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A novel computed tomography guided, transcutaneous approach to treat refractory autophony in patients with a patulous Eustachian tube – a case series

Published online by Cambridge University Press:  21 February 2019

A Alli ,
R Shukla ,
J-L Cook  and
A Waddell
A Alli*
Affiliation:
ENT Department, Great Western Hospital NHS Foundation Trust, Swindon, UK
R Shukla
Affiliation:
ENT Department, Great Western Hospital NHS Foundation Trust, Swindon, UK
J-L Cook
Affiliation:
Radiology Department, Great Western Hospital NHS Foundation Trust, Swindon, UK
A Waddell
Affiliation:
ENT Department, Great Western Hospital NHS Foundation Trust, Swindon, UK
*
Author for correspondence: Mr Adebayo Alli, ENT Department, Great Western Hospital NHS Foundation Trust, Marlborough Road, Swindon SN3 6BB, UK E-mail: bayoalli@doctors.org.uk
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Abstract

Background

Patulous Eustachian tube is a benign but notoriously difficult condition to treat successfully. Symptoms include autophony of voice and breathing, and aural fullness.

Methods

This paper presents a series of 8 patients (12 ears) for whom a novel computed tomography guided injection of silicone elastomer suspension implant (Vox) was used to treat patulous Eustachian tube. This is the largest and only series in the current literature using this technique.

Results

The combined complete and partial symptom resolution rate was 91 per cent. Complications related to the procedure are described. The pros and cons of this novel approach are also discussed in relation to traditional endoscopic transnasal techniques.

Conclusion

Computed tomography guided injection of Vox for the treatment of patulous Eustachian tube is suggested to be a feasible alternative to endoscopic transnasal approaches, particularly for refractory cases.

Keywords

Patulous Eustachian Tube
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 3 , March 2019 , pp. 201 - 204
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Mr A Alli takes responsibility for the integrity of the content of the paper

Presented as a poster at the British Association of Otorhinolaryngology (BACO) International conference, 4–6 July 2018, Manchester, UK.

References

1Poe, D. Measurements of Eustachian tube dilation by video endoscopy. Otol Neurotol 2011;32:794–8Google Scholar
2Poe, D. Diagnosis and management of the patulous Eustachian tube. Otol Neurotol 2007;28:668–77Google Scholar
3Mackeith, S, Bottrill, I. Polydimethylsiloxane elastomer injection in the management of the patulous Eustachian tube. J Laryngol Otol 2016;130:805–10Google Scholar
4Muñoz, D, Aedo, C, Der, C. Patulous Eustachian tube in bariatric surgery patients. Otolaryngol Head Neck Surg 2010;143:521–4Google Scholar
5O'Connor, AF, Shea, JJ. Autophony and the patulous Eustachian tube. Laryngoscope 1981;91:1427–35Google Scholar
6Robinson, PJ, Hazell, JW. Patulous Eustachian tube syndrome: the relationship with sensorineural hearing loss. Treatment by Eustachian tube diathermy. J Laryngol Otol 1989;103:739–42Google Scholar
7Rotenberg, B, Busato, G, Agrawal, S. Endoscopic ligation of the patulous Eustachian tube as treatment for autophony. Laryngoscope 2013;123:239–43Google Scholar
8Oh, SJ, Lee, IW, Goh, EK, Kong, SK. Endoscopic autologous cartilage injection for the patulous Eustachian tube. Am J Otolaryngol 2016;37:78–82Google Scholar
9Vaezeafshar, R, Turner, JH, Li, G, Hwang, PH. Endoscopic hydroxyapatite augmentation for patulous Eustachian tube. Laryngoscope 2014;124:62–6Google Scholar
10Schröder, S, Lehmann, M, Sudhoff, HH, Ebmeyer, J. Treatment of the patulous Eustachian tube with soft-tissue bulking agent injections. Otol Neurotol 2015;36:448–52Google Scholar
11Rodrigues, JC, Waddell, A, Cook, JL. A novel, computed tomography guided, trans-cutaneous approach to treat refractory autophony in a patient with a patulous Eustachian tube. J Laryngol Otol 2014;128:182–4Google Scholar