Patulous Eustachian Tube (PET)

Eustachian Tubes That Are Stuck Open

Anatomy of the Ear
Anatomy of the Ear. MediaForMedical/UIG/Getty Images

Also known as: PET

Patulous eustachian tube, is a very rare disorder where the eustachian tube remains wide open (patulous). The eustachian tubes run from the middle ear to the back of the throat and remain closed most of the time except during times when the inner ear needs to equalize pressure and activities like swallowing, yawning, or sneezing. Patulous eustachian tube only occurs in about 0.3 to 6.6 percent of the people.

Causes of Patulous Eustachian Tube

While not knowing the cause of a disorder can be discouraging, you may not be able to identify a cause for your patulous eustachian tube, as the cause is usually unknown. However there are several factor that may predispose you to developing chronically open eustachian tubes, including:

  • radiation therapy (causes scarring to occur)
  • high levels of estrogen (Pregnancy, high dose birth control, or hormonal therapy for prostate cancer)
  • nasal decongestants
  • fatigue, stress or anxiety
  • temporomandibular joint syndrome
  • weight loss
  • neurological disorders (stroke, multiple sclerosis, trauma to facial nerves)
  • excessive gum chewing or frequent forced nose blowing

Symptoms Related to Patulous Eustachian Tube

Normally the eustachian tubes remain closed except to equalize pressure within the middle ear. When you have a patulous eustachian tube, the eustachian tube is open instead which can result in the following symptoms:

  • autophony (a condition in which your own voice seems unusually loud) - this is the most common symptom and a classic sign of patulous eustachian tube
  • tinnitis (a ringing in the ears)
  • a feeling that the ear is stuffed up or clogged (sometimes called “glue ear”)
  • hearing your own breath sounds (a condition called tympanophonia).

    Treatment of Patulous Eustachian Tube

    Common belief for symptom relief involves use of nasal decongestants or steroids. This practice however will likely worsen your symptoms and should not be continued. However do not stop any medications without consulting your physician. If your physician wants you to stop taking steroids, they will give you a taper schedule. Stopping steroids too quickly can be harmful.

    Mild symptoms may not require any treatment. However if the symptoms are severe enough and have persisted for greater than 6 weeks. Initial treatments involve proper hydration. Drinking sufficient water is essential and can be supplemented with nasal saline drops or irrigation of the nose.

    If proper hydration is insufficient, more advanced therapy can include surgical treatments. The most common surgical intervention is placement of a tympanostomy, or ear tubes. This therapy is only about 50% effective for patients and only helps with symptoms related to the movement of the ear drum in relation to breathing. However ear tubes do not resolve the symptom complained about the most, autophony.

    Other therapies that are continually being studied, and not available in all areas includes:

    • Catheter placement inside the eustachian tube
    • Surgical placement of cartilage inside the eustachian tube
    • Closing off the eustachian tube

    Inserting a catheter inside the eustachian tube allows for a narrowing of the eustachian due to the size of the catheter. While this does not return normal function of the tube, it reduces the amount of air flow into the middle ear, which helps to reduce the symptoms of patulous eustachian tube including autophony.

    Surgically placing cartilage inside the eustachian tube has a similar purpose to catheter placement and is used only if the catheter has failed. As a last resort, you can have a surgery where your otolaryngologist completely closes off the eustachian tube.

    This procedure alone is insufficient to help manage symptoms, as you lose the ability to regulate pressure in the middle ear. For this reason, your physician will also place ear tubes. You will always require ear tubes if you have this procedure, so it is only used as a last resort.


    National Center for Advancing Translational Services.(2011). Patulous Eustachian Tube: Overview. Accessed on December 2, 2015 from

    Poe. D & Hanna, B.MN. (2015). Eustachian tube dysfunction. Accessed on December 2, 2015 from (subscription required)

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