Since my illness started, my ear problems became an extreme nuisance. I have researched this problem and believe I have a condition called Patulous Eustachian tube. I definitely have all the symptoms. Because I am being treated for Thyroiditis and Toxicosis, what do you think I should do about this? The only time I am relieved of it is when I am laying down or when I put my head between my knees. Both my ears fill up with air and everything around me becomes muffled. I have asked both the endocrinologist about this, but she isn't addressing it at all. Getting her office to respond and return calls seems impossible. Does anyone have the same problems that can help me?
This is a description of Patulous Eustachian tube:
Patulous Eustachian tube, also known as patent Eustachian tube, is the name of a rare physical disorder where the Eustachian tube, which is normally closed, instead stays intermittently open. When this occurs, the patient experiences autophony, the hearing of self-generated sounds. These sounds, such as one's own breathing, voice, and heartbeat, vibrate directly onto the ear drum and can create a "bucket on the head" effect.
Patulous Eustachian tube sounds very similar to the standard congestion one gets from a cold or allergies, though there are subtle differences. The effect is often described as "drier"; with normal congestion, breathing and talking echo in the head with a muffled sound. With patulous Eustachian tube, all breaths echo on the eardrum without the muffled effect. Similarly, external noises such as the voices of other people are also not muffled. In addition, patulous Eustachian tube generally feels dry with no clogged feeling or sinus pressure.
Some patients with this condition are debilitated by the perceived volume of their voice, causing them to speak very quietly. Their own voice may also sound lower to other people, because with the trachea has more volume when the Eustachian tube is open. The patient may also sound as if they have congestion when speaking. Some sufferers may have difficulty in normal activities. Increased breathing rate, such as that brought on by physical activity, would cause more air to be pushed onto the eardrum more frequently, which can become quite loud and sometimes lead to a period of increased tinnitus after exertion.
Patulous Eustachian tube is a physical disorder. The exact causes may vary depending on the person. Weight loss is a commonly cited cause of the disorder due to the nature of the Eustachian tube itself. Fatty tissues hold the tube closed most of the time in healthy individuals. When circumstances cause overall body fat to diminish, the tissue surrounding the Eustachian tube shrinks and this function is disrupted. While this is seen in severe cases of anorexia nervosa, it may also happen with very small amounts of weight loss in individuals with no eating disorder.
Activities and substances which dehydrate the body have the same effect and are also possible causes of patulous Eustachian tube. Examples are stimulants (including caffeine) and exercise. Exercise may have a more short-term effect than caffeine or weight loss in this regard.
Pregnancy can also be a cause of patulous Eustachian tube due to the effects of pregnancy hormones on surface tension and mucous in the respiratory system.
Patients with patulous eustachian tubes complain of aural fullness, humming tinnitus, and autophony. They also may hear their own breath sounds, which is known as tympanophonia. The sound is synchronous with nasal respiration and resolves when the patient is supine or when upper respiratory tract inflammation occurs. The sounds may be aggravated by mastication.
Symptoms are usually absent when the patient is supine or relieved when the patient bends forward with the head between the knees. For this reason, patients should not be examined in a supine position. Physical examination may reveal a tympanic membrane that moves during forced breathing through one nostril, and an amorphic sound may be heard using a diagnostic tube in the patient's ear.
The eustachian tube is usually closed, and closure is maintained by the elasticity of its cartilage, mucosal lining, surrounding muscles and fat. Alteration of any of these anatomic components may cause patulous eustachian tubes.
Conditions associated with patulous eustachian tubes include: radiation therapy, hormonal therapy, pregnancy, nasal decongestants, fatigue, stress, and weight loss.
Patulous eustachian tubes in the most severe form may be patent at all times, whereas a less severe form has been reported, where the tube is anatomically closed at rest, but may open easily during exercises or in association with a decrease in peritubal extracellular fluid.