What is ET (Eustachian Tube)?
The eustachian tube is a canal that connects the middle ear to the nasopharynx, which consists of the upper throat and the back of the nasal cavity. It controls the pressure within the middle ear, making it equal to the air pressure outside the body. it is also called the Pharyngotympanic tube.
Most of the time the eustachian tube is closed, opening only during various activities such as
- Yawning.
- Swallowing.
- Chewing
These activities allow air through the passage between the middle ear and the nasopharynx.
When atmospheric pressure changes rapidly, causing a sudden feeling of blockage in the ear (such as during aeroplane travel), these activities can be done on purpose to open the tube and equalize the pressure within the middle ear.
What is Patulous Eustachian tube?
Patulous Eustachian tube (PET) is the name of a physical disorder where the Eustachian tube, which is normally closed, instead stays intermittently open.
When this occurs, the person experiences autophony, the hearing of self-generated sounds like
- Hearing one’s own breathing.
- Hearing one’s own voice.
- Sound of heartbeat.
Prevalence
A patulous Eustachian tube is a form of eustachian tube dysfunction (ETD), which is said to be present in about 1 % of the general population.
Signs and symptoms
With a patulous Eustachian tube, variations in upper airway pressure associated with respiration are transmitted to the middle ear through the Eustachian tube.
Patients hear their own voice or its echo from inside. As if their own voice is amplified and unpleasant.
Lying head down may help since it increases venous blood pressure and congestion of the mucosa.
Causes
- Sudden weight loss is a commonly cited cause of the disorder due to the nature of the Eustachian tube itself.
- Pregnancy- Pregnancy can also be a cause of patulous Eustachian tube due to the effects of pregnancy hormones on surface tension and mucus in the respiratory system.
- Granulomatosis with polyangiitis can also be a cause of this disorder, the exact reason is yet not known.
- Radiation therapy.
- High levels of estrogen.
- Stress.
- Neurological disorders.
Diagnosis
- Otoscopic examination shows Tympanic membrane vibrates with every breath taken by the patient.
Treatment
- The most common treatment for a patulous eustachian tube is nasal sprays. Saline is the most common choice . While many inner ear conditions can benefit from nasal decongestants or steroids. If steroids are used, the treatment should be gradually tapered to prevent a rebound of symptoms and withdrawal side effects.
- Nasal estrogen creams and other intranasal bulking agents have generated much anecdotal support.
- When less invasive methods prove insufficient to resolve symptoms of patulous eustachian tube, surgical treatments may be more effective. The most common surgical intervention is the placement of a tympanostomy tube. It holds the ear open, provides ventilation, and allows excess fluids in the ear to drain.
- Cauterizing the eustachian tube.
- Injecting the eustachian tube with cartilage-filling agents.
- Manipulating the muscles around the eustachian tube.
- Placing cartilage inside the eustachian tube.
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