Pumping and clearance function of the eustachian tube.

The purpose of this study was to clarify the relationship between mucociliary and muscular clearance in the eustachian tube. Displacement of various viscosities and volumes of a colored fluid through the tube was observed endoscopically in cats. To test ciliary clearance, the fluid was placed in either the tympanum or the mastoid bulla. The interval between the instillation and beginning of discharge of the fluid from the pharyngeal orifice of tube was measured. Clearance time was prolonged with fluids having high viscosities, and the clearance time from the tympanum was shorter than that from the mastoid bulla. To test muscular clearance, the tensor veli palatini muscle was stimulated electrically to simulate swallowing, and the number of contractions necessary for massive discharge of the fluid was counted. Massive discharge occurred only with low viscosity fluid placed in the tympanum, whereas small amounts of highly viscous fluid were cleared by linear discharge. The authors concluded that when the volume of middle ear effusion was small, the fluid was cleared by mucociliary clearance. When the volume of fluid was large, the low viscosity fluid was cleared by muscular clearance only, while highly viscous fluid was cleared both by ciliary and muscular clearance.