Article
The patulous Eustachian tube: Long-term results after conservative treatment
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Authors
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Sören Wenzel
- ENT-Department, Hamburg University Medical School, Germany
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Hartwig Seedorf
- Department of Dental Prosthetics, Hamburg University Medical School, Germany
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Thomas Kucinski
- 3Department of Neuroradiology, Hamburg University Medical School, Germany
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Rudolf Leuwer
- ENT-Department, Hamburg University Medical School, Germany
| Published: | September 22, 2005 |
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Outline
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Objectives: Treatment outcomes of patients with patulous eustachian tube (pET) disorder are often poor. On the basis of the functional synergy between the medial pterygoid muscle and the tensor veli palatini muscle a conservative therapy was developed. The aim of the study was to assess its long-term outcome. Besides a safe and definitive surgical method was to be evolved for refractory cases.
Methods: In a study of twenty-one concurrent patients with pET symptoms the diagnostic procedures, the therapeutical approaches and the outcome after at least six months were investigated. The patients attended a special physical therapy and occlusal splints to train and strengthen the medial pterygoid.
Results: Seven patients showed a complete and lasting resolution of their complaints six monthes after the physical therapy. The distressing symptoms were improved significantly in thirteen patients who required no further treatment. One patient had no positive effect after the conservative therapy.
Conclusion: If we look at the rate of success and the negligible invasiveness of the musclar physical therapy, irrespective of the pathogenesis, the training of the medial pterygoid and the tensor veli palatini muscle should be the first therapeutic step. In the case of persistent or recurrent complaints of the pET, obstructing surgical augmentation of the tubal environment with autogenous cartilage chips could follow.
