Functional Anatomy of Levator Veli Palatini Muscle and Tensor Veli Palatini Muscle in Association with Eustachian Tube Cartilage

2002 ◽  
Vol 111 (6) ◽  
pp. 530-536 ◽  
Author(s):  
Ken Ishijima ◽  
Isamu Sando ◽  
Makoto Miura ◽  
Carey D. Balaban ◽  
Kenji Takasaki
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Functional Anatomy ◽  
Cross Sectional ◽  
3 Dimensional ◽  
Inferior Margin ◽  
Levator Veli Palatini ◽  
Medial Rotation ◽  
Dimensional Reconstruction ◽  
Tensor Veli Palatini Muscle

The anatomic relationships among the levator veli palatini muscle (LVPM), the tensor veli palatini muscle (TVPM), and the eustachian tube (ET) cartilage were investigated by computer-aided 3-dimensional reconstruction and measurement methods. The study used 13 normal temporal bone–ET specimens obtained from 13 individuals (range of age at death, 3 months to 88 years). This study revealed several anatomic features of the anterior cartilaginous portion of the ET First, the LVPM is always located inferolateral to the inferior margin of the medial lamina (ML) of the ET cartilage. Second, the LVPM has a large cross-sectional area throughout the extent of the anterior cartilaginous portion of the ET. Third, although the LVPM lies close to the ML of the ET cartilage (0.44 ± 0.16 mm in children and 1.02 ± 0.58 mm in adults), there is no region of attachment. Finally, the TVPM is not attached to the lateral lamina (LL) of the ET cartilage of the anterior quarter of the cartilaginous portion. Accordingly, it could be assumed that the most anterior cartilaginous portion of the ET is opened primarily by the contraction of the LVPM, which causes a superior-medial rotation of the ML. Furthermore, since the contraction time of the LVPM is reported to be longer than that of the TVPM, the anterior cartilaginous portions of the ET may remain open, even after the middle to posterior cartilaginous portions are closed after relaxation of the TVPM. This process would produce a pumping action of the ET in the direction from the middle ear to the pharyngeal side. The pumping function may be beneficial to clearance of the middle ear.

Narrowest (ISTHMUS) Portion of Eustachian Tube: A Computer-Aided Three-Dimensional Reconstruction and Measurement Study

1997 ◽  
Vol 106 (7) ◽  
pp. 583-588 ◽  
Author(s):  
Masaharu Sudo ◽  
Isamu Sando ◽  
Akihiro Ikui ◽  
Chiaki Suzuki
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Three Dimensional ◽  
Three Dimensional Reconstruction ◽  
Cross Sectional ◽  
Computer Aided ◽  
Dimensional Reconstruction ◽  
Tensor Veli Palatini Muscle ◽  
Normal Human ◽  
Temporal Bones

Nine normal human temporal bones from persons 16 to 88 years old were studied by computer aided three-dimensional reconstruction and measurement. The length of the eustachian tube (ET) lumen in three portions (from pharyngeal orifice to tympanic orifice: cartilaginous, junctional, and bony) averaged 23.6 ±4.3 mm, 3.0 ± 1.9 mm, and 6.4 ± 2.6 mm. The narrowest portion of the ET lumen was in the cartilaginous portion in all cases: 20.5 ± 4.2 mm from the pharyngeal orifice and 3.1 ± 1.6 mm from the pharyngeal margin of the junctional portion. The cross-sectional area of the narrowest portion was 0.65 ± 0.2 mm2. The tendon of the tensor veli palatini muscle (TVPM) inserted into the lateral lamina in the narrowest portion of the ET lumen in five of nine cases. These results suggest that contraction of the TVPM opens the narrowest portion of the ET lumen to ventilate the middle ear and that this portion also plays a role in protecting the middle ear.

Difference in Attachment of the Tensor Veli Palatini Muscle to the Eustachian Tube Cartilage with Age

2003 ◽  
Vol 112 (5) ◽  
pp. 439-443 ◽  
Author(s):  
Chiaki Suzuki ◽  
Isamu Sando ◽  
Miwa Kitagawa ◽  
Carey D. Balaban ◽  
Kenji Takasaki
Keyword(s):  
Eustachian Tube ◽  
Later Life ◽  
Measurement Methods ◽  
3 Dimensional ◽  
Dimensional Reconstruction ◽  
Tensor Veli Palatini Muscle ◽  
Normal Human ◽  
Development And Aging ◽  
Temporal Bones ◽  
The Relationship

