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The isthmus and the tympanic portion of the eustachian tube play no part in the opening and closing movement of the tube. They are constantly open. The pharyngeal portion of the tube is the door to the middle ear. It opens and closes in order to ventilate the middle ear properly, to sweep away any nasal secretion from the orifice of the tube and to break up the surface tension of any secretion stretched across the orifice of the tube.1Should the pharyngeal portion fail to open, on account of adhesions, edema or other conditions, the middle ear will suffer. When one examines the nasal orifice of the eustachian tube with the aid of a nasopharyngoscope, one sees a vertical slit. The tube is closed. During the act of swallowing, or when the patient says "ka," the soft palate rises and there is also visible a concomitant movement of