Patulous Eustachian Tube

Patulous Eustachian Tube

National Organization for Rare Disorders, Inc.

Important

It is possible that the main title of the report Patulous Eustachian Tube is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report.

Synonyms

  • P.E.T.
  • pET

Disorder Subdivisions

  • None

General Discussion

In patulous eustachian tube (pET) dysfunction, the eustachian tube stays open most of the time. The eustachian tube is a passageway from the back of the nose to the middle ear that may be opened or closed by action of a valve-like device. Under normal circumstances, it remains closed for most of the day, opening only on occasion to equalize air pressure in the middle ear and the exterior environment.



If the tube remains open, the patient complains of hearing one's own voice or one's breathing as too loud (autophony), hearing echoes of one's own voice, or hearing ocean waves much like the sound produced by holding a shell over one's ear.



The condition is benign but may generate, over time, serious and even extreme responses to the abnormal sounds.

Symptoms

Symptoms of pET include variable intensity of the sensation of fullness in the ear; oceanic roaring sounds associated with breathing; loud, echoing sensations and a sense of hearing one's own speech at a high volume. There may also be a stopped-up feeling in the ear.



Dizziness may, on occasion, accompany the abnormal sound sensations. The heightened sounds of chewing may be loud enough to interfere with eating.

Causes

Patulous eustachian tube results when the eustachian tube is open continuously or for long periods. Under normal conditions, the eustachian tube remains closed because the natural elasticity of the structure tends towards closure or because of surface tension of the interior of the tube (lumen) and pressure by the muscles outside the tube. If any (or all) of these forces fail, the tube does not close.



For reasons that are not clear, the condition is often associated with recent weight loss, and with a high concentration of estrogens in the blood due to pregnancy or medication. Other possible causes of pET dysfunction are neuromuscular disorders such as multiple sclerosis, poliomyelitis, Parkinson's disease and neurovascular accident. Adhesions and scarring of the pharyngeal recess and of the posterior lip of the pharyngeal opening of the eustachian tube can also result in the disorder.

Affected Populations

Patulous eustachian tube is most prevalent in women who have had a significant recent weight loss and in pregnant women. Adults and adolescents are most often affected. Instances of this occurring among children are very rare.



Various epidemiological studies suggest that the incidence of the condition in the general population is 0.3% to 6.6%. Of those affected however, only about 20% seek medical treatment.

Standard Therapies

Diagnosis

A clinical history and patient description of the symptoms are often sufficient for the diagnosis. There are several tests that may be used to confirm the diagnosis, including the detection of movement of the ear drum along with respiration, (tympanometry) and others.



Treatment

Temporary relief may be achieved by having the affected person lie down or bend forward with the head between the knees. Sniffing can also provide momentary relief.



In some cases, estrogen-based nasal drops or anticholinergics may be effective. Weight gain may also cause pET to recede.

Investigational Therapies

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.



For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:



Tollfree: (800) 411-1222

TTY: (866) 411-1010

Email: prpl@cc.nih.gov



For information about clinical trials sponsored by private sources, contact:

www.centerwatch.com



Patulous eustachian tube dysfunction has been treated surgically by cutting the hook around which the tendon of the tensor veli palatini muscle passes (pterygoid hamulotomy) combined with transposition or transection of the tendon of this muscle. Good results have been obtained in approximately 70 percent of persons undergoing this procedure.



The drug Patul-end has received an orphan drug designation for its use in the treatment of patulous eustachian tube. More studies are needed to determine the long-term safety and effectiveness of this drug for the treatment of patulous eustachian tube. For more information, contact:



Ear Foundation (of Santa Barbara)

2420 Castillo Street

Suite 100

Santa Barbara, CA 93105-5307

Telephone: (805) 563-1111

Fax: (805) 563-2277

E-mail: earfdn@aol.com

Website: http://www.EarFdn.org

References

TEXTBOOKS

Ballenger JJ, ed. Diseases of the Nose, Throat, Ear, Head and Neck. 14th ed. Lea & Febiger, Malvern, PA; 1991:1101-02.



JOURNAL ARTICLES

Kano S, Kawase T, Baba Y, et al. Possible new assessment of patulous eustachian tube function: Audiometry or tones presented in the nasal cavity. Acta Otolaryngol. 2004;124:431-35.