To test a hypothesis that ventilation of the eustachian tube (ET) varies with age, we investigated the relationship between age and the attachment of the tensor veli palatini muscle (TVPM) to the lateral lamina of the ET cartilage in 12 normal human temporal bones obtained from individuals 3 months to 81 years old. We used computer-aided 3-dimensional reconstruction and measurement methods. We found that the length of the TVPM attachment and its ratio to the length of the ET, especially that of the cartilaginous portion of the ET, increases with age from infancy to adulthood, and decreases with age from young adulthood to later life. These findings are thought to be related to postnatal development and aging. The possibility of differences in ventilation function with age is discussed.

scholarly journals Airway Abnormalities in Adult Mucopolysaccharidosis and Development of Salford Mucopolysaccharidosis Airway Score

2021 ◽  
Vol 10 (15) ◽  
pp. 3275
Author(s):  
Chaitanya Gadepalli ◽  
Karolina M. Stepien ◽  
Reena Sharma ◽  
Ana Jovanovic ◽  
Govind Tol ◽  
...  
Keyword(s):  
Airway Disease ◽  
Lysosomal Storage ◽  
Cross Sectional ◽  
Airway Narrowing ◽  
3 Dimensional ◽  
Multiple Parameters ◽  
Validated Questionnaire ◽  
Dimensional Reconstruction ◽  
Cross Sectional Imaging ◽  
Airway Abnormalities

(1) Background: Mucopolysaccharidoses (MPS) are a heterogeneous group of lysosomal storage disorders caused by the absence of enzymes required for degradation of glycosaminoglycans (GAGs). GAGs deposition in tissues leads to progressive airway narrowing and/or tortuosity. Increased longevity of patients has posed newer problems, especially the airway. This study aims to characterise various airway abnormalities in adult MPS from a regional centre and proposes a method to quantify the severity of the airway disease. (2) Methods: Retrospective analysis by case notes review, clinical examination, endoscopy, cross-sectional imaging, 3-dimensional reconstruction, and physiological investigations were used to assess the airway abnormalities. Quantitative assessment of the airway severity was performed a validated questionnaire of 15 parameters to derive Salford Mucopolysaccharidosis Airway Score (SMAS). (3) Results: Thirty-one adult MPS patients (21M/ 9F; median 26.7 years; range 19–42 years) were reviewed. There were 9 MPS I, 12 MPS II, 2 MPS III, 5 MPS IV, 2 MPS VI, and 1 MPS VII. Airway abnormalities in each MPS type are described. Patients scoring more than 35 on SMAS had some form of airway intervention. The area under curve of 0.9 was noted at a score of 25, so SMAS more than 25 may predict a difficult airway and potential to have complications. Pearson’s correlation between SMAS and height, weight, BMI were poor (p < 0.05). (4) Conclusions: Airway abnormalities in adult MPS are varied and complex. Assessment of the airway should be holistic and include multiple parameters. An objective multidimensional score such as SMAS may help to predict and manage difficult airways warranting further investigation and validation.

scholarly journals Eustachian Tube Dysfunction and Wideband Absorbance Measurements at Tympanometric Peak Pressure and 0 daPa

2019 ◽  
Vol 30 (09) ◽  
pp. 781-791 ◽  
Author(s):  
Sreedevi Aithal ◽  
Venkatesh Aithal ◽  
Joseph Kei ◽  
Shane Anderson ◽  
Simon Liebenberg
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Repeated Measures ◽  
Peak Pressure ◽  
Cross Sectional Study ◽  
Eustachian Tube Dysfunction ◽  
Control Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Tube Dysfunction

AbstractAlthough wideband absorbance (WBA) provides important information about middle ear function, there is limited research on the use of WBA to evaluate eustachian tube dysfunction (ETD). To date, WBA obtained under pressurized condition has not been used to evaluate ETD.The objective of the study was to compare WBA at 0 daPa and tympanometric peak pressure (TPP) conditions in healthy ears and ears with ETD.A cross-sectional study design was used.A total of 102 healthy ears from 79 participants (mean age = 10.0 yr) and 43 ears from 32 patients with ETD (mean age = 16.0 yr) were included in this cross-sectional study. WBA was measured at 0 daPa (WBA0) and TPP WBA at TPP (WBATPP).WBA results were analyzed using descriptive statistics and t-tests with the Bonferroni correction. An analysis of variance with repeated measures was applied to the data.WBA0 was significantly lower in the ETD group than in the control group. The WBA0 of the control group demonstrated a broad peak between 1.25 and 4 kHz, whereas the WBA0 of the ETD group had a peak between 2.5 and 4 kHz. WBATPP of the ETD group approached values close to that of the control group. In the control group, WBATPP was only 0.06 to 0.09 higher than WBA0, whereas in the ETD group, WBATPP was 0.29 to 0.42 higher than WBA0 between 0.6 and 1.5 kHz. A differential pattern of WBA at TPP relative to 0 daPa was observed between ears with ETD and ears with otitis media with effusion (OME) and negative middle ear pressure (NMEP).Hence, a comparison of WBA0 and WBATPP can provide potentially useful diagnostic information, and hence can be used as an adjunct tool to evaluate ETD. This is important especially in young children or some adults who are unable to perform maneuvers such as Toynbee or Valsalva during ETD assessment. Further research is needed to verify the results using test performance measures to determine whether WBA0 and WBATPP can objectively determine the presence of ETD or OME with NMEP.

