The Journal of International
Advanced Otology
Original Article

Evaluation of the Peritubal Region Between the Osseous Eustachian Tube and the Internal Carotid Artery: Usefulness of Oblique Temporal Computed Tomography with Valsalva Maneuver


Department of Otorhinolaryngology-Head and Neck Surgery, Daejeon Eulji Medical Center, Eulji University, Daejeon, Korea


Department of Radiology, Daejeon Eulji Medical Center, Eulji University, Daejeon, Korea

J Int Adv Otol 2024; 20: 147-153
DOI: 10.5152/iao.2024.22806
Read: 100 Downloads: 55 Published: 29 March 2024

BACKGROUND: As indications for surgical Eustachian tube (ET) procedures have been expanded, it is essential to understand the anatomy of ET surroundings for safe ET interventions.

METHODS: We evaluated the peritubal region using oblique planes of temporal computed tomography (CT) with the Valsalva maneuver and classified the peritubal region between the osseous ET and the internal carotid artery (ICA) into 5 types: 1. bony prominence; 2. air cell; 3. absence of peritubal structures (3a. thick canal [>0.5 mm], 3b. thin canal [≤0.5 mm], 3c. dehiscence).

RESULTS: Bony prominence and air cell types were observed in 41.0% (50/122 ears) and 13.1% (16/122 ears), respectively. The ICA was located directly medial to the osseous ET in 39.4% (48/114 ears), of which thick and thin canal types were found in 23.8% and 15.6%, respectively. Internal carotid artery canal wall dehiscence was observed in 8 ears (6.6%). The shortest perpendicular distance between the osseous ET and ICA was 1.6 (range: 0.4-4.9) mm and 2.7 (range: 1.3-5.8) mm in the bony prominence and air cell types, respectively. Osseous ET-ICA distances were 1.2 (range: 0.6-3.6) mm and 0.4 (range: 0.1-0.5) mm in thick and thin canal types, respectively.

CONCLUSION: Distinct peritubal structure types were observed on oblique CT planes with Vasalva maneuver. Bony prominence and air cell types provide a protective layer between the osseous ET and ICA. Imaging information on peritubal structures may help to better understand the anatomy of the ET pathway, leading to safe and accurate surgical approaches to the osseous ET

Cite this article as: Ho Jin M, Youn Kim H, Young Kwak M. Evaluation of the peritubal region between the osseous eustachian tube and the internal carotid artery: Usefulness of oblique temporal computed tomography with valsalva maneuver. J Int Adv Otol. 2024;20(2):147-153.

EISSN 2148-3817