- David M Vernick, MD
David M Vernick, MD
- Assistant Professor of Otolaryngology
- Harvard Medical School
The middle ear is a gas-filled space. It is separated from the outside world by the tympanic membrane laterally and the eustachian tube anteromedially. Pressure within the middle ear has to match that of the outside world for the tympanic membrane to vibrate normally and for hearing to sound clear. During normal physiologic function, air in the middle ear is absorbed slowly by the lining mucous membranes and has to be continually replaced . This happens normally when one swallows or yawns, opening the eustachian tube for a second and allowing air flow to occur. When the eustachian tube does not function adequately, pressure differences develop between the middle ear and the outside world. These pressure differences can distort the tympanic membrane and lead to discomfort, hearing loss, and injury, otherwise known as barotrauma.
This topic will focus on the clinical manifestations, diagnosis, and treatment of barotrauma. Other issues related to eustachian tube dysfunction are discussed in detail elsewhere. (See "Eustachian tube dysfunction".)
EUSTACHIAN TUBE FUNCTION
The eustachian tube extends from the middle ear to the nasopharynx and is made up of two parts :
●The posterior half leading from the ear is a bony tube lined with mucosa that does not change shape.
●The anterior half is made of soft tissue that is mucosa-lined; it is normally collapsed.
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