Patulous Eustachian Tube Dysfunction

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Patulous Eustachian Tube Dysfunction

Eustachian tube dysfunction (ETD) is often regarded as a problem of the tube not opening properly, but a patulous eustachian tube (PET) is another type of ETD. Though clinically less common, PET (also known as a patent eustachian tube) results in symptoms that can be bothersome to the afflicted patient.

The condition involves a eustachian tube that is abnormally open, in some cases all or nearly all of the time and in other cases during periods of heavy respiration. At the beginning, patients experience autophony as hear their own voice “from inside”, amplified and unpleasant. With time, they hear “from inside” also their respiration (tympanophonia). General symptoms may also include hyperacusis, distortion to speech sounds, tinnitus, aural fullness and a sense of blockage. These symptoms may suggest a problem in the inner ear, but PET is not associated with hearing loss. Many patients will also be misdiagnosed due to the fact that the symptoms closely remember those of a blocked eustachian tube. Treatment for a congestion or eustachain tube dysfunction with make patulous eustachian tube worse. Patients report that lying down or bending over resolves symptoms as this closes the eustachian tube.

The average age is 30 years, with a female prevalence. It’s rare to find patients of less than 15 years of age, which seems to confirm the opinion that PET is an acquired condition. Chronic upper respiratory inflammatory diseases are almost always associated with PET; History of recurrent otitis media with effusion, with tympanostomy and adenoidectomy during childhood is also frequent. Laryngopharyngeal reflux (LPR) is identified in a great proportion of patients.

Conditions that tend to be associated with PET include pregnancy, radiation therapy, hormone therapy, fatigue, stress, and weight loss. Additionally, anecdotal evidence suggests that some patients only experience symptoms or have an increase in symptoms during humid weather and especially during increased respiration in humid conditions (i.e. aerobic exercise in high humidity).

The evaluation of PET includes a hearing assessment and tympanometry, which is highly sensitive to PET.

For more information, please contact Westside Hearing and Balance Clinic on 9749 4444 or

The Hearing Clinic Bankstown on 97094888.

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