Patulous Eustachian tube
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Patulous Eustachian tube is the name of a rare physical disorder where the Eustachian tube, which is normally closed, instead stays intermittently open. As a result, when it is open, all of the patient's breathing, talking, swallowing, heart beat, etc. vibrates directly on the ear drum creating an effect that sounds like the patient has a bucket on his/her head.
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[edit] Diagnosis
Many patients will be misdiagnosed with this disorder due to the fact that the symptoms closely resemble those of Eustachian Tube Dysfunction. The problem with this is that treatment for Eustachian Tube Dysfunction will make Patulous Eustachian Tube worse because the two disorders are opposite one another. One major symptom that will tell the two apart is if when a patient with Patulous Eustachian Tube flips their head upside down, the symptoms clear up temporarily. This will not happen with Eustachian Tube Dysfunction.
[edit] What it sounds like
It sounds very similar to the standard congestion one gets from a cold or allergies. If you listen carefully, though, there are a couple subtle differences: (1) The effect sounds drier. When you have normal congestion your breathing and talking echos in your head, but muffled. With PET you hear ALL of your breaths echo on your ear drum, and they aren't muffled. (2) Everything on the outside world sounds the same. Other people's voices aren't muddled at all, like they commonly are with congestion.
[edit] What others will notice
Your voice will sound lower to other people because with the Eustachian tube open the trachea has more volume. Most people will ask if you have a cold because your voice sounds "stuffed up."
[edit] What it feels like
The easiest way to distinguish PET from congestion is by how it feels. With PET you aren't blowing your nose, and you don't feel any sinus pressure. Your ears don't feel clogged, they feel dry. Also try the temporary treatments listed below and see if those help. If they do, it is likely PET, because they don't usually do anything for congestion.
[edit] What it looks like
A doctor looking directly at your ear drum with his light will be able see that every breath you take vibrates the drum.
[edit] Cause
PET is a physical disorder. The exact causes may vary depending on the person, however weight loss is a very common cause. [1]The eustachian tube remains closed when normal most of the time, and there is fat tissue surrounding it that holds it closed. Weight loss, even as little as 5 lbs., may be enough to cause the tissue surrounding the eustachian tube to shrink. This will cause it to remain open.
Caffeine, especially the amount in coffee, is also a major cause, as it may dehydrate enough to affect the surrounding tissue. Exercise does the same thing, although for a shorter amount of time.
[edit] Treatment
[edit] Temporary treatments
- Tilt your head to the side or flip it upside down.
- Lie down on your back.
[edit] More rigorous treatments
- Weight gain [2]
- Lying down 4 times a day for 15 minutes each with legs raised on stairs or a chair - about 20 inches. Recommend first time when you get up in the morning and last time just before going to bed at night. Within about 2 weeks noticed improvement. *Discontinue exercise during this program. [3]
- Jia-Wei-Gui-Pi-Tang [4] - an herbal tea.
- Discontinue coffee use.
[edit] Long term complications
Because at face value PET seems like standard congestion both to yourself and others, a decongestant is usually prescribed which will make the situation worse. The Eustachian tube relies on sticky fluids to keep it closed, and the decongestant will dry the tube out making it stay open even more. Because of the rarity of PET, even ear-nose-throat specialists often misdiagnose it. And sometimes doctors will tell the patient to have a tube surgically inserted into their ear drum to no avail... a tube which puts the patient at constant risk of an ear infection from normal activities like swimming in a lake. And in some cases, exhausted doctors who have tried every treatment might conclude that the patient has a psychological rather than physical disorder.
