Definition Eustachian tube patency describes a condition in which the eustachian tube is continually open. The eustachian tube is a structure in the ear that runs from behind the eardrum to the back part of the nasal cavity.
What is going on in the body? Normally, the eustachian tube is closed at the back of the nasal cavity. It can open during swallowing or yawning to equal the air pressure on either side of the eardrum. In a eustachian tube patency, the canal is constantly open. As a result, there is greater chance of infections spreading into the middle ear space.
What are the signs and symptoms of the condition? A common complaint is the sensation of ear plugging or fullness that improves with "popping" the ear. It is also difficult to control the volume of speech. Some people complain that their speech has an echo quality as if they are speaking through a barrel. Symptoms are often worse later in the day than in the morning. This is because the mucous membranes in the nose and sinuses swell when people lie down, causing partial closure of the ear canal.
What are the causes and risks of the condition? In most cases, the cause of eustachian tube patency is unclear. It is often seen in a person who has lost an excessive amount of weight. One theory is that the loss of fat tissue around the canal allows it to be constantly open. Other possible causes are radiation therapy and Down syndrome.
What can be done to prevent the condition? Because there is no clear cause, there is no known way to prevent this.
How is the condition diagnosed? During the physical examination, the doctor will see an eardrum that moves in and out with breathing. Sometimes the doctor will perform a tympanogram, which is a procedure used to indirectly measure the pressure behind the eardrum.
What are the long-term effects of the condition? There is an increased risk of chronic infections of the middle ear, known as chronic otitis media, in a person with eustachian tube patency.
What are the risks to others? There is no risk to others, as the condition is not contagious.
What are the treatments for the condition? While there is no adequate treatment for this condition, some people respond to nasal steroid sprays. Insertion of an ear tube in the eardrum is helpful for some individuals. In severe cases, injection of Teflon under the lining of the tube may close it. Another extreme case involves plugging the eustachian tube surgically.
What are the side effects of the treatments? Nasal steroid sprays can reduce mucous membrane thickness, worsening the problem. An ear tube can cause infection if soapy or contaminated water enters through its opening. When the tube falls out, some people are left with a hole in the eardrum.
After surgery to close the eustachian tube, a person may development a chronic infection of the middle ear, known as chronic otitis media, or mastoiditis, an infection of the bone behind the ear.
What happens after treatment for the condition? Symptoms usually resolve with successful treatment.
How is the condition monitored? Any new or worsening symptoms should be reported to the doctor.
Author: Mark Loury, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
