Posture and Eustachian Tube Function

Abstract

It has been well known for a long time that the patency of the Eusta-chian tube is affected by body position, particularly in patients with patulous tubes. The ventilatory capacity of the Eustachian tube was studied quantitatively in subjects with normal tubal function in different postures and during compression of the neck veins. In the horizontal position or during compression of the neck veins with 35 cm H₂O the volumes passing through the tube during deglutition were reduced to 1/3in a body elevation of 20° or 30° the tubal function quantitatively decreased to 2/3. When the subject was lying on one side the tube of the downturned ear seemed most affected. In subjects who caught colds the consequence of horizontal position was very marked.

Clinicians are familiar with the fact that the symptoms of acute otitis media often start at night when the patient has been in bed for some hours. During upper respiratory infections or after intratympanic surgery, when tubal dysfunction may be expected, patients should be advised to take up a body position of not less than 20° above the horizontal plane in order to prevent middle ear complications due to the positional influence on the tubal function. In selected cases tests of the tubal function might be performed also in the recumbent position.