Patulous eustachian tube with ipsilateral deafness

The patulous eustachian tube is an often overlooked pathology in ENT. The symptoms are similar to those of an obstructed eustachian tube with patients reporting of an aural pressure sensation with concurrent change in hearing with a high degree of discomfort. As a differential diagnosis the pathognomic symptoms of autophonia and breathing-synchronous tinnitus should be considered. Besides taking patient history the leading indicator of a patulous eustachian tube diagnosis are breathing-synchronous movements of the tympanic membrane.We report on an 80 year old female patient with a history of sudden sensorineural hearing loss with resulting deafness of the right ear. Due to the deafness the typical symptoms of autophonia and breathing-synchronous tinnitus did not apply. However the patient was reporting of a breathing-synchronous dull pressure sensation of the right ear. During the ear microscopy there were signs of movement of the tympanic membrane with heavy nasal breathing. This was present in both ears with the pathology on the right being more prominent (see video documentation for reference). The decision for surgical eustachian-tube augmentation was made. Vox-Implants® is a polymer used for vocal chord augmentation following chordectomy. For several years we have been using Vox-Implants® for eustachian tube augmentation in patients suffering of patulous eustachian tube. This is achieved using endoscopic surgery and the aid of an applicator for needle insertion. Using this procedure has resulted in a high degree of patient satisfaction.

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Publication History

Article published online:
10 June 2020