European Archives of Oto-Rhino-Laryngology

, Volume 273, Issue 11, pp 3673–3678 | Cite as

Eardrum thickening approach for the treatment of patulous Eustachian tube

  • Yu Si
  • Yubin Chen
  • Peng Li
  • Huaili Jiang
  • Guo Xu
  • Zhuohao Li
  • Zhigang ZhangEmail author


This study aims to explore the eardrum thickening approach via cartilage myringoplasty for the cessation of symptoms of patulous Eustachian tube (PET), including autophony, aural fullness and breathing synchronous tinnitus. A total of 12 patients who met the diagnosis criteria of PET were included and given an eardrum patching test preoperatively. Then, myringoplasty with ipsilateral full-thickness tragus cartilage under general anesthesia was performed. All patients were followed up for at least 6 months postoperatively. Gross movements of the eardrum under deep respiration disappeared and symptoms were relieved in all patients during the patching test and at 1 month after surgery. All patients were followed up for a length that varied from 6 months to 5 years postoperatively, which demonstrated sustained satisfactory symptom cessation. PET symptoms may have been possibly caused by the gross outward movements of the acoustic transmission system. The eardrum thickening approach via myringoplasty with full-thickness tragus cartilage can be an accessible choice for PET with permanent satisfactory control of symptoms. Furthermore, the preoperative patching test could be a valid way to predict the outcome of the surgery.


Patulous Eustachian tube Cartilage myringoplasty 


Compliance with ethical standards


This work was supported by National Natural Science Foundation of China (81371082).

Conflict of interest

There is not any conflict of financial interest in this research.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the Health Ethics Committee of Sun Yat-Sen University and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Supplementary material

405_2016_4022_MOESM1_ESM.mpg (24.4 mb)
Supplementary material 1 (MPG 24980 kb)
405_2016_4022_MOESM2_ESM.mpg (17.9 mb)
Supplementary material 2 (MPG 18368 kb)


  1. 1.
    Grimmer JF, Poe DS (2005) Update on Eustachian tube dysfunction and the patulous Eustachian tube. Curr Opin Otolaryngol Head Neck Surg 13:277–282CrossRefPubMedGoogle Scholar
  2. 2.
    Poe DS (2007) Diagnosis and management of the patulous Eustachian tube. Otol Neurotol 28:668–677PubMedGoogle Scholar
  3. 3.
    Luxford WM, Sheehy JL (1982) Myringotomy and ventilation tubes: a report of 1568 ears. Laryngoscope 92:1293–1297CrossRefPubMedGoogle Scholar
  4. 4.
    Hussein AA, Adams AS, Turner JH (2015) Surgical management of patulous Eustachian tube: a systematic review. Laryngoscope 125(9):2193–2198CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Rotenberg BW, Busato GM, Agrawal SK (2013) Endoscopic ligation of the patulous Eustachian tube as treatment for autophony. Laryngoscope 123(1):239–243CrossRefPubMedGoogle Scholar
  6. 6.
    Brace MD, Horwich P, Kirkpatrick D et al (2014) Tympanic membrane manipulation to treat symptoms of patulous Eustachian tube. Otol Neurotol 35:1201–1206PubMedGoogle Scholar
  7. 7.
    Diaz RC (2009) Patulous Eustachian tube and Eustachian-tube dysfunction. N Engl J Med 360(21):e27CrossRefPubMedGoogle Scholar
  8. 8.
    Tsuji K, Sone M, Kakibuchi M et al (2002) Bilateral cholesteatoma and habitual sniffing. Auris Nasus Larynx 29:111–114CrossRefPubMedGoogle Scholar
  9. 9.
    Kong SK, Lee IW, Goh EK et al (2011) Autologous cartilage injection for the patulous Eustachian tube. Am J Otolaryngol 32(4):346–348CrossRefPubMedGoogle Scholar
  10. 10.
    Boedts M (2014) paper patching of the tympanic membrane as a symptomatic treatment for patulous Eustachian tube syndrome. J Laryngol Otol 128(3):228–235CrossRefPubMedGoogle Scholar
  11. 11.
    Bartlett C, Pennings R, Ho A et al (2010) simple mass loading of the tympanic membrane to alleviate symptoms of patulous Eustachian tube. J Otolaryngol Head Neck Surg 39(3):259–268PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Yu Si
    • 1
  • Yubin Chen
    • 2
  • Peng Li
    • 2
  • Huaili Jiang
    • 1
  • Guo Xu
    • 1
  • Zhuohao Li
    • 1
  • Zhigang Zhang
    • 1
    Email author
  1. 1.Department of Otolaryngology Head and Neck Surgery, Sun Yat-Sen Memorial Hospital, Institute of Hearing and Speech-Language ScienceSun Yat-sen UniversityGuangzhouPeople’s Republic of China
  2. 2.Department of Otolaryngology Head and Neck SurgeryThe Third Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouPeople’s Republic of China

Personalised recommendations