Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-05T04:25:09.396Z Has data issue: false hasContentIssue false

Paper patching of the tympanic membrane as a symptomatic treatment for patulous eustachian tube syndrome

Published online by Cambridge University Press:  25 February 2014

M Boedts*
Affiliation:
Department of ENT, AZ Maria Middelares, Ghent, Belgium
*
Address for correspondence: Dr M Boedts, Department of ENT, AZ Maria Middelares, Kortrijksesteenweg 1026, 9000 Ghent, Belgium Fax: +32 9 2220809 E-mail: [email protected]

Abstract

Background:

Application of one or several paper patches on the tympanic membrane can improve autophony and other symptoms in some patients with a patulous eustachian tube.

Method:

The charts of 21 patients treated for patulous eustachian tube syndrome between 2006 and 2011 were studied for subjective improvement of symptoms following the application of paper patches.

Results:

Paper patching of the tympanic membrane provided symptomatic relief in 76.2 per cent of patients; relief was permanent in 50 per cent of these patients.

Conclusion:

Paper patching of the tympanic membrane is a simple and effective means of temporarily or permanently alleviating patulous eustachian tube syndrome symptoms. It is postulated that the patches decrease the admittance of low- to mid-frequency acoustic input at the tympanic membrane by increasing the stiffness of the tympanic membrane, thereby counteracting the middle-ear cushion effect caused by the open eustachian tube.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2014 

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.)

References

1Chi, FL, Ren, DD, Dai, CF. Variety of audiologic manifestations in patients with superior semicircular canal dehiscence. Otol Neurotol 2010;3:210CrossRefGoogle Scholar
2Bluestone, C, Magit, A. The abnormally patulous tube. In: Brackmann, D, Shelton, C, Arriaga, M, eds. Otologic Surgery. Philadelphia: WB Saunders, 1994;103–9Google Scholar
3Olthoff, A, Laskawi, R, Kruse, E. Successful treatment of autophonia with botulinum toxin: case report. Ann Otol Rhinol Laryngol 2007;116:594–8CrossRefGoogle ScholarPubMed
4Tsuji, T, Yamaguchi, N, Moriyama, H. Patulous eustachian tube following otitis media [in Japanese]. Nihon Jibiinkoka Gakkai Kaiho 2003;106:1023–9CrossRefGoogle ScholarPubMed
5DiBartolomeo, JR, Henry, DF. A new medication to control patulous eustachian tube disorders. Am J Otol 1992;13:323–7Google Scholar
6Murakami, S, Nakazawa, M, Watanabe, N, Takahashi, M, Honda, N, Goode, RL. Role of tympanic membrane in symptoms of patulous eustachian tube syndrome: a new treatment with use of adhesive tape on the tympanic membrane. In: Gyo, K, Wada, H, eds. Proceedings of the 3rd Symposium on Middle Ear Mechanics in Research and Otology, Matsuyama, Ehime, Japan, July 9-12, 2003. Singapore: World Scientific Publishing, 2004;438–40Google Scholar
7Bartlett, 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
8Wada, H, Koike, T, Kobayashi, T. Three-dimensional finite-element method (FEM) analysis of the human middle ear. In: Hüttenbrink, KB, ed. Middle Ear Mechanics in Research and Otosurgery: Proceedings of the International Workshop on Middle Ear Mechanics in Research and Otosurgery, Dresden, Germany, September 19–22, 1996. Dresden: UniMedia, 1997;7681Google Scholar
9Koike, T, Wada, H, Kobayashi, T. Modeling of the human middle ear using the finite-element method. J Acoust Soc Am 2002;111:1306–17CrossRefGoogle ScholarPubMed
10Kawase, T, Kano, S, Otsuka, T, Hamanishi, S, Koike, T, Kabayashi, T et al. Autophony in patients with patulous eustachian tube: experimental investigation using an artificial middle ear. Otol Neurotol 2006;27:600–3CrossRefGoogle ScholarPubMed
11Voss, SE, Horton, NJ, Woodbury, RR, Sheffield, KN. Sources of variability in reflectance measurements on normal cadaver ears. Ear Hear 2008;29:651–65CrossRefGoogle ScholarPubMed
12Gyo, K, Goode, RL, Miller, C. Effect of middle ear modification on umbo vibration. Human temporal bone experiments with a new vibration measuring system. Arch Otolaryngol Head Neck Surg 1986;112:1262–8CrossRefGoogle ScholarPubMed
13Teoh, SW, Flandermeyer, DT, Rosowski, JJ. Effects of pars flaccida on sound conduction in ears of Mongolian gerbil: acoustic and anatomical measurements. Hear Res 1997;106:3965CrossRefGoogle ScholarPubMed
14Tonndorf, J, Khanna, SM. Tympanic-membrane vibrations in human cadaver ears studied by time-averaged holography. J Acoust Soc Am 1972;52:1221–33CrossRefGoogle ScholarPubMed
15Khanna, SM, Tonndorf, J. Tympanic membrane vibrations in cats studied by time-averaged holography. J Acoust Soc Am 1972;51:1904–20Google Scholar
16Khanna, SM, Decraemer, WF. Vibration modes and the middle ear function. In: Hüttenbrink, KB, ed. Middle Ear Mechanics in Research and Otosurgery: Proceedings of the International Workshop on Middle Ear Mechanics in Research and Otosurgery, Dresden, Germany, September 19-22, 1996. Dresden: UniMedia, 1997;21–6Google Scholar
17Kano, S, Tawase, T, Baba, Y, Sato, T, Kobayashi, T. Possible new assessment of patulous eustachian tube function: audiometry for tones presented in the nasal cavity. Acta Otolaryngol 2004;124:431–5CrossRefGoogle ScholarPubMed
18Yoshida, H, Kobayashi, T, Takasaki, K, Takahashi, H, Ishimaru, H, Morikawa, M et al. Imaging of the patulous eustachian tube: high-resolution CT evaluation with multiplanar reconstruction technique. Acta Otolaryngol 2004;124:918–23CrossRefGoogle ScholarPubMed
19Mathew, GA, Kuruvilla, G, Job, A. Dynamic slow motion video endoscopy in eustachian tube assessment. Am J Otolaryngol 2007;28:91–7Google Scholar
20Mewes, T, Mann, W. Function of the eustachian tube in epitympanic retraction pockets [in German]. HNO 1998;46:914–18Google Scholar
21Bluestone, CD, Cantekin, EI, Beery, QC. Certain effects of adenoidectomy of eustachian tube ventilatory function. Laryngoscope 1975;85:113–27CrossRefGoogle ScholarPubMed
22Magnuson, B. Tubal closing failure in retraction type cholesteatoma and adhesive middle ear lesions. Acta Otolaryngol 1978;86:408–17Google Scholar
23Flisberg, K, Ingelstedt, S. Middle-ear mechanics in patulous tube cases. Acta Otolaryngol Suppl 1969;263:1822Google ScholarPubMed