Patulous Eustachian Tube Workup

Updated: Jun 26, 2023
  • Author: Alpen A Patel, MD, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Imaging Studies

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  • 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

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  • 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

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  • 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.