Overview:

Patulous Eustachian Tube (PET, also abbreviated as pET) is a disorder of the Eustachian tube. The Eustachian tube is located in the middle ear and it's responsible for regulating pressure in the ears. PET can manifest unilaterally or bilaterally. When a Eustachian tube is patent, it's unable to properly close. Instead, it will stay open.

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Located at: http://www.umm.edu/patiented/articles/who_gets_chickenpox_shingles_000082_3.htm


Causes:

Some cases of PET are caused by sudden weight loss. The fat that surrounds the Eustachian tubes may dissipate, resulting in less tension on the tubes. This can cause them to stay open. People who have conditions that dry out the Eustachian tube may also experience PET. Eustachian tubes require mucus in order to remain shut, so anything that eliminates or thins mucus is capable of causing PET.

Many PET cases do not have a culprit. This is evident with children who exhibit signs of PET at a young age. Acute otitis media (ear infection) may be indicative of PET, especially during childhood.

Symptoms:

- A sensation of the ear feeling "full" or "plugged."
- Recurring ear infections
- Excess fluid in ears
- Autophony (amplified hearing of internal sounds) that amplifies breathing, speaking, and virtually every noise perceptible with human hearing.

Diagnosis:

A physician will examine the eardrum while the patient speaks. They can make a determination based off of the vibrations. A history of ear infections can also be helpful to a physician. PET is commonly misdiagnosed because patients report that their ears feel "full." This leads providers to believe that they have a different condition that requires a decongestant. Decongestants will not correct PET.

Treatment:

Blue-Tack is currently being evaluated for the treatment of PET. It does not correct the dysfunction of the Eustachian tube, but it alleviates the autophony that accompanies it. It is the most prevalent symptom of PET. The blob of Blue-Tack reduces unnecessary vibrations in the eardrum. It is a painless and swift procedure that can be performed by a physician. Blue-Tack may be the most promising hope for PET if it's approved for widespread treatment.

The Blue-Tack must be replaced. Applications have lasted for as long as six months in trials.

Surgery can be performed on patients with PET. The Eustachian tube itself can be modified so that symptoms of PET are alleviated.

Patients suffering from PET can attempt to equalize their pressure by using the Valsalva manoeuvre and the reverse Valsalva manoeuvre. These techniques are also commonly used by divers and by patients who need to stabilize from supraventricular tachycardia.

References:
http://www.dailymail.co.uk/health/article-1208835/Could-blob-Blue-Tack-really-help-hear-better.html
http://www.hearing.yale.edu/care/adult/diseases/tube_dysfunction.aspx
http://www.ems1.com/ems-products/education/articles/397955-The-Valsalva-Maneuver/
http://www.webmd.com/a-to-z-guides/patulous-eustachian-tube
http://www.dallasear.com/conditions-patulous-eustachian-tubes.html

Image References:
http://www.umm.edu/patiented/articles/who_gets_chickenpox_shingles_000082_3.htm