Patulous tube syndrome, or patulous dysfunction of the Eustachian tube, is a form of Eustachian tube dysfunction in which the tube remains abnormally open, allowing transmission of nasopharyngeal pressure to the middle ear.
During strong inspiration (i.e 'sniff') transmits negative pressure to the middle ear and tympanic membrane retraction of the tympanic membrane and even acquired cholesteatomas secondary to retraction pockets.
Although commonly idiopathic, patulous tube syndrome is more frequently seen with:
On imaging, the diagnosis can be suggested by wide patency of the Eustachian tube, often associated with failure to visualize Ostmann's fat pad (inferolateral to the Eustachian tube and thought to contribute to tubal occlusion).
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