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Patulous Eustachian Tube Workup

  • Author: Alpen A Patel, MD, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
Updated: Apr 03, 2015

Imaging Studies

See the list below:

  • 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.

Other Tests

See the list below:

  • 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.

Diagnostic Procedures

See the list below:

  • 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.
Contributor Information and Disclosures

Alpen A Patel, MD, FACS Lead Physician for Hospital Utilization, Mid-Atlantic Permanente Medical Group; Staff Physician, Department of Otolaryngology, Towson Medical Center

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

Disclosure: Nothing to disclose.


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, Minnesota Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

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

Disclosure: Received salary from Medscape for employment. for: Medscape.

Gerard J Gianoli, MD Clinical Associate Professor, Departments of Otolaryngology-Head and Neck Surgery and Pediatrics, Tulane University School of Medicine; President, The Ear and Balance Institute; Board of Directors, Ponchartrain Surgery Center

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

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Vesticon<br/>Received none from Vesticon, Inc. for board membership.

Chief Editor

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, 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, American Head and Neck Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan;RxRevu;SymbiaAllergySolutions<br/>Received income in an amount equal to or greater than $250 from: Symbia<br/>Received from Allergy Solutions, Inc for board membership; Received honoraria from RxRevu for chief medical editor; Received salary from Medvoy for founder and president; Received consulting fee from Corvectra for senior medical advisor; Received ownership interest from Cerescan for consulting; Received consulting fee from Essiahealth for advisor; Received consulting fee from Carespan for advisor; Received consulting fee from Covidien for consulting.

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Anatomy of the ear.
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