The auditory (Eustachian or pharyngotympanic) tube connects the middle ear to the nasopharynx. It is about 36 mm long in adults: the back third is bone and the front two-thirds is cartilage. It is normally closed and opens briefly during swallowing and yawning, mainly through the action of tensor veli palatini.
| Location | From the anterior wall of the middle ear, running forward, medially and downward to the lateral wall of the nasopharynx |
|---|---|
| Parts |
|
| Nerve Supply | Tympanic plexus (CN IX) for the bony part; Pharyngeal branch of the pterygopalatine ganglion (CN V2) for the pharyngeal end; Mandibular nerve (CN V3) to tensor veli palatini |
| Blood Supply | Ascending pharyngeal artery; Middle meningeal artery; Artery of the pterygoid canal |
Equalises middle ear pressure with the atmosphere, drains middle ear secretions to the nasopharynx and protects the middle ear from nasopharyngeal sound and secretions.
In young children the tube is shorter, wider and more horizontal, which helps explain why middle ear infections are so common. Tube dysfunction causes ear fullness, muffled hearing and pain with flying or diving. A persistent one-sided middle ear effusion in an adult should prompt examination of the nasopharynx to exclude a tumour. A patulous tube stays open and makes one's own voice sound loud.
Failure of the tube to open properly, causing negative middle ear pressure, fullness and muffled hearing, often after colds or with allergies.
Ear pain and possible eardrum damage when the tube cannot equalise pressure during descent in flying or diving.
Fluid build-up behind an intact eardrum from poor tube ventilation, a common cause of hearing loss in children.
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