Other risk factors include ongoing exposure to bacterial or viral infection (eg, to multiple children at a child care center). Enlargement may be physiologic or secondary to viral or bacterial infection, allergy, irritants, and, possibly, gastroesophageal reflux. They are largest in children age 2 to 6 years. The latter arises from the hook of the cartilage and from the membranous part of the tube, and blends below with the Tensor veli palatini.The adenoids are a rectangular mass of lymphatic tissue in the posterior nasopharynx. The tube is opened during deglutition by the Salpingopharyngeus and Dilatator tubæ.
The mucous membrane of the tube is continuous in front with that of the nasal part of the pharynx, and behind with that of the tympanic cavity it is covered with ciliated epithelium and is thin in the osseous portion, while in the cartilaginous portion it contains many mucous glands and near the pharyngeal orifice a considerable amount of adenoid tissue, which has been named by Gerlach the tube tonsil. The position and relations of the pharyngeal orifice are described with the nasal part of the pharynx. The diameter of the tube is not uniform throughout, being greatest at the pharyngeal orifice, least at the junction of the bony and cartilaginous portions, and again increased toward the tympanic cavity the narrowest part of the tube is termed the isthmus. The cartilaginous and bony portions of the tube are not in the same plane, the former inclining downward a little more than the latter. The cartilage lies in a groove between the petrous part of the temporal and the great wing of the sphenoid this groove ends opposite the middle of the medial pterygoid plate. The upper edge of the cartilage is curled upon itself, being bent laterally so as to present on transverse section the appearance of a hook a groove or furrow is thus produced, which is open below and laterally, and this part of the canal is completed by fibrous membrane. in length, is formed of a triangular plate of elastic fibrocartilage, the apex of which is attached to the margin of the medial end of the osseous portion of the tube, while its base lies directly under the mucous membrane of the nasal part of the pharynx, where it forms an elevation, the torus tubarius or cushion, behind the pharyngeal orifice of the tube. The cartilaginous portion ( pars cartilaginea tubæ auditivæ), about 24 mm. It begins in the carotid wall of the tympanic cavity, below the septum canalis musculotubarii, and, gradually narrowing, ends at the angle of junction of the squama and the petrous portion of the temporal bone, its extremity presenting a jagged margin which serves for the attachment of the cartilaginous portion. The osseous portion ( pars osseo tubæ auditivæ) is about 12 mm. It is formed partly of bone, partly of cartilage and fibrous tissue Its length is about 36 mm., and its direction is downward, forward, and medialward, forming an angle of about 45 degrees with the sagittal plane and one of from 30 to 40 degrees with the horizontal plane.
The auditory tube ( tuba auditiva Eustachian tube) is the channel through which the tympanic cavity communicates with the nasal part of the pharynx.
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