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Can insertion of grommet's tube worsen symptoms of Patulous eustachian tube?

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ENT Specialist
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9 weeks ago I had a grommett inserted in my left ear (I am 53 years of age) after suffering pressure build up and ringing mainly in my left ear after a sinus infection wtih a lot of fluid in both middle ears. The symptons had been going on for approx 4 months and my ENT specilaist said the grommet may relieve the pressure as probably my eustachian was blocked or not opening when it should but added that the fluid was not evident in either middle ear and hadnt been for some time. However the insertion of the grommett made things worse the pressure was still the same if not worse and I had symptons like being able to hear myself talk like having my head in a barrel and real problems with any situations where there were various noises like in a room full of people. This is worse after I exercise and the only relief I seem to get is when I am laying down and have no symptons after sleeping until I get up and then they seem to appear failry quickly again. After doing some research these symptoms seem to be consistent with a Patulous Eustachain Tube ie the tube remains open excessively for prolonged periods. Yesterday I had the grommett removed at my insistence and while talking to my ENT specialist suggested the Patulous Eustachain Tube issue he said that he didnt think that the tube could stay open I am confused can this condition actually occur and I have also read that the insertion of a grommett could in fact worsen the symptoms if you have a Patulous Eustachain Tube, is this the case?
Posted Thu, 19 Apr 2012 in Ear, Nose and Throat Problems
Answered by Dr. Naveen Kumar 2 hours later

Thanks for the query.

Patulous Eustachian tube is a condition wherein there is muscular dysfunction at the nasal end of the tube, which is evidence by the movements of the tympanic membrane (ear drum) with each respiration.

In your history, it has been mentioned that “you had sinus infection following which there was pressure build up in the ear” - This describes that the Eustachian tube was blocked because of the congestion around the Eustachian tube following a sinus infection and the tube was not patulous. If the tube were to be patulous the pressure would not have built up in the middle ear and it would have remained patent. Moreover, your doctor would have definitely noticed the movements of the ear drum on physical as well as the tympanometric examination of the ear, if it were to be patulous.

Autophony due to patulous Eustachian tube is one of the indications for the grommet insertion. Secondly, the autophony noticed by you following grommet insertion is a common phenomenon. And, in our clinical experience it has been noticed that nearly fifty percent of those adults who had undergone grommet insertion were not comfortable following the insertion and hence the grommet was removed after a period 5-10 weeks.

The best remedy for your present condition is to use saline/steroid nasal spray for nasal decongestion and opening of the Eustachian tube.

Hope I have answered your query; I will be available for the follow-up queries.

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
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