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Updated: May 6, 2025
That its motion may be free, the air contained within the drum has free communication with the external air by an open passage, called the Eustachian tube, leading to the back of the mouth. This tube is sometimes obstructed by wax, when a degree of deafness ensues.
The luckless position of the third tonsil could hardly have been better planned if it had been devised for the special purpose of setting up trouble in the mouths of these Eustachian tubes. Just as soon as the enlargements become chronic, they pour out a thick mucous secretion, which quickly becomes purulent, or, in the vernacular, "matter."
The Eustachian tube admits air freely to the middle ear, providing in this way for an equality of atmospheric pressure on the two sides of the drum membrane. The bridge of bones and the air in the middle ear receive vibrations from the membrana tympani and communicate them to the membrane of the internal ear. *Purposes of the Middle Ear. *—The middle ear serves two important purposes.
It is bitter to return to infancy, to be supported, and directed, and perpetually set upon your feet, by the hand of some one else. The air besides, as it is supplied to you by the busy millers on the platform, closes the eustachian tubes and keeps the neophyte perpetually swallowing, till his throat is grown so dry that he can swallow no longer.
The first effect of its enlargement is naturally to block the posterior opening of the nostrils. But it has another most serious vantage-ground for harm in its peculiar position. Only about three-fourths of an inch below it upon either side open the mouths of the Eustachian tubes, the little funnels which carry air from the throat out into the drum-cavity of the ear.
On the other side of this membrane, inside the ear, there is air, which fills the whole of the inner chamber and the tube, which runs down into the throat behind the nose, and is called the Eustachian tube after the man who discovered it. This tube is closed at the end by a valve which opens and shuts.
Beethoven's deafness probably began with a "cold in the head" which was neglected. The inflammatory process then extended to the Eustachian tubes. When it reached this point it was considered out of the reach of treatment in his time, and for long after.
The mouth opens directly into the pharynx, and just above it are two openings leading into the posterior passages of the nose. There are also little openings, one on each side, from which begin the Eustachian tubes, which lead upward to the ear cavities. The windpipe opens downward from the pharynx, but this communication can be shut off by a little plate or lid of cartilage, the epiglottis.
If you breathe out strongly, and then shut your mouth and swallow, you will hear a little "click" in your ear. This is because in swallowing you draw the air out of the Eustachian tube and so draw in the membrane, which clicks as it goes back again. But unless you do this the tube and the whole chamber cavity behind the membrane remains full of air.
With the closure of the Eustachian tubes the air supply to the middle ear was cut off; the air in the cavity finally became absorbed, and a retraction and thickening of the drum-membrane with consequent inability to transmit sound vibrations followed.
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