Expert: Harriet B Jacobster, Au.D. - 4/15/2009

Question
Hi Dr. Jacobster,

For the last 6 weeks I have experienced 24/7 an echo-like wind tunnel sound in my left ear.  The reverb when either I talk or someone else talks is worse than the wind tunnel sound. It is like listening through a broken speaker.  I don't feel pressure, actually the right ear feels pressure and the left feels hollow and a little moist. There is a pulsating feel to it but it does not stop when I press into the neck artery. My Immitance measurements probe and audigram were normal.  I think I might have Abnormal patent eustation tube.  Can this be seen in an MRI?  If not what other tests can I get to possibly diagnose this? Or do you have any thought at what else this might be? I have seen 2 ENT's and they see nothing abnormal in my exams. This condition started after I had a lot of ear itching and kept rubbing my tongue against the back of my throat to try and scratch the ear instead of sticking my fingers in the ear. I have had ear problems most of my life.  Had one of the first myringotomy's performed: over 40 years ago, had lots of ear infections as a child, but nothing like this before.  It is very hard to function and focus with this condition.  Help!

Answer
Hi Susan,
The diagnosis of patent ET is done mainly by symptomology.  The patulous eustachian tube is  diagnosed by noting that people have autophony (hear their own voice in their ear), an abnormal resonance to the voice (due to the tube being open), or the simple expediant of watching the ear drum move while the person breathes. There are no specific tests, nor does a patulous ET show up on MRI. Treatment usually involved the application of topical solutions.

My advice is to discuss your thoughts with the ENT. The only other idea I can think of is finding a teaching hospital that has an ENT division.  The physicians there may be a bit more aggressive in their thinking and treatments.

Hope this helps.
Harriet B. Jacobster, AuD
Board Certified in Audiology