Location of the Eustachian tube The tuba Eustachii – also called Eustachian tube or auditory tube – was named after the Italian anatomist Bartolomeo Eustachi who was the first to describe it. It is a narrow, tube-like connection between the nasopharynx and the middle ear with a length of about 3.5 centimetres in adults. It is lined with respiratory epithelial cells (ciliated epithelium) and consists of a longer cartilaginous part on the nasopharynx side and a shorter osseous part towards the tympanic membrane.
The Eustachian tube serves for pressure equalisation between the nasopharynx and the middle ear. This pressure equalisation is mainly achieved via swallowing and yawning where this connection is briefly opened and immediately closed again. Thus, pressure in the middle ear is normalised. By closing one's mouth and pinching one's nose shut with two fingers and at the same time trying to exhale, pressure in the nasopharynx may be increased thus achieving a passive opening of the Eustachian tube (Valsalva manoeuvre).
The natural way of supporting pressure equalisation consists in contracting certain throat muscles which open the entrance to the Eustachian tube during swallowing and yawning and cause the typical "clicking" sound within the ear (this may require some training).
Another function of the Eustachian tube is the draining of secretions from the middle ear ("drainage"). In case of diseases of the upper respiratory tract, the Eustachian tube may be narrowed due to swelling of the mucous membranes or, especially in children, serve as transport channel for an ascending bacterial infection causing inflammation of the middle ear (otitis media). Obstruction of the Eustachian tube leads to tympanic effusion.
If ventilation of the Eustachian tube is disturbed, pressure equalisation cannot be achieved. Unpleasant sensations like a feeling of pressure and muffled hearing remain.
A very good method for treating disturbed ventilation of the Eustachian tube is balloon dilation using TubaVent®. This minimally invasive intervention is performed under brief anaesthesia using a balloon: A doctor inserts a balloon catheter into the cartilaginous part of the Eustachian tube through the nose and / or mouth. Then he / she fills the balloon, building up a pressure of 10 bar and holding it for two minutes. This way, the bottlenecks within the auditory tube are dilated. This restores the function of the auditory tube thus allowing both the normal exchange of air and the equalisation of pressures.
In case of narrow anatomic conditions, for example in children, a shorter insertion path is better suited and allows easier handling. According to this requirement, TubaVent® short has been developed in combination with the single-use insertion instrument TubaInsert®. The catheter has been optimally adapted to the single-use insertion instrument and equipped with an especially rounded tip.
The TubaClean® catheter was developed in order to be able to probe and ﬂush the tube also in the course of middle ear surgery.