Yoshida H, Kobayashi T, Morikawa M, et al. CT imaging of the patulous eustachian tube - comparison between sitting and recumbent positions. Auris Nasus Larynx. 2003;30:135-40.



Doherty JK, Slattery WH 3rd. Analogous fat grafting for the refractory patulous eustachian tube. Otolaryngol Head Neck Surg. 2003;128:88-91.



Poe DS, Abou-Halawa A, Abdel-Razek O. Analysis of the dysfunctional eustachian tube by video endoscopy. Otol Neurotol. 2001;22:590-95.



Kaneko A, Hosoda Y, Doi T, et al. Tubal compliance - changes with age and tubal malfunction. Auris Nasus Larynx. 2001;28:121-24.



Tideholm B, Carlborg B, Brattmo M. Continuous long-term measurements of the middle ear pressure in subjects with symptoms of patulous eustachian tube. Acta Otolaryngol. 1999;119:809-15.



Chen DA, Luxford WM. Myringotomy and tube for relief of patulous eustachian tube symptoms. Am J Otol. 1990;11:272-73.



Robinson PJ, Hazell JW. Patulous eustachian tube syndrome: the relationship with sensorineural hearing loss. Treatment by eustachian tube diathermy. J Laryngol Otol. 1989;103:739-42.



FROM THE INTERNET

Patulous Eustachian Tube. emedicine. Last updated: August 6, 2002. 7pp.

www.emedicine.com/ent/topic208.htm



Own Voice Sounds Distorted & Loud. IVillage. nd. 2pp.

www.ivillagehealth.com



Kuppersmith RB. Eustachian Tube Function and Dysfunction. Grand Rounds Archives. The Bobby R. Alford Department of Otorhinolaryngology and Communicative Sciences. Baylor College of Medicine. July 11, 1996. 11pp.

www.bcm.tmc.edu/oto/grand/71196.html

Resources

Better Hearing Institute

1444 I Street NW

Suite 700

Washington, DC 20005

United States

Tel: (202)449-1100

Fax: (703)684-6048

Tel: (800)327-9355

Email: mail@betterhearing.org

Internet: http://www.betterhearing.org



Starkey Hearing Foundation

6700 Washington Avenue South

Suite 300

Eden Prairie,, MN 55344

United States

Tel: (866)354-3254

Fax: (952)828-6946

Tel: (800)648-4327

TDD: (800)648-4327

Email: joanita@sotheworldmayhear.org

Internet: http://www.sotheworldmayhear.org/



American Hearing Research Foundation

8 South Michigan Avenue Suite 1205

Chicago, IL 60603-4539

USA

Tel: (312)726-9670

Fax: (312)726-9695

Email: sparmet@american-hearing.org

Internet: http://www.american-hearing.org/



NIH/National Institute on Deafness and Other Communication Disorders

31 Center Drive, MSC 2320

Communication Avenue

Bethesda, MD 20892-3456

Tel: (301)402-0900

Fax: (301)907-8830

Tel: (800)241-1044

TDD: (800)241-1105

Email: nidcdinfo@nidcd.nih.gov

Internet: http://www.nidcd.nih.gov



Genetic and Rare Diseases (GARD) Information Center

PO Box 8126

Gaithersburg, MD 20898-8126

Tel: (301)251-4925

Fax: (301)251-4911

Tel: (888)205-2311

TDD: (888)205-3223

Internet: http://rarediseases.info.nih.gov/GARD/



American Academy of Audiology

11730 Plaza America Drive, Suite 300

Reston, VA 20190

Tel: (703)790-8466

Fax: (703)790-8631

Tel: (800)222-2336

Email: infoaud@audiology.org

Internet: http://www.audiology.org



Ear Foundation of Santa Barbara

2420 Castillo Street

Suite 100

Santa Barbara, CA 93105-4346

Tel: (805)569-1111

Fax: (805)563-2277

Email: info@earfdn.org

Internet: http://earfdn.org/index.htm



For a Complete Report

This is an abstract of a report from the National Organization for Rare Disorders, Inc.® (NORD). Cigna members can access the complete report by logging into myCigna.com. For non-Cigna members, a copy of the complete report can be obtained for a small fee by visiting the NORD website. The complete report contains additional information including symptoms, causes, affected population, related disorders, standard and investigational treatments (if available), and references from medical literature. For a full-text version of this topic, see http://www.rarediseases.org/search/rdblist.html.

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