There has been very little change in our understanding of the anatomy of the auditory tube since it was described by Bartholomaeus Eustachius in 1563.3 Considerable controversy has existed, however, concerning the physiology of the tube, in spite of the accurate observations of Toynbee, who in 1853 insisted that the pharyngeal portion of the tube is normally closed in the resting state, opening during deglutition for the inflow of air.8 Present opinion concerning the physiology of the tube rests upon a careful experimental and clinical study reported by Rich in 1920.6
In spite of the miracles of modern medicine, it must be admitted that very few refinements have been added to our practical methods of evaluating tubal function since the time of Valsalva (1717), Cleland (1741), and Politzer (1883). Although Toynbee, by 1860, realized that the Eustachian tube has two functions, namely, to allow the ingress of