patulous eustachian tube

What is Patulous Eustachian Tube?

The patulous eustachian tube, also known as a patent eustachian tube, is a condition where the eustachian tube, which normally closes at rest to protect the middle ear from nasopharyngeal secretions [4], remains abnormally open or patent. This can cause various symptoms and discomfort in the ear.

Symptoms of Patulous Eustachian Tube

The symptoms of patulous eustachian tube dysfunction include:

• A sense of fullness in the ears [1]
• The ability to hear one's own voice, breathing, or bodily functions very loudly (voice or breath autophony) [7]
• Abnormal sound of one's own voice (voice sounds abnormally loud and low-pitched) [8]

Causes and Effects

The patulous eustachian tube can occur due to various reasons such as anatomical abnormalities, infections, or other medical conditions. When the eustachian tube remains open, it can cause discomfort and annoyance in the ear, affecting daily life.

References: [1] Symptoms of Patulous Eustachian Tube Dysfunction · A sense of fullness in the ears · The ability to hear your own voice, breathing or bodily functions very loudly ... [4] by M Bance · 2019 · Cited by 24 — The Eustachian tube (ET) is normally closed at rest, in order to protect the middle ear from nasopharyngeal secretions, opening only briefly ... [7] by R Ikeda · 2020 · Cited by 19 — Patients with patulous Eustachian tubes (PET) suffer from annoying aural symptoms, such as voice or breath autophony, and aural fullness due ... [8] Feb 12, 2024 — Definition -- Abnormally patent eustachian tube · Abnormal sound of one's own voice (voice sounds abnormally loud and low-pitched) · Abnormal ...

Common Signs and Symptoms of Patulous Eustachian Tube

The patulous eustachian tube is a rare medical condition that can cause a variety of symptoms, affecting the quality of life. Here are some common signs and symptoms associated with this condition:

• A sense of fullness in the ears: Many people experience a feeling of fullness or pressure in their ears, which can be uncomfortable and distracting.
• Hearing own voice, breathing, or bodily functions very loudly: One of the most distinctive symptoms of patulous eustachian tube is the ability to hear one's own voice, breathing, or other bodily functions extremely clearly. This can be startling and embarrassing at times.
• Echoing voice while speaking: Some individuals may experience an echoing effect when they speak, which can make it difficult to communicate effectively.
• Spinning sensation in the head: A spinning or vertigo-like sensation in the head is another symptom that some people with patulous eustachian tube may experience.

Other Possible Symptoms

In addition to these common symptoms, some individuals may also experience:

• Tinnitus: A ringing or buzzing sound in the ears
• Aural fullness: A feeling of fullness or pressure in the ears
• Autophony: The abnormal perception of one's own breath and voice sounds

Causes and Risk Factors

While the exact causes of patulous eustachian tube are not fully understood, some possible risk factors include:

• Infections of the nose, such as a cold or sinusitis
• Enlarged adenoids and tonsils, especially in children
• Allergies
• Smoking

Treatment Options

Fortunately, patulous eustachian tube is not a serious medical condition, and treatment options are available to alleviate symptoms. These may include:

• Weight gain (recommended only if underweight)
• Discontinuing decongestants and nasal steroids
• Good hydration
• Premarin nasal solution

It's essential to consult with a healthcare professional for proper diagnosis and treatment of patulous eustachian tube.

References: [1] [2] [3] [4] [5]

To diagnose patulous Eustachian tube dysfunction, several tests can be performed by a healthcare professional.

Tests to Diagnose Patulous Eustachian Tube Dysfunction

• Ear Exam: A doctor will examine the ear using an otoscope to observe any changes in the shape or movement of the eardrum. This test is mentioned in [1] and [6].
• Tympanometry: A probe is placed in the ear, and air pressure is applied to assess Eustachian tube function. This test is commonly used by many clinicians, as stated in [7].
• Long time-base tympanometry: This measures the acoustic immittance of the middle ear over a long period, which can help diagnose patulous Eustachian tube dysfunction. According to [4], this test is particularly useful for difficult-to-diagnose patients.
• CT scanning: In some cases, CT scanning may be used to assist in making a diagnosis, especially when anatomical patency is suspected. However, it's essential to note that radiology only assists in the diagnosis of anatomic patency, as stated in [5].
• Special tympanogram: A special tympanogram can be utilized for patients who are difficult to diagnose, and setting the tympanogram to reflex decay mode without changing the pressure can help identify the location and severity of the dysfunction. This is mentioned in [3].

These tests can provide valuable information to healthcare professionals to accurately diagnose patulous Eustachian tube dysfunction.

References: [1] - To diagnose patulous Eustachian tube dysfunction, your doctor will ask you about your symptoms and what makes them better or worse. [2] - The Eustachian tube (ET) is closed under normal conditions and opens temporarily during swallowing. [3] - The eustachian tube dysfunction test helps to identify the location & severity by combining information from patient history, physical exam findings, and testing. [4] - Perhaps the most important test for diagnosis of the truly patulous ET is long time-base tympanometry. [5] - CT scanning may be useful in making the diagnosis in some patients. Radiology only assists in the diagnosis of anatomic patency. [6] - Your doctor may use a variety of techniques to diagnose patulous Eustachian tube dysfunction while viewing your ear drum (tympanic membrane). [7] - Many clinicians utilize traditional tympanometry to assess eustachian tube function.

The drug treatment for patulous Eustachian tube (PET) involves various medications to alleviate symptoms and manage the condition.

• Nasal or oral decongestants can help relieve nasal congestion, which may be contributing to the patulous ET ([6]). These medications can reduce swelling in the nasal passages and sinuses, potentially alleviating some of the symptoms associated with PET.
• Oral antihistamines may also be prescribed to address any allergic reactions or inflammation that could be exacerbating the condition ([6]).
• Nasal steroids can help relieve nasal congestion and enable the Eustachian tube to function properly, reducing the likelihood of patulous ET ([6]).

Additionally, some studies have explored the use of other medications in treating PET. For example:

• A study by J Akiyama et al. (2023) found that sphenopalatine ganglion (SPG) block was effective in managing symptoms of patulous Eustachian tube ([7]). This treatment involves injecting a local anesthetic into the SPG to reduce inflammation and alleviate symptoms.

It's essential to note that these treatments may not be suitable for everyone, and the most effective approach will depend on individual circumstances. A healthcare professional should be consulted to determine the best course of action for treating patulous Eustachian tube.

References: [6] Medical Treatment for Eustachian Tube Dysfunction [7] by J Akiyama · 2023 · Cited by 1 — We concluded that successful management of PET can be obtained with SGB; this treatment was not previously used for this disorder.