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If you hear a flapping noise in your ear...

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Old August 11th 05, 02:03 AM
Todd Gastaldo
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Default If you hear a flapping noise in your ear...


The fellow described in the case report below heard a flapping noise.

I guess not all patulous eustachian tubes create a flapping noise, but...

"A patulous eustachian tube is associated with pregnancy..."

From the New England Journal of Medicine Volume 353:e5 August 11, 2005
Number 6


Patulous Eustachian Tube

A healthy 26-year-old man reported a three-month history of aural fullness
and a flapping noise in his right ear. Otoscopy revealed inward-and-outward
movements of his right tympanic membrane in time with his nasal respiration
(Video Clip 1). Both the symptoms and the motion in his eardrum were greatly
reduced when he lay down. We diagnosed a patulous eustachian tube,
signifying abnormal patency of the tube. This anomaly permits the movement
of air into and out of the middle ear by means of the eustachian tube during
nasal breathing. The tympanic membrane moved outward when the patient
exhaled, owing to the transmission of positive nasopharyngeal air pressure
(relative to the atmospheric pressure) to the middle ear. When the patient
inhaled, the tympanic membrane moved inward because of the opposite
mechanism. Adopting a recumbent position relieved the symptoms because of
increased venous stasis and passive compression of the eustachian tube.

A patulous eustachian tube is associated with pregnancy, rapid weight loss,
mucosal atrophy (e.g., that due to atrophic rhinitis or occurring after
radiotherapy), or muscular dysfunction. In many instances, however, a
satisfactory explanation cannot be found, as was the case with this patient.
The patient was treated with the insertion of a grommet into the right
tympanic membrane, which led to the resolution of his symptoms.

Siu Kwan Ng, F.R.C.S.Ed.
Charles Andrew van Hasselt, M.M.E.D.
Prince of Wales Hospital
Shatin NT, Hong Kong

END NEJM Patulous Eustachian Tube case report


Old August 11th 05, 05:03 AM
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Posts: n/a

That's one ear thing I've never had. The closest thing I've had was
hearing my pulse when I had excessive ear wax. The only time my
eustachian tube speaks to me is when I purposly flex something in my
head. I think it's my brain muscle.


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