Abstract
The function of the E-tube is to adjust the balance of both sides of the ear drum. The patulous Eustachian tube (PET) is a rare disease and a benign condition. So, most of the doctors ignored this disease. But, patients with PET suffer from ear fullness, autophony, hearing their own breathing, and etc. Many treatment methods have been introduced and injection is also one way of treating the disease. We introduce an injection technique for the treatment of PET using calcium hydroxylapatitie (Radiesse®).
1
Introduction
The Eustachian tube (ET) plays a crucial role in the regulation of the middle ear pressure. It is usually closed but opens temporarily during swallowing.
The patulous Eustachian tube (PET) is a condition in which the lumen remains anatomically open, even at rest. Predisposing factors are weight loss, fatigue, stress, caffeine and pregnancy . Patients with PET are suffering from various symptoms such as aural fullness, autophonia, audition of breathing sound by the ear, and fluctuating sensation of the tympanic membrane upon respiration . The symptom is being relaxed in the position, such as lying down or, sitting in a chair with the head between the knees. Various methods have been used for the treatment of PET, including medical and surgical procedures.
We introduce an injection technique for the treatment of PET using calcium hydroxylapatite (Radiesse®).
2
Case reports
A 39-year-old man complained of right ear autophonia and vibration of hearing sound. He was being treated for pancreatic cancer and had lost weight recently. Both ear drums are intact but the right tympanic membrane vibrated with every breath taken by the patient. We performed nasopharyngoscope and diagnosed PET ( Fig. 1 A ). We used ipratropium bromide (Rhinovent®) nasal spray for 2 months, but the symptom did not improve. We decided to use calcium hydroxylapatite injection for the treatment of PET.
Under topical anesthesia, a nasal packing was performed with a gauze soaked with a mixture of 2% lidocaine and 1:100,000 epinephrine. We used 23-gauge needle and injected the calcium hydroxylapatite submucosally into the anterior (0.8 mL) and posterior aspects (0.8 mL) of the nasopharyngeal ET orifice using a 30°, 4-mm nasal endoscope ( Fig. 1 B). The patient achieved complete symptomatic relief. One year postoperatively, he remains free of symptoms.
2
Case reports
A 39-year-old man complained of right ear autophonia and vibration of hearing sound. He was being treated for pancreatic cancer and had lost weight recently. Both ear drums are intact but the right tympanic membrane vibrated with every breath taken by the patient. We performed nasopharyngoscope and diagnosed PET ( Fig. 1 A ). We used ipratropium bromide (Rhinovent®) nasal spray for 2 months, but the symptom did not improve. We decided to use calcium hydroxylapatite injection for the treatment of PET.
