Those familiar with aviation medicine are well aware that airplane pilots suffer more frequently from disturbances of the middle ear than from all other occupational diseases combined.1
The phenomenal growth of commercial air transport, which carried approximately one million passengers in 1936, makes this problem of interest and importance to the general medical profession, for airplane passengers are exposed to the same influences as the pilots during flight and in most instances are much more adversely affected.
ANATOMY AND PHYSIOLOGY
Since the deleterious effects of flight on the middle ear depend entirely on the peculiar structure and functioning of the eustachian tube, a brief anatomic, normal physiologic and special physiologic review of the latter structure will be presented.
The eustachian tube is a slitlike, potential tube extending from the middle ear to the nasopharynx. It is formed of bone, cartilage and fibrous tissue.The bony portion begins at
ARMSTRONG HG, HEIM JW. THE EFFECT OF FLIGHT ON THE MIDDLE EAR. JAMA. 1937;109(6):417–421. doi:10.1001/jama.1937.02780320019007
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