It is not generally known that the continuously open eustachian tube is a definite clinical entity with symptoms which are as distinctive as those produced by pathologic occlusion of the tube. Thus, the continuously open tube has not even been mentioned in such standard textbooks of otology as those of Politzer, Kerrison, Barnhill, WatkynThomas and Yates, Fraser and Turner, and Jackson and Coates. Ballenger devoted a paragraph to the condition but omitted discussion of treatment. Bezold alone gave a complete account of the continuously open tube. The purpose of this communication is to call attention to this generally unrecognized clinical condition, to add several other etiologic factors to the single factor described by Bezold and to add a therapeutic measure to that advised by Bezold. ANATOMY AND PHYSIOLOGY The normal eustachian tube lies closed in its cartilaginous portion, forming a vertical slit. This closure is maintained by a thick pad