Summary
The aim of this study was to correlate current morphologic data relating to the lumen of the auditory tube. Four methods were used: dissection under the operating microscope; microendoscopy of the tubal lumen; optical and electron microscope histology; and MR or CT imaging. The auditory tube consists of two unequal cones, a small posterior third, fixed and osseous (protympanum), and a mobile fibrocartilaginous anterior two-thirds, both joined by the tubal isthmus, a short constriction which is pseudosphincteric at endoscopy. The tensor veli palatini muscle (TVPM) and the levator veli palatini muscle (LVPM) are the chief muscles that vary the tubal lumen of the fibrocartilaginous portion, which is collapsed at rest. CT and especially MR imaging allows their observation in static conditions. Serial histologic sections reveal the continuity between the TVPM and the tensor tympani muscle. The main cartilage framing the lumen varies in shape according to the level surveyed. The tubal mucosa is lined with an epithelium combining ciliated and mucus cells, involved in mucociliary drainage and gas exchanges in the auditory tube. These morphologic elements represent a basis for study of tubal physiology and for planning treatment in dysfunctions of the auditory tube.
Résumé
Ce travail a pour but la confrontation des données morphologiques actuelles concernant la lumière de la trompe auditive (tuba auditiva) ou trompe d'Eustache. 4 méthodes ont été utilisées: la dissection effectuée avec un microscope opératoire, la micro endoscopie de la lumière tubaire, I'histologie en microscopie optique et électronique, I'imagerie par résonance magnétique nucléaire ou tomodensitométrie. La trompe auditive est faite de deux cônes inégaux, I'un petit (1/3) postérieur, fixe et osseux (protympanum), I'autre plus allongé (2/3), mobile fibro-cartilagineux, réunis tous deux par l'isthme tubaire, étranglement court, pseudo-sphinctérien en endoscopie. Le muscle tenseur du voile du palais (MTVP) et le muscle élévateur du voile du palais sont les principaux muscles faisant varier la lumière tubaire de la portion fibro-cartilagineuse, colla∼ée au repos. L'imagerie en TDM et surtout en IRM permet de les observer de façon statique. Les coupes sériées en histologie révèlent la continuité entre le MTVP et le muscle tenseur du tympan. Le cartilage principal, armature de la lumière a une forme variable suivant la hauteur considérée. La muqueuse tubaire est tapissée d'un épithélium associant cellules ciliées et cellules à mucus, participant au drainage muco-ciliaire et aux échanges gazeux de la trompe auditive. Ces éléments morphologiques représentent une base pour l'étude de la physiologie tubaire, et I'orientation thérapeutique des dysfonctions de la trompe auditive.
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Prades, J.M., Dumollard, J.M., Calloc'h, F. et al. Descriptive anatomy of the human auditory tube. Surg Radiol Anat 20, 335–340 (1998). https://doi.org/10.1007/BF01630616
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DOI: https://doi.org/10.1007/BF01630616