Auditory tube: what is it?

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The auditory tube, located in the middle ear, helps with balance and hearing by equalizing pressure and draining fluids. Children are more prone to ear infections due to a shorter and more horizontal tube.

The tympanic cavity, or middle ear, of the human auditory system is a compressed space within the temporal bone of the skull. It sits between the tympanic membrane, also known as the eardrum, and the inner ear. The auditory tube, referred to as the Eustachian or pharyngotympanic tube, is found there, located towards the front of the general structure of the auditory system. It connects the middle ear to the pharynx through the nasopharynx, or nasal passages. In adults, this small tube averages about 35mm in length.

The auditory tube helps with two important physiological functions: balance and hearing. To do its job, this structure must be able to open and close properly. Normally the auditory tube remains in a closed position, but when necessary, it opens just enough to admit the correct amount of air needed to equalize the pressure in the middle ear with the atmospheric pressure outside the ear.

This equalization process, sometimes referred to as ear clearing, will be most active when traveling in a mountainous region or flying in an airplane. At certain heights, hearing is reduced or dulled until pressure balance is restored, usually with chewing, swallowing, or using the Valsalva maneuver, in which an attempt is made to exhale while the mouth is closed and the nose is stuffy. When the correct pressure is reached between the air in the middle ear and ambient air, a popping noise will occur and the Eustachian tube will return to its closed position to maintain the appropriate pressure and protect the eardrum from loud noises.

Another important job done by the auditory tube is the drainage of mucosal fluids from the tympanic cavity of the middle ear. Fluid secretions are moved to the nasopharynx by hair cells along the distal end of the tube. This function may be impaired if the tube is slow to drain, which may be caused by tissue swelling. Such swelling can be caused by inflammation related to allergies or upper respiratory system infections. A swollen eustachian tube can get bacteria trapped in the middle ear, leading to an ear infection.

Children tend to have more problems with earache and infections than adults because their Eustachian tube is shorter and has a more horizontal angle. Horizontal placement, combined with a smaller tube opening in children, may impair the movement of normal secretions from the middle ear. This can lead to pain and infection.




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