The eustachian tube can’t open itself. It’s a passive structure that sits closed by default, and the only thing that opens it is a muscle bolted directly onto the bone you adjust every day.
This episode breaks down the mechanism after Dr. Anthony sat through a live dissection from Anatomy Trains on head and neck anatomy, and one section stopped him cold: the tensor veli palatini, the eustachian tube, and the pterygoid muscles, all packed into a few millimeters around the pterygoid plates of the sphenoid.
What’s covered:
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Why the eustachian tube is closed at rest, not open until something clogs it, and why every recurring ear infection is a tube that isn’t opening enough
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The tensor veli palatini: it originates on the sphenoid, is woven into the wall of the tube itself, wraps around the hamulus like a pulley, and fans into the soft palate. One muscle, two jobs.
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Why a child’s flat, horizontal tube plus a compressed sphenoid and narrow palate is two strikes before anyone’s touched the kid
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The shared nerve supply between the tensor veli palatini and the tensor tympani, and what that means for tinnitus, specifically the clicking or arrhythmic kind
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Why TMJ patients so often report ear fullness and ringing, and why ENTs have started sending Dr. Anthony referrals calling it a jaw issue instead of an ear issue
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The adjusting order Dr. Anthony actually uses: occiput and OA clearance, sphenobasilar motion, category one versus category two, pterygoid and sphenomandibular contact points, disc tracking, and why this needs a corrective phase of care, not two visits
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The hard line on what cranial work does and doesn’t promise for ear infections, tinnitus, and vertigo, and why vertigo runs a different mechanism and shouldn’t get lumped into this conversation
The takeaway: the sphenoid and palate aren’t optional in these cases. They’re the reason you can help a patient nobody else could.
Want to learn how to work this region hands-on? Get on the list at thecranialdoc.com
00:00 Tube Can’t Self Open 00:38 Dissection Sparked Insight 02:43 Why Tubes Fail 05:03 Closed By Default 07:31 Tensor Veli Palatini 08:57 Cranial Mechanics Link 10:45 Tinnitus Nerve Coupling 12:42 TMJ Next Door 14:48 Clinical Approach Steps 17:00 Scope And Vertigo 18:45 Key Takeaway Recap 19:43 Training And Wrap Up