title: Involvement of pterygoid venous plexus in patulous eustachian tube symptoms.
abstract: 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.
authors.affiliation: Department of Otorhinolaryngology--Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan. oshima@orl.med.tohoku.ac.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Oshima
authors.forename: Masaki
authors.initials: M
authors.lastname: Ogura
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Kikuchi
authors.forename: Yoko
authors.initials: Y
authors.lastname: Hori
authors.forename: Shunji
authors.initials: S
authors.lastname: Mugikura
authors.forename: Shuichi
authors.initials: S
authors.lastname: Higano
authors.forename: Shoki
authors.initials: S
authors.lastname: Takahashi
authors.forename: Tetsuaki
authors.initials: T
authors.lastname: Kawase
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Kobayashi
mesh_terms: 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*