Current Treatment Options for Patulous Eustachian Tube: A Review of the Literature.

OBJECTIVE Patulous Eustachian tube (PET) is a clinical condition that is associated with troublesome aural symptoms and is difficult to be treated successfully. The purpose of this review is to examine the published literature regarding the therapeutic value of the current treatment options for PET. METHODS We searched Web of Science, PubMed and Medline from 1999 to 2019. The search focused on papers concerning the clinical evaluation of treatment methods in PET patients. Statistical techniques were not used. RESULTS Prospective and retrospective case series were the types of trials available for review. We included 28 articles that evaluated the efficacy of various conservative and surgical therapeutic options. The recovery rates ranged from 50% to 100%. In most studies the assessment of efficacy was based on the subjective improvement of patient symptoms as there is no validated outcome tool available. No severe adverse events were observed in any study. CONCLUSION On the basis of the available literature, it seems that conservative treatments can be considered as a primary therapeutic option for PET. Concerning the surgical interventions they seem to be a safe and valuable solution in patients with refractory disease. Finally, given the low level of evidence, prospective case-control studies with long follow-up and robust setting looking into the therapeutic approach of PET are required. The need for establishment of standard criteria of PET recovery should be underlined.

[1]  Toshimitsu Kobayashi,et al.  Efficacy of a silicone plug for patulous eustachian tube: A prospective, multicenter case series , 2020, The Laryngoscope.

[2]  Se-Joon Oh,et al.  Management of Acquired Cholesteatoma Associated With Patulous Eustachian Tube and Habitual Sniffing , 2019, Clinical and experimental otorhinolaryngology.

[3]  J. Cook,et al.  A novel computed tomography guided, transcutaneous approach to treat refractory autophony in patients with a patulous Eustachian tube – a case series , 2019, Journal of Laryngology and Otology.

[4]  Ho Yun Lee,et al.  Paper patching for patulous eustachian tube , 2019, Acta oto-laryngologica.

[5]  W. Chao,et al.  Twelve‐month outcomes of Eustachian tube procedures for management of patulous Eustachian tube dysfunction , 2018, The Laryngoscope.

[6]  Toshimitsu Kobayashi,et al.  Diagnostic criteria for Patulous Eustachian Tube: A proposal by the Japan Otological Society. , 2017, Auris, nasus, larynx.

[7]  H. Sudhoff,et al.  Treatment of pharyngotympanic tube dysfunction. , 2017, Auris, nasus, larynx.

[8]  Toshimitsu Kobayashi,et al.  Patulous Eustachian Tube and Otitis Media With Effusion as Complications After Trigeminal Nerve Injury. , 2017, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[9]  Toshimitsu Kobayashi,et al.  Effectiveness of Kobayashi plug for 252 ears with chronic patulous Eustachian tube , 2017, Acta oto-laryngologica.

[10]  Toshimitsu Kobayashi,et al.  Endoscope‐assisted silicone plug insertion for patulous Eustachian tube patients , 2017, The Laryngoscope.

[11]  S. MacKeith,et al.  Polydimethylsiloxane elastomer injection in the management of the patulous eustachian tube , 2016, The Journal of Laryngology & Otology.

[12]  Zhigang Zhang,et al.  Eardrum thickening approach for the treatment of patulous Eustachian tube , 2016, European Archives of Oto-Rhino-Laryngology.

[13]  I. Lee,et al.  Endoscopic autologous cartilage injection for the patulous eustachian tube. , 2016, American journal of otolaryngology.

[14]  H. Nakanishi,et al.  The effect of ventilation tube insertion or trans-tympanic silicone plug insertion on a patulous Eustachian tube , 2016, Acta oto-laryngologica.

[15]  B. Westerberg,et al.  Treatment Effectiveness for Symptoms of Patulous Eustachian Tube: A Systematic Review , 2015, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[16]  I. Lee,et al.  Trans-tympanic catheter insertion for treatment of patulous eustachian tube. , 2015, American journal of otolaryngology.

[17]  J. Turner,et al.  Surgical management of Patulous eustachian tube: A systematic review , 2015, The Laryngoscope.

[18]  H. Sudhoff,et al.  Treatment of the Patulous Eustachian Tube with Soft-Tissue Bulking Agent Injections , 2015, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[19]  B. Rotenberg,et al.  Endoscopic transnasal shim technique for treatment of patulous eustachian tube , 2014, The Laryngoscope.

[20]  M. Bance,et al.  Tympanic Membrane Manipulation to Treat Symptoms of Patulous Eustachian Tube , 2014, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[21]  M. Boedts Paper patching of the tympanic membrane as a symptomatic treatment for patulous eustachian tube syndrome , 2014, The Journal of Laryngology & Otology.

[22]  J. Turner,et al.  Endoscopic hydroxyapatite augmentation for patulous eustachian tube , 2014, The Laryngoscope.

[23]  B. Rotenberg,et al.  Endoscopic ligation of the patulous eustachian tube as treatment for autophony , 2013, The Laryngoscope.

[24]  Toshimitsu Kobayashi,et al.  Management of Patulous Eustachian Tube With Habitual Sniffing , 2011, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[25]  I. Lee,et al.  Autologous cartilage injection for the patulous eustachian tube. , 2011, American journal of otolaryngology.

[26]  N. Mora,et al.  Curvature Inversion Technique , 2011, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[27]  Toshimitsu Kobayashi,et al.  Nasal instillation of physiological saline for patulous eustachian tube , 2010, Acta oto-laryngologica.

[28]  D. Poe Diagnosis and Management of the Patulous Eustachian Tube , 2007, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[29]  H. Kumagami,et al.  Ligation of eustachian tube for intractable patulous eustachian tube: a preliminary report , 2007, European Archives of Oto-Rhino-Laryngology.

[30]  Toshimitsu Kobayashi,et al.  Trans-tympanic silicone plug insertion for chronic patulous Eustachian tube , 2005, Acta oto-laryngologica.

[31]  W. Slattery,et al.  Autologous Fat Grafting for the Refractory Patulous Eustachian Tube , 2003, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[32]  J. Dibartolomeo,et al.  A new medication to control patulous eustachian tube disorders. , 1992, The American journal of otology.

[33]  J. Mcelveen,et al.  The Patulous Eustachian Tube: Management Options , 1991, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[34]  J. Shea,et al.  Autophony and the patulous eustachian tube , 1981, The Laryngoscope.

[35]  J. Pulec Abnormally patent eustachian tubes: Treatment with injection of poly‐tetrafluoroethylene (teflon) paste , 1967, The Laryngoscope.