The authors give a review of the current knowledge on the function of the Eustachian tube (ET) regarding the surface-active material - surfactant – present at its mucosal surface. Detergent-like surface properties of ET linning fluid act to support ET function by facilitating the intermittent opening and closure of its lumen. Specialized cells in ET epithelium express surfactant specific proteins SP-A and SP-D and these proteins are secreted into the ET lumen. They play a role in local immune mechanisms by clearance of pathogenes and acting as immunomodulators. Dysfunction of the local mucosal immunity in the ET may predispose infants to recurrent otitis media. Administration of surfactant improves mechanical properties of ET and restores the impaired local immunity. The authors further discuss the results of the experimental studies in order to indicate the future trends in the use of exogenous surfactant for the treatment of otitis media.

        Key words: surfactant, Eustachian tube, otitis media, middle ear.