European Archives of Oto-Rhino-Laryngology

, Volume 275, Issue 11, pp 2675–2682 | Cite as

Cartilaginous Eustachian tube length and carotid canal dehiscence in children: a radiological study

  • E. C. TollEmail author
  • M. Browning
  • R. Shukla
  • J. W. Rainsbury



The use of Balloon Eustachian tuboplasty (BET) for Eustachian tube dysfunction is increasing in adults but to a lesser extent in children. Despite growing experience, concerns remain that BET could theoretically cause carotid artery rupture, which may be more likely if there is carotid canal dehiscence adjacent to the bony Eustachian tube. This radiological study aims to assess the prevalence of carotid canal dehiscence and length of cartilaginous Eustachian tube in children.

Materials and methods

75 consecutive computed tomography scans of the petrous temporal bones performed in children were identified (150 carotid canals/Eustachian tubes). Two independent raters measured the length of the cartilaginous Eustachian tube and thickness of carotid canal wall.


8% of carotid canals had radiological dehiscence. Prevalence of carotid canal dehiscence on either side per child was 12%. Mean cartilaginous Eustachian tube length was 24.5 mm (SD 3.1 mm) and the minimum measured was 14.1 mm. The minimum length measured in a child over 3 years old (n = 65) was 18.1 mm. The mean thickness of bone of the carotid canal was 0.7 mm (SD 0.27 mm). There was a positive relationship between age and Eustachian tube length (Pearson’s correlation coefficient = 0.622, p < 0.001).


Carotid canal dehiscence in children has a low prevalence. Variation in the length of the cartilaginous Eustachian tube is low but is correlated with age. More research is required to define the indications, safety, efficacy and technical aspects of BET in children.


Cholesteatoma, Middle ear Eustachian tube Ear, Middle Tympanic membrane 



The authors received no funding for this study.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institution (Plymouth Hospitals NHS Trust R&D approval reference 15/P/073) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Due to the retrospective design of this radiological study and lack of study intervention, informed consent from the individual participants was deemed not required.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Otolaryngology, Head and Neck SurgeryTorbay HospitalTorquayUK
  2. 2.Department of General SurgeryDerriford HospitalPlymouthUK
  3. 3.Department of Otolaryngology, Head and Neck SurgeryJohn Radcliffe HospitalOxfordUK
  4. 4.Department of Otolaryngology, Head and Neck SurgeryDerriford HospitalPlymouthUK

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