From catheterization to crenotherapy: historical and functional perspective on the Eustachian tube

The Eustachian tube has played a surprisingly central role in the development of modern otology. Although often overshadowed by the clinical study of the inner ear and tympanic cavity, it was the Eustachian tube, and its treatment, that led to the establishment of Otology as an independent medical discipline in the early 19th century. This article aims to retrace this evolution, beginning with the historical, anatomical, and physiological background of catheterization techniques, continuing with the functional anatomy of the peritubal muscles, and concluding with a discussion of the most common middle ear pathologies. It also highlights the modern rediscovery of thermal therapy as a potential ally in the management of Eustachian tube dysfunction.