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A novel, computed tomography guided, trans-cutaneous approach to treat refractory autophony in a patient with a patulous eustachian tube

Published online by Cambridge University Press:  27 January 2014

J C L Rodrigues ,
A Waddell  and
J-L Cook
J C L Rodrigues*
Affiliation:
Department of Radiology, Great Western Hospital, Swindon, UK
A Waddell
Affiliation:
Department of Ear, Nose and Throat, Great Western Hospital, Swindon, UK
J-L Cook
Affiliation:
Department of Radiology, Great Western Hospital, Swindon, UK
*
Address for correspondence: Dr Jonathan C L Rodrigues, Department of Radiology, Great Western Hospital, Great Western NHS Foundation Trust, Malborough Rd, Swindon SN3 6BB, UK Fax: +44 (0)1793 604795 E-mail: [email protected]
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Abstract

Objective:

We report a novel, computed tomography guided treatment for autophony associated with a patulous eustachian tube.

Methods:

Case report and literature review of the management of patulous eustachian tube.

Results:

A 36-year-old woman presented with disabling autophony. Otoscopic examination revealed a poorly mobile right tympanic membrane. High resolution temporal bone computed tomography excluded superior semicircular canal dehiscence. The patient was diagnosed with patulous eustachian tube but failed to achieve therapeutic benefit from conventional endoscopic placement of a silicone elastomer suspension implant adjacent to the eustachian tube. Subsequently, she underwent further silicone elastomer suspension implant placement via a trans-cutaneous, computed tomography guided approach. The patient achieved prompt symptomatic relief and remained symptom-free at six-month follow up.

Conclusion:

This is the first published description of treatment of patulous eustachian tube using a computed tomography guided, trans-cutaneous approach. It serves to highlight to otolaryngologists the fact that computed tomography guided treatment of patulous eustachian tube may control disabling symptoms in patients who have failed to respond to convention endoscopic management.

Keywords

Eustachian TubeMultidetector Computed TomographyPathologyMedical Imaging
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 2 , February 2014 , pp. 182 - 184
Copyright
Copyright © JLO (1984) Limited 2014 

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References

1Poe, DS. Diagnosis and management of the patulous Eustachian tube. Otol Neurotol 2007;28:668–77CrossRefGoogle ScholarPubMed
2Crane, BT, Lin, FR, Minor, LB, Carey, JP. Improvement in autophony symptoms after superior canal dehiscence repair. Otol Neurotol 2010;31:140–6CrossRefGoogle ScholarPubMed
3Grimmer, JF, Poe, DS. Update on Eustachian tube dysfunction and the patulous Eustachian tube. Curr Opin Otolaryngol Head Neck Surg 2005;13:277–82Google Scholar
4Oshima, T, Kikuchi, T, Kawase, T, Kobayashi, T. Nasal instillation of physiological saline for patulous Eustachian tube. Acta Otolaryngol 2010;130:550–3Google Scholar
5Bartlett, 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 Scholar
6Rotenberg, BW, Busato, GM, Agrawal, SK. Endoscopic ligation of the patulous Eustachian tube as treatment for autophony. Laryngoscope 2013;123:239–43CrossRefGoogle ScholarPubMed
7Yañez, C, Pirrón, JA, Mora, N. Curvature inversion technique: a novel tuboplastic technique for patulous Eustachian tube – a preliminary report. Otolaryngol Head Neck Surg 2011;145:446–51Google Scholar
8Kong, SK, Lee, IW, Goh, EK, Park, SH. Autologous cartilage injection for the patulous Eustachian tube. Am J Otolaryngol 2011;32:346–8Google Scholar
9Vaezeafshar, R, Turner, JH, Li, G, Hwang, PH. Endoscopic hydroxyapatite augmentation for patulous Eustachian tube. Laryngoscope 2013, in pressGoogle Scholar