Effect of Nasal Packing on Middle Ear Pressure

2016 ◽  
Vol 1 (2) ◽  
pp. 52-56
Author(s):  
Abhinav Srivastava ◽  
Puneet Shukla
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Hearing Threshold ◽  
Cross Sectional Study ◽  
Nasal Packing ◽  
Cross Sectional ◽  
Nasal Pack ◽  
Middle Ear Pressure ◽  
Tube Function

ABSTRACT Introduction Eustachian tube connects nasopharynx with the tympanic cavity. The normal middle ear has an inherent tendency to lose gas to maintain the middle ear pressure by diffusion into the surrounding tissues and circulation. Materials and methods This cross-sectional study was conducted in 2012 to 2014. A total of 100 ears of 50 consecutive cases undergoing nasal surgery followed by bilateral nasal packing were included in the study and the middle ear pressure and hearing threshold were determined in all the subjects in presurgery, and then after 48 hours of surgery with nasal packing in situ and then at 7 and 30 days of nasal pack removal. Conclusion There is an increase in middle ear pressure transiently for few days while the nasal pack is in situ, which returns to normal in a month after pack removal; but, in chronic nasal obstruction cases, such as nasal polyps, there is persistent negative middle ear pressure, probably due to irreversible changes in the Eustachian tube function. How to cite this article Mohan C, Srivastava A, Shukla P. Effect of Nasal Packing on Middle Ear Pressure. Int J Adv Integ Med Sci 2016;1(2):52-56.

Three-Dimensional Reconstruction and Measurement Study of Human Eustachian Tube Structures: A Hypothesis of Eustachian Tube Function

1998 ◽  
Vol 107 (7) ◽  
pp. 547-554 ◽  
Author(s):  
Masaharu Sudo ◽  
Isamu Sando ◽  
Chiaki Suzuki
Keyword(s):  
Eustachian Tube ◽  
Three Dimensional ◽  
Lymphoid Tissues ◽  
Reconstruction Method ◽  
Eustachian Tube Function ◽  
Three Dimensional Reconstruction ◽  
Inferior Margin ◽  
Dimensional Reconstruction ◽  
Tube Function ◽  
Temporal Bones

Histologic sections from nine temporal bones with eustachian tubes (ETs) attached were analyzed with a computer-aided three-dimensional reconstruction method to determine the curvature and tilt of the ET and the anatomic relationships between the medial lamina of the ET cartilage, the levator veli palatini muscle (LVPM), and Rosenmüller's fossa. It was found that the ET is convex superomedially and is tilted medially. The LVPM is located inferolateral to the inferior margin of the medial lamina of the anterior ET cartilage. The LVPM is inferior to the medial lamina of the posterior ET cartilage. These findings suggest that the LVPM opens the anterior cartilaginous portion of the ET by rotating the medial lamina with increased dimension of the muscle body when it contracts. Rosenmüller's fossa extends along the ET with rich lymphoid tissues as far as approximately one half the total length of the ET and very close to the skull base.

Eustachian Tube Lumen: Comparison between Normal and Inflamed Specimens

1989 ◽  
Vol 98 (8) ◽  
pp. 630-634 ◽  
Author(s):  
Jacob Sadé ◽  
Michal Luntz
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Sectional Area ◽  
Secretory Otitis Media ◽  
Cross Sectional ◽  
Tube Lumen ◽  
Luminal Area ◽  
The Mean ◽  
Temporal Bones

This study presents measurements of the cross-sectional luminal area of the eustachian tube. Comparisons are made between the lumens of eustachian tubes obtained from temporal bones presenting acute or secretory otitis media and those from noninflamed temporal bones. The material consisted of 71 temporal bones obtained postmortem from individuals up to 2 years of age. Forty-six of these showed no middle ear inflammation, while 25 presented either acute or secretory otitis media. In both groups the lumens of all the eustachian tubes were patent, presenting no obstruction. The mean cross-sectional area of the lumens of inflamed temporal bones was smaller than that of the noninflamed ones. This difference was not found to be statistically significant in the cartilaginous regions and was found to be statistically significant or borderline significant in the bony parts of the eustachian tube.

