A text-book of the diseases of the ear for students and practitioners . er, Cerutti, and v. Troltsch, and theindications for its use were at the same time established. METHODS OF PHYSICAL EXAMINATION 35 The Topography of the Pharyngeal Orifice of the EustachianTube.—The pharyngeal orifice of the Eustachian tube (Fig. 73, h) is situatedon the lateral wall of the naso-pharynx, nearly on a level with the horizontalprolongation of the inferior turbinated bone. It is an oval depression boundedin front by an ill-defined swelling, above and behind, however, by a strong,firm lip projecting towards the
A text-book of the diseases of the ear for students and practitioners . er, Cerutti, and v. Troltsch, and theindications for its use were at the same time established. METHODS OF PHYSICAL EXAMINATION 35 The Topography of the Pharyngeal Orifice of the EustachianTube.—The pharyngeal orifice of the Eustachian tube (Fig. 73, h) is situatedon the lateral wall of the naso-pharynx, nearly on a level with the horizontalprolongation of the inferior turbinated bone. It is an oval depression boundedin front by an ill-defined swelling, above and behind, however, by a strong,firm lip projecting towards the pharynx. The anterior lip is separated fromthe lateral wall of the nose by the sulcus nasalis posterior. An extensivefold, the plica salpingo-pharyngea, extends from the posterior lip to thesuperior portion of the arcus palato-pharyngeus. Kosenmiillers fossa (g) lies between the posterior lip of the tube and theposterior pharyngeal wall; it is rich in glandular tissue and is subject to greatindividual variations in size. Chronic naso-pharyngeal catarrhs often give. Fig. 73.—Vertical Section of the Naso-Pharynx with the Catheterintroduced into the eustachian tube. a Inferior turbinated bone ; I, Middle turbinated bone ; c, Superior turbinatedbone ; d, Hard palate ; e, Velum palati; /, Posterior pharyngeal wall; g, Rosen-mullers fossa ; h, Posterior lip of tbe orifice of the Eustachian tube. rise to cystic hypertrophy of the adenoid tissue and the formation of largegaps and bridge-like bands which may hold the beak of the catheter uponits removal. The distance of the orifice of the tube from the posteriorpharyngeal wall will, therefore, not only vary in different individuals (average1*8 cm., L. Mayer), but will also depend on the degree of swelling, hyper-trophy or growth of the mucous membrane of the naso-pharynx. For thisreason, the distance of the pharyngeal orifice of the tube from the posteriorpharyngeal wall cannot be used as a safe guide for the introduction of thecat
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