Patulous Eustachian Tube Workup

  • Author: Alpen A Patel, MD; Chief Editor: Arlen D Meyers, MD, MBA   more...
 
Updated: Jul 11, 2011
 

Imaging Studies

  • CT scanning in an axial plane has been used to show the presence of a patulous eustachian tube.
  • CT scanning may be useful in making the diagnosis in some patients.
  • Radiology only assists in the diagnosis of anatomic patency.
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Other Tests

  • Tympanometry may detect movements of the tympanic membrane with nasal respiration, especially with the patient in an erect position.[2]
  • Distorted sounds of nasal respiration and speech may be heard with a microphone placed in the external meatus.
  • With sonotubometry, a test sound is introduced into the nasal vestibule and a microphone is fitted into the external auditory meatus. With a patulous tube, sound pressure level in the external canal is at a maximum; because the tube does not close, no sudden drop in transmitted sound occurs.
  • Observe a regular change in middle ear pressure when increasing or decreasing the ambient pressure during the measurement of impedance in a pressure chamber. Usual variations in pressure with opening and closing of the tube are not seen because the tube remains open all of the time.
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Diagnostic Procedures

  • In some patients with patulous tube, direct nasopharyngoscopy may show the continuous presence of a triangular opening of the eustachian tube orifice.
  • Transnasal endoscopic (video analysis) exam has been used to study the nasopharyngeal opening of the eustachian tube during rest, swallowing, and yawning.
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Contributor Information and Disclosures
Author

Alpen A Patel, MD  Otolaryngologist, Towson Medical Center

Alpen A Patel, MD, is a member of the following medical societies: American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American Association of Physicians of Indian Origin, American College of Surgeons, Phi Beta Kappa, and Society of University Otolaryngologists-Head and Neck Surgeons

Disclosure: Nothing to disclose.

Coauthor(s)

Samuel C Levine, MD  Professor of Otolaryngology and Neurosurgery, University of Minnesota Medical School

Samuel C Levine, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Otological Society, and Minnesota Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Carol A Bauer, MD, FACS  Associate Professor of Surgery, Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine

Carol A Bauer, MD, FACS is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Neurological Association, and Society of University Otolaryngologists-Head and Neck Surgeons

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Gerard J Gianoli, MD  Clinical Associate Professor, Department of Otolaryngology-Head and Neck Surgery, Tulane University School of Medicine; Vice President, The Ear and Balance Institute; Chief Executive Officer, Ponchartrain Surgery Center

Gerard J Gianoli, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Neurotology Society, American Otological Society, Society of University Otolaryngologists-Head and Neck Surgeons, and Triological Society

Disclosure: Vesticon, Inc. None Board membership

Christopher L Slack, MD  Private Practice in Otolaryngology and Facial Plastic Surgery, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders

Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA  Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society

Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation Unrestricted gift Unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo Consulting; Medvoy Ownership interest Management position; Cerescan Imaging Honoraria Consulting; GYRUS ACMI Honoraria Consulting

References

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  14. Sehhati-Chafai-Leuwer S, Wenzel S, Bschorer R. Pathophysiology of the Eustachian tube--relevant new aspects for the head and neck surgeon. J Craniomaxillofac Surg. 2006;34(6):351-4. [Medline]. [Full Text].

  15. Stroud MH, Spector GJ, Maisel RH. Patulous eustachian tube syndrome. Preliminary report of the use of the tensor veli palatini transposition procedure. Arch Otolaryngol. Jun 1974;99(6):419-21. [Medline].

  16. Tolley NS, Phelps P. Patulous eustachian tube: a radiological perspective. J Laryngol Otol. Apr 1990;104(4):291-3. [Medline].

  17. Virtanen H, Palva T. Surgical treatment of patulous eustachian tube. Arch Otolaryngol. Nov 1982;108(11):735-9. [Medline].

  18. Yoshida H, Kobayashi T, Takasaki K, et al. Imaging of the patulous Eustachian tube: high-resolution CT evaluation with multiplanar reconstruction technique. Acta Otolaryngol. Oct 2004;124(8):918-23. [Medline].

 
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