Comparison of the Anatomy of the Eustachian Tube in the Rhesus Monkey (Macaca Mulatto) and Man

1980 ◽  
Vol 89 (1) ◽  
pp. 49-57 ◽  
Author(s):  
William J. Doyle ◽  
Stewart R. Rood
Keyword(s):  
Rhesus Monkey ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Anatomical Characteristic ◽  
Tube Function ◽  
Macaca Mulatto ◽  
Tensor Veli Palatini Muscle ◽  
Morphologic Data ◽  
Pterygoid Muscles ◽  
Membranous Wall

The primate nasopharynx-eustachian tube-middle ear complex is being used to model both the normal and pathologic functions of the human eustachian tube by several researchers. An extensive search of the literature has indicated little detailed information on the primate eustachian tube/middle ear system. This study was undertaken to define the anatomical characteristic of the system in the Rhesus monkey ( Macaca mulatto) and to determine the limits on the use of the monkey as a model of human eustachian tube function. Although the direct application of morphologic data to explain the function of a system is tenuous, the data on the Rhesus monkey eustachian tube appears to be consistent with that published for other mammals. The tensor veli palatini muscle appears to be the only muscle to act directly on the tube and effect tubal dilation. The muscle is attached to the lateral membranous tubal wall along its extrabullar extension. The muscle has an inferior attachment to the posterior hard palate and thus possesses a vector directed inferolaterally; contraction would appear to pull the membranous wall inferiorly and laterally, resulting in the tubal dilation. The eustachian tube relationships of the salpingopharyngeus, levator veli palatini, and internal pterygoid muscles are described. Their possible role in primate tubal function is minimal at best.

Age-Related Morphologic Differences in the Components of the Eustachian Tube/Middle Ear System

1989 ◽  
Vol 98 (11) ◽  
pp. 854-858 ◽  
Author(s):  
Deborah Sadler-Kimes ◽  
Michael I. Siegel ◽  
John S. Todhunter
Keyword(s):  
Computer Graphics ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Three Dimensional ◽  
Size And Shape ◽  
Levator Veli Palatini ◽  
Age Related

The current study utilized a three-dimensional computer graphics technique to analyze the size, shape, and positional associations of the eustachian tube (ET) cartilage and lumen, the levator veli palatini (LVP) muscle, and the tensor veli palatini (TVP) muscle. Older specimens 7 years and above (n = 13) were compared to young specimens less than 7 years (n = 4). Our results suggest that changes in ET function associated with age could result from size and shape differences in the ET cartilage and changes in the position of the LVP and TVP muscles.

Postnatal Development of the Eustachian Tube and its Surrounding Structures Preliminary Study

1987 ◽  
Vol 96 (2) ◽  
pp. 191-198 ◽  
Author(s):  
Masanori Kitajiri ◽  
Isamu Sando ◽  
Tetsuo Takahara
Keyword(s):  
Postnatal Development ◽  
Eustachian Tube ◽  
Acinar Cells ◽  
Tissue Sections ◽  
Levator Veli Palatini ◽  
The Face ◽  
Tensor Veli Palatini Muscle ◽  
Preliminary Study ◽  
Temporal Bones ◽  
The Relationship

The postnatal development of the eustachian tube and its surrounding structures (tubal cartilage, tubal gland, tensor veli palatini muscle, and levator veli palatini muscle) was investigated in serial vertical histologic sections from 12 normal temporal bones of individuals whose ages ranged from 39 weeks' gestation to 19 years of age. After projecting tissue sections onto paper and tracing the structures, several measurements were made in order to analyze this development. Findings revealed that 1) the eustachian tube and its accessory structures developed postnatally up to the age of 19 years. 2) The lumen area in a 19-year-old specimen was 4.7 times that of the 1-day-old infant. The development of the tube was greatest in the pharyngeal part. Postnatal development of the eustachian tube appears to be related to growth of the face. 3) The cartilage area in the 19-year-old specimen was 3.6 times that of the 1-day-old infant. 4) The mucosal acinar cells were predominant in infants but no greater than the number of serous acinar cells by the age of 19 years. 5) The areas of the tensor and levator veli palatini muscles in a 19-year-old specimen were 5.1 and 11.1 times, respectively, those of the 1-day-old infant. This preliminary study reports the postnatal development of the eustachian tube and its accessory structures, a subject never thoroughly investigated to date. However, because of the limited number of cases available, further investigation of a greater number of cases should be performed so that the relationship between tubal development and alterations in function that occur with age can be understood clearly.

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