ENT

1. EUSTACHIAN TUBE AND ITS
DISORDER
Dr. Uzwal kumar jha

2.  Downward, forward and
medially
 45 degree
 Parts
 Bony(12mm)
 fibrocartilagenous(24mm)

3.  Tympanic end
 Pharyngeal end
 Slit-like
 Vertical
 Torus tubaris
 1-1.25cm

4. Tensor veli palatini
Levator veli palatini
salpingopharyngeus
Elastin hinge
Ostmann’s pad of fat

5. Lining of eustachian tube
 Pseudostratified ciliated columnar epithelium
Nerve supply
 Tympanic branch of 9th nerve
 Muscles
 Tensor veli palatini-mandibular nerve
 Levator veli palatini, salphingophyaryngeus-pharyngeal
plexus

7. FUNCTIONS
 Ventilation and regulation of middle ear pressure
 Middle ear clearance of secretion
 Protection against reflux of nasopharyngeal
secretion

8. ETIOLOGY OF ET DYSFUNCTION
 URTI
 Chronic rhinosinusitis
 Allergic rhinitis
 Adenoid hypertrophy
 Tobacco smoke
 Reflux
 Cleft palate-79%
 Radiation
 Down’s syndrome

9. DISORDER OF ET

10. EVALUATION OF ET
Symptoms
 Aural fullness
 Pain or discomfort
 Hearing loss
 Tinnitus
 Dizziness
Signs
 Retracted tympanic
membrane
 Features of OME

11. TESTS
 Valsalva test
 Politzer test
 Toynbee test
 Catheterisation
 Tympanometry
 Radiological test
 Saccharine or methylene blue test
 Sonotubometry

13. M/M
No clear consesus on oral/topical medications
 Correction of predisposing factors
 Topical Dexamethasone
 Pressure equalization tubes
 Adenoidectomy-controversy

14. PATULOUS ET
Etiology
 Idiopathic
 Rapid wt loss
 Pregnacny
 OC pills
 Malignancy
 Multiple sclerosis
Sign and symptom
 Autophony
 Movement of TM on
respiration

15.  Self limiting
 Laser Eustachian tuboplasty - obliteration of ET
 grommet

16. THANK YOU