Involvement of pterygoid venous plexus in patulous eustachian tube symptoms.
CONCLUSIONS
The pterygoid venous plexus (PVP) is an important factor in the mechanism of eustachian tube (ET) closure under conditions that can cause increased venous pressure in the head, such as during neck compression and postural change from the sitting/standing to the recumbent position.


OBJECTIVE
The symptoms of patulous ET are usually improved by neck compression or postural change (from sitting/standing to recumbent position). Venous congestion around the ET and/or gravitational change may be involved in the changing degree of symptoms, but its mechanism is not understood. This study investigated whether the PVP is involved.


METHODS
The dimensions of soft tissues surrounding ET were measured on magnetic resonance images before and after neck compression.


RESULTS
The lateral pterygoid muscle became enlarged after neck compression. Simultaneously, the volume of venous plexus observed between the medial pterygoid muscle and tensor veli palatini muscle was increased. Such enlargement was probably due to blood pooling in the PVP, resulting in protrusion of the ET anterior wall to the luminal side, and decreased ET patency.
Oshima
Takeshi
T
Department of Otorhinolaryngology--Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan. oshima@orl.med.tohoku.ac.jp
Ogura
Masaki
M
Kikuchi
Toshiaki
T
Hori
Yoko
Y
Mugikura
Shunji
S
Higano
Shuichi
S
Takahashi
Shoki
S
Kawase
Tetsuaki
T
Kobayashi
Toshimitsu
T
D000328:Adult; D003250:Constriction; D004724:Endoscopy; D005064:Eustachian Tube / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009333:Neck; D011187:Posture / Q000502:physiology; D011312:Pressure; D011626:Pterygoid Muscles / Q000098:blood supply* / Q000473:pathology*; D012039:Regional Blood Flow / Q000502:physiology; D014680:Veins / Q000473:pathology / Q000503:physiopathology*; D014690:Venous Pressure / Q000502:physiology*