Anatomiste de talent, Bartolomeo Eustachi a fait progresser cette science dans la seconde moitié du XVIe siècle. Outre la fameuse trompe d'Eustache, il a révélé l'existence de la valvule qui porte son nom, des surrénales, du canal thoracique.
Le grand oeuvre de Bartolomeo Eustachi devait être un traité d'anatomie « De dissensionibus ac controvesiis anatomicis ». Il devait comporter 47 planches anatomiques, dessinées avec l'aide de Pier Matteo Pini, richement détaillées et légendées. Seulement 8 planches furent publiées de son vivant. Les 39 autres, perdues, ont été longtemps recherchées. Elles ont été retrouvées 162 ans plus tard chez un descendant de Pier Matteo Pini. Publiées en 1714 sous le titre « Tabulae anatomicae Bartolomaei Eustachi quas a tenebris tandem vindicatas » (illustrations anatomiques de Bartolomeo Eustachi sauvées de l'obscurité), elles font de leur auteur, avecVésale, l'un des pères de l'anatomie moderne.

mise à jour du
22 septembre 2005
Acta Oto-Laryngologica
2005; 125: 625-628
La trompe d'Eustache
Radiopaque contrast dye in nasopharynx reaches the middle ear during swallowing and/or yawning 
B Winther, JM Gwaltney, CD Phillips, J Hendley
Departments of Otolaryngology, Head and Neck Surgery, University of Virginia Health System, Charlottesville, Virginia, USA


The middle ear is believed to be sterile under normal conditions. However, it is possible that nasopharyngeal fluid containing bacteria and bacterial DNA may transiently reflux through the Eustachian tube (ET) to reach the middle ear during normal activities. This possibility has been examined using a roentgenographic technique as described by Wittenborg and Neuhauser. Using this method Bluestone and coworkers studied 120 children with active or previous middle ear effusions who either had tympanostomy tubes in place at the time of the study or had had them in the past. Reflux of contrast material through the ET into the middle ear occurred in 15/219 ears (7%) following multiple swallows. In 7 control children without a history of ear disease (14 ears), reflux into the middle ear was not observed after multiple swallowing episodes. Based on these findings it has been suggested that, during swallowing, fluid from the nasopharynx is prevented from refluxing into a normal middle ear with an intact tympanic membrane by the narrow midportion (isthmus) of the ET and by the cushion of air or gas present in the intact middle ear and mastoid air cell system. However, a clinical diagnosis of presumed acute bacterial otitis media has been made in up to a quarter of normal children with colds. Bacteria have been detected in 60 - 70% of middle ear secretion samples obtained by tympanocentesis from suspected cases. This suggests that displacement of bacteria in nasopharyngeal secretion to the middle ear of children may be a more frequent occurrence than anticipated from the work reported by Bluestone and colleagues, or that negative middle ear pressure during colds may facilitate aspiration of nasopharyngeal secretion into the middle ear.
In this descriptive study, CT scans of the temporal bone were utilized to examine whether radiopaque contrast medium in the nasopharynx was displaced into the middle ear cavity during swallowing and/or yawning in healthy adults.
In these healthy adults, swallowing and yawning with radiopaque contrast dye at the ET orifice allowed it to enter the middle ear, as evidenced by the presence of residual contrast dye visualized by CT. Under natural conditions, nasopharyngeal secretions/fluid may overlie the orifice of the ET when an individual is either supine or lying on his/her side during sleep. In this study the lateral decubitus technique, in which there was ambient air pressure at the orifice during swallowing and yawning, resulted in deposition of contrast dye in the middle ear. This suggests that secretion overlying the ET orifice may reach the middle ear on opening of the ET during sleep in healthy adults. The effect of viral respiratory infection, which has been shown to produce ET dysfunction, on this phenomenon is not known.
The majority of adults carry bacterial species in the nasopharynx which are the cause of otitis media; the bacteria are usually present in titers of > 10*3 colony-forming units per milliliter of secretion. In view of the findings in our study, it seems likely that bacteria in nasopharyngeal fluid/secretion frequently reach the middle ear by way of the normal ET. Also, bacterial DNA from the nasopharynx may do likewise, making it difficult to interpret the significance of bacterial DNA detection in middle ear fluid.
Ciliary epithelial and mucus-secreting cells line a portion of the wall of the middle ear and the entire ET. Mucociliary transport helps maintain the sterility of the middle ear by clearing foreign particles entrapped in the mucus blanket. The direction of flow of the mucus blanket is from the middle ear via the ET to nasopharynx. Thus, the normal sterility of the middle ear cavity, like that of the sinuses, is likely due to the effectiveness of the mucociliary epithelium in clearing bacteria from the nasopharynx which reach the cavity during activities of daily life.
Generalization of the findings of this study is limited by the small number of subjects examined. However, contrast medium was detected in the ears of two out of three subjects in each positional group, suggesting that reflux during swallowing and yawning is a common event. Exposure of additional subjects to radiation, although minimal, was not felt to be justified. Also, the study was performed in adults rather than children. In young children, nasopharyngeal secretion would be expected to reach the middle ear with even greater ease because the ET is shorter and straighter than in adults.
Radiopaque contrast dye in nasopharynx reaches the middle ear during swallowing and/or yawning
Winther B et al
Acta Oto-Laryngologica
2005; 125: 625-628 
The role of the Eusatchius tube and the tympanal muscles in yawning
Laskiewicz A
Revue de Laryngologie Otologie Rhinologie
Mai-Juin 1953 74° année; n°5-6
Yawning with regard to the respiratory organs and the ear
Laskiewicz A
Acta Oto laryngologica (Stockholm)
1953; 43; 2-3; 267-270
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Bull Group Int Rech Sci
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1982; 25; 251-290
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Eur Arch Otorhinolaryngol. 2006