Understanding the pathophysiology of Eustachian tube dysfunction is critical for the management of ear disease. The complex anatomy of the Eustachian tube through the base of the skull makes its function difficult to assess and many early attempts of surgical treatment were unsuccessful. This book discusses anatomy, physiology, pathology, diagnosis and the evolution of surgery of the Eustachian tube. It encapsulates our present knowledge of the principles and present day practice of the management of Eustachian tube dysfunction.

1.Anatomy of the Eustachian tube161.1.Systematic anatomy161.1.1.Eustachian tube cartilage161.1.2.Eustachian tube muscles171.1.2.1.Levator veli palatini muscle171.1.2.2.Tensor veli palatini muscle171.1.2.3.Salpingopharyngeal muscle181.1.2.4.Medial pterygoid muscle181.1.3.Eustachian tube ligaments181.2.Topographic compartments of the Eustachian tube181.2.1.Lumen181.2.2.Membranous wall191.3.References192.Physiology of Eustachian tube dysfunction242.1.Tubal function242.2.Pressure balance of the temporal pneumatic spaces The role of tubal physiology262.2.1.Gas exchanges272.2.2.Regulating systems272.2.2.1.The in-situ adaptation systems282.2.2.2.The central and peripheral nervous regulating system302.2.2.3.How the system operates312.3.References313.Diagnosis of Eustachian tube function363.1.Clinical testing363.2.Endoscopy363.3.Radiology373.3.1.Conventional X-ray373.3.2.Computed tomography (CT) and Magnetic resonance imaging (MRI)383.4.Manometric testing383.4.1.Tympanometry383.4.2.Nine-step inflation deflation test383.4.3.Modified Inflation deflation test393.4.4.Forced response test393.4.5.Tubomanometry393.5.Acoustic testing Sonotubometry403.6.Pressure chamber413.7.Electromyography413.8.Other methods423.9.References424.Eustachian tube dysfunction consensus484.1.Difficulty defining ETD484.2.International consensus of ETD484.2.1.Definition484.2.2.Symptoms of ETD484.2.3.Signs of ETD494.2.4.Test for ETD494.3.Future work504.4.References505.Evolution of Eustachian tube surgery525.1.Evolutionary techniques525.2.Techniques to improve tubal function545.3.References596.Patulous Eustachian tube646.1.Causes of PET646.2.Epidemiology646.3.Symptoms646.4.Diagnosis656.5.PET in middle ear diseases and"masked patulous Eustachian tube"686.6.Treatment of PET686.7.Plugging the Eustachian tube in PET patients through the middle ear696.8.References717.Surgical techniques and learning curve767.1.Pharyngeal access or combined endonasal and transoral approach767.2.Contralateral access777.3.Ipsilateral access787.4.Learning curve797.5.References798.Laser ablation of the Eustachian tube828.1.Selection of patients and pretreatment828.2.Practical performance of laser tuboplasty of the Eustachian tube838.3.Scientific data848.4.Measurement of the Eustachian tube function858.5.Discussion of the study results868.6.References869.Balloon dilation Eustachian Tuboplasty (BET)909.1.Technique929.2.Diagnostics and indications929.2.1.ETDQ-7939.2.2.Tubomanometry (TMM)939.2.3.Eustachian tube score (ETS)949.2.4.Patient selection959.3.Results959.4.Complications969.5.Discussion969.6.References9710.BET in chronic obstructive Eustachian tube dysfunction in children10010.1.Methods10110.2.Results10210.2.1.Sociodemographic factors10210.2.2.Pre-interventional clinical findings10210.3.Post-interventional clinical findings10310.4.Discussion10410.5.Special aspects of Eustachian tube dilation in children10510.6.Conclusion10810.7.References10911.Reusable and disposable instruments for BET11211.1.Reusable instruments for TubaVent® standard length11211.2.TubaInstruments11412.Middle ear surgery and Eustachian tube dysfunction11612.1.Eustachian tube dysfunction and its differential diagnosis11612.2.Middle ear surgery in patients with middle ear ventilation problems11712.3.Tympanoplasty and balloon dilation of the Eustachian tube11812.4.References120Index124