What is the Patulous Eustachian Tube?

G.W. Poulos

A patulous eustachian tube is a physical ailment where the eustachian tubes open at inappropriate times instead of remaining closed. This condition allows sounds to travel to the inner ears from the throat and often causes a condition referred to as “bucket head,” where the afflicted hear their own voices with an echo as though they were speaking in a confined space, as with buckets over their heads. Many who suffer from patulous eustachian tubes can also hear their own heartbeats and breathing at abnormally loud levels.

Sudden weight loss can affect the function of the eustachian tube.
Sudden weight loss can affect the function of the eustachian tube.

The eustachian tubes are pathways that connect the inner ears to the upper throat and normally open briefly when a person swallows to adjust the pressure behind the inner ear to match the pressure exerted on the eardrum. In people with a patulous eustachian tube, patulous meaning “spreading,” one or both eustachian tubes open and remain open. This allows sounds and pressure variations, such as occur with the heartbeat, to inappropriately travel though the eustachian tubes to the inner ear.

Pregnant women may experience patulous eustachian tube as a result of hormonal changes.
Pregnant women may experience patulous eustachian tube as a result of hormonal changes.

The severity of a patulous eustachian tube can vary from person to person. In more severe cases the sounds of breathing and the pulse can become so loud as to interfere with the person’s ability to speak properly. It can also cause the sounds created when talking to seem much louder than they actually are, leading someone afflicted with the condition to speak abnormally softly, making conversations difficult. Other symptoms can be a feeling of the ears being congested or stuffed up, an uncomfortable pressure in the ears, and extremely loud ringing in the ears.

It is often difficult for physicians to determine the exact cause of a patulous eustachian tube because there are many things that can lead to the condition. Sudden weight loss, caused by either a change in diet or illness, can change the amount of fatty tissue surrounding the eustachian tubes and affect their operation. Dehydration can also affect the volume of the tissues surrounding the eustachian tubes, causing the illness to present itself. In pregnant women, changes in hormone levels can affect the tension of the tissue in the eustachian tubes themselves, causing the condition. Additionally, patulous eustachian tube can present in some people as a result of strenuous exercise or caffeine use.

Treatment of patulous eustachian tube varies with the severity of the affliction. In some mild cases, the repositioning of one’s head and slight modifications to lifestyle is all that is needed. In moderate to severe cases, drugs are administered that cause a slight swelling of the tissue surrounding the eustachian tubes. In the most severe instances, surgery to change the volume of tissue surrounding the tubes is performed; however, the results are not always sufficient to eliminate the symptoms entirely. A new treatment under clinical study is the application of Blu-Tack, an adhesive-like substance similar to the glue on Post-It® notes. Applied to the eardrum, it can dampen the vibrations of the eardrum caused by patulous eustachian tube.

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Discussion Comments


I finally figured out what to call this. This happens to me from time to time. Usually, I can fix it within a few hours by working my jaw, swallowing, clearing my ears, and putting pressure behind my upper jaw/behind earlobe region. I've tried to describe it to people but they never understand it and it's a problem when I have to present something in class, but even speaking quietly sounds so loud.

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