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Updated: Aug 18, 2026

Discovering Middle Ear Anatomy by Transcanal Endoscopic Ear Surgery: A Dissection Manual
Published on: January 11, 2018
[Endoscopic examinations of the eustachian tube]
E Di Martino1, L E Walther, P Maneschi
1Klinik für Hals-Nasen-Ohrenheilkunde und Plastische Kopf- und Halschirurgie, Universitätsklinikum Aachen. edimartino@ukaachen.de
Background And Objective:
Endoscopy of the eustachian tube allows direct examination of endoluminal alterations in the course of the organ. The aim of this study was to describe anatomic and functional findings in healthy awake subjects.
Patients/Methods:
Ten eustachian tubes in six healthy individuals with no history of tube dysfunction were examined under local anesthesia using different types of rigid and flexible endoscopes.
Results:
Nine of ten tubes presented with no pathologic finding. The motility of the tube cartilage could be visualized in all cases and showed a wide variety. Prior anesthesia of the mucosa with the subject in the supine position, if necessary supplemented by a tube catheter, rendered the procedure more comfortable.
Conclusion:
The eustachian tube shows a wide spectrum of anatomic and functional varieties in normal subjects. The method allows comprehensive evaluation of anatomic and functional stenoses of the eustachian tube. The transnasal-transpharyngeal approach allows only limited evaluation of the middle ear structures.
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