The main complaint associated with the condition is autophony, said Dr. Michaelides. Other symptoms may include subtle hearing loss and respiratory tinnitus.
Explore this issue:July 2009
Traditional treatments for patulous disease include medical therapies such as nasal sprays to induce irritation of the eustachian tube mucus membranes, causing them to become more bulky and narrowing the passageway. Weight gain in patients who have recently lost weight and developed patulous symptoms may also help, said Dr. Michaelides, who offers eustachian tuboplasty to patients in whom these therapies aren’t effective.
For patulous disease, surgeons augment the eustachian tubal walls, narrowing the passageway, using autograft cartilage, he said.
The lumen may also be narrowed with diathermy or silver nitrate cautery, according to the Eustachian Tube Institute (www.eustachian-tube.net/SOLUTIONS.html ). Extrinsic compression by paraffin, Teflon, gelatin, sponge or collagen injection are other options. The surgery usually requires general anesthesia and is an outpatient procedure.
So far, patients have not had any significant complications from undergoing eustachian tuboplasty for patulous disease, and they generally experience little to no pain, said Dr. Michalides. As with eustachian tuboplasty for chronic obstruction, he recommends that patients use nasal rinses or saline sprays to assist in the healing process.
If the surgery is successful, autophony will be eliminated immediately, said Dr. Michaelides, adding that unlike chronic obstructive disease, researchers do not have to wait for long-term outcomes to determine whether the treatment is effective. The outcomes of surgery for patulous symptoms are much more clear for patients than for those with chronic eustachian tube obstruction, he explained.
Research data on treating patulous eustachian tubes are in the process of being collected, noted Dr. Michaelides.
©2009 The Triological Society