adult; D000368:Aged; D003679:Deglutition / Q000502:physiology; D004724:Endoscopy / Q000379:methods*; D005064:Eustachian Tube / Q000033:anatomy & histology* / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014741:Video Recording