Surgery for patulous (open) Eustachian tube Dysfunction

The Eustachian tube should be closed at rest and open momentarily during swallowing or yawning. Sometimes the tube is open all the time (patulous ETD). This sometimes happens after vigorous exercise or weight loss, but at other times no cause is found.

Patients with patulous ETD experience symptoms such as:

• a blocked feeling in the ear

• voice echoing in the ear

• the sound of their breathing or heartbeat in the ear.

There are other conditions that mimic patulous ETD (eg superior semi-circular canal dehiscence), so it is important to see a specialist to make the diagnosis.

If the Eustachian tube is open all the time, pressure changes in the back of the nose (eg sniffing) are easily transmitted to the eardrum and can sometimes lead to retraction pockets, where the drum is sucked in and floppy.

There are a variety of different treatments for patulous ETD, including nasal sprays, grommets, ear surgery (to fix and reinforce a floppy section of ear drum), injection or augmentationEustachian tuboplasty (to plump up the Eustachian cushions)