Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-22T18:33:23.140Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparison of patulous Eustachian tube patients with and without a concave defect in the anterolateral wall of the tubal valve

Published online by Cambridge University Press:  11 June 2020

S-W Choi ,
J-H Park ,
S Lee ,
S-J Oh  and
S-K Kong
S-W Choi*
Affiliation:
Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Republic of Korea
J-H Park
Affiliation:
Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Republic of Korea
S Lee
Affiliation:
Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Republic of Korea
S-J Oh
Affiliation:
Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Republic of Korea
S-K Kong
Affiliation:
Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Republic of Korea
*
Author for correspondence: Dr Soo-Keun Kong, Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, Gudeok-ro 179, Seo-Gu, Busan, 49241, Republic of Korea E-mail: [email protected] Fax: +82 51 246 8668
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

Patulous Eustachian tube appears to be caused by a concave defect in the anterolateral wall of the tubal valve of the Eustachian tube. This study aimed to compare the clinical features of patulous Eustachian tube patients with or without a defect in the anterolateral wall of the tubal valve.

Methods

Sixty-six patients with a patulous Eustachian tube completed a questionnaire, which was evaluated alongside endoscopic findings of the tympanic membrane, nasal cavity and Eustachian tube orifice.

Results

Females were more frequently diagnosed with a patulous Eustachian tube, but the valve defect was more common in males (p = 0.007). The ratio of patulous Eustachian tube patients with or without defects in the anterolateral wall of the tubal valve was 1.6:1. Weight loss in the previous six months and being refractory to conservative management were significantly associated with the defect (p = 0.035 and 0.037, respectively). Symptom severity was significantly higher in patients with the defect.

Conclusion

Patulous Eustachian tube patients without a defect in the anterolateral wall of the tubal valve can be non-surgically treated more often than those with the defect. Identification of the defect could assist in making treatment decisions for patulous Eustachian tube patients.

Keywords

Eustachian TubeConservative TreatmentEar, Middle
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 6 , June 2020 , pp. 526 - 532
Copyright
Copyright © JLO (1984) Limited, 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr S-K Kong takes responsibility for the integrity of the content of the paper

References

Bluestone, CD, Doyle, WJ. Anatomy and physiology of eustachian tube and middle ear related to otitis media. J Allergy Clin Immunol 1988;81:997–1003CrossRefGoogle ScholarPubMed
Poe, DS. Diagnosis and management of the patulous eustachian tube. Otol Neurotol 2007;8:668–77CrossRefGoogle Scholar
Mondain, M, Vidal, D, Bouhanna, S, Uziel, A. Monitoring eustachian tube opening: preliminary results in normal subjects. Laryngoscope 1997;107:1414–19CrossRefGoogle ScholarPubMed
Poe, DS, Metson, RB, Kujawski, O. Laser eustachian tuboplasty: a preliminary report. Laryngoscope 2003;113:583–91CrossRefGoogle ScholarPubMed
Grimmer, JF, Poe, DS. Update on eustachian tube dysfunction and the patulous eustachian tube. Curr Opin Otolaryngol Head Neck Surg 2005;13:277–82CrossRefGoogle ScholarPubMed
O'Connor, AF, Shea, JJ. Autophony and the patulous eustachian tube. Laryngoscope 1981;9:1427–35CrossRefGoogle Scholar
Bluestone, CD. Eustachian tube function: physiology, pathophysiology, and role of allergy in pathogenesis of otitis media. J Allergy Clin Immunol 1983;72:242–51CrossRefGoogle ScholarPubMed
Yoshida, H, Kobayashi, T, Morikawa, M, Hayashi, K, Tsujii, H, Sasaki, Y. CT imaging of the patulous eustachian tube--comparison between sitting and recumbent positions. Auris Nasus Larynx 2003;30:135–40CrossRefGoogle ScholarPubMed
Adil, E, Poe, D. What is the full range of medical and surgical treatments available for patients with Eustachian tube dysfunction? Curr Opin Otolaryngol Head Neck Surg 2014;22:8–15CrossRefGoogle ScholarPubMed
Takahashi, H, Honjo, I, Fujita, A. Endoscopic findings at the pharyngeal orifice of the eustachian tube in otitis media with effusion. Eur Arch Otorhinolaryngol 1996;253:42–4CrossRefGoogle ScholarPubMed
Oh, SJ, Lee, IW, Goh, EK, Kong, SK. Trans-tympanic catheter insertion for treatment of patulous eustachian tube. Am J Otolaryngol 2015;36:748–52CrossRefGoogle ScholarPubMed
Sato, T, Kawase, T, Yano, H, Suetake, M, Kobayashi, T. Trans-tympanic silicone plug insertion for chronic patulous Eustachian tube. Acta Otolaryngol 2005;125:1158–63CrossRefGoogle ScholarPubMed
Hussein, AA, Adams, AS, Turner, JH. Surgical management of patulous Eustachian tube: a systematic review. Laryngoscope 2015;125:2193–8CrossRefGoogle ScholarPubMed
Choi, SW, Kim, J, Lee, HM, Oh, SJ, Lee, IW, Goh, EK et al. Prevalence and incidence of clinically significant patulous Eustachian tube: a population-based study using the Korean National Health Insurance Claims Database. Am J Otolaryngol 2018;39:603–8CrossRefGoogle ScholarPubMed
Tjernström, O, Andréasson, L, Groth, P, Ivarsson, A, Malm, L. Effect of atropine on the eustachian tube function. ORL J Otorhinolaryngol Relat Spec 1985;47:95–100CrossRefGoogle ScholarPubMed
DiBartolomeo, JR, Henry, DF. A new medication to control patulous eustachian tube disorders. Am J Otol 1992;13:323–7Google ScholarPubMed
Bartlett, C, Pennings, R, Ho, A, Kirkpatrick, D, van Wijhe, R, Bance, M. Simple mass loading of the tympanic membrane to alleviate symptoms of patulous eustachian tube. J Otolaryngol Head Neck Surg 2010;39:259–68Google ScholarPubMed
Luu, K, Remillard, A, Fandino, M, Saxby, A, Westerberg, BD. Treatment effectiveness for symptoms of patulous Eustachian tube: a systematic review. Otol Neurotol 2015;36:1593–600CrossRefGoogle ScholarPubMed
Oh, SJ, Kang, DW, Goh, EK, Kong, SK. Calcium hydroxylapatite injection for the patulous Eustachian tube. Am J Otolaryngol 2014;35:443–4CrossRefGoogle ScholarPubMed
Rotenberg, BW, Busato, GM, Agrawal, SK. Endoscopic ligation of the patulous eustachian tube as treatment for autophony. Laryngoscope 2013;123:239–43CrossRefGoogle ScholarPubMed