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  1. #1
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    Angry Ever heard of this ear problem? Patulous Eustachian Tube

    I been having this problem with my ears being plugged up for 3 weeks and it sucks because it screws with me so i cant work out!
    I went to my doctor and he seen an ear infection in my r-ear so he flushed out my ear with peroxide and warm water. He gave me some antibiotics and the swelling is gone but my ears are still plugged. He told me its my eustachian tube and to come back in 3 weeks and follow up
    I did a little workout after 3 weeks this morning and it started messing with me as i was feeing off balance. It went away after a few minutes and i was able to finish.

    So today i went to see an ENT. I dont know about this guy. He asked me what my symptoms were and i told him my ears are plugged. He checked both them out and said " i dont see any wax, your ears are clean" then jumps to the conclusion that i have PET = Patulous Eustachian Tube. He broke out this peace of paper explaining it and showed me a diagram of the ET. Says to go back Tuesday and do a hearing test and we'll talk more. He said what caused it is because i have low body fat. Im like WTF!!!!!!!!!!! Im 6'4 225 at about 7% bf. He put the blame on that. So i have an appt. to go back tuesday to do some hearing test. I only seen this ENT for 10 minutes....it's like he was in a hurry to get me out of there. He told me that the antibiotic my other doc gave me wont work, but it took away the swelling from the ear infection, and this ENT didnt even see any swelling so it did work. What'll happen now is he will want to do surgery to cash out on me it sounds like. He told me to lay off the workouts and ear more and put on body fat and it will go away.

    I did a search on this PET, and i dont have any of the conditions that it says talking about echo, hear myself speak, ringing noises, roaring noises and all that other crap. The only thing i have is plugged up ears and i had an ear infection which doesnt appear to be there anymore after the antibiotics.

    I attached a description of this PET. What are your thoughts? Should i trust this ENT, or should i pass and get a 2nd opinion. Hopefully this time the ENT will actually ask me what my symptoms are.

    Frequency: Incidence of patulous eustachian tube is 0.3-6.6%, and 10-20% of persons who have it are bothered enough by symptoms to seek medical attention. This condition is more common in females than in males and is usually present in adolescents and adults; it is rarely found in young children.

    Etiology: In most instances, patulous eustachian tube is idiopathic. Weight loss (sometimes caused by chronic illness) and pregnancy are identified as important predisposing factors. Neurologic disorders that may cause muscle atrophy (eg, stroke, multiple sclerosis, motor neuron disease) have been implicated. Adhesion formation in the nasopharynx following adenoidectomy or radiotherapy may also predispose individuals to a patulous tube. The condition is sometimes associated with medications (eg, oral contraceptives, diuretics). Other predisposing factors include fatigue, stress, anxiety, exercise, and temporomandibular joint syndrome.

    Pathophysiology: Under normal resting conditions, the eustachian tube is closed and only opens with swallowing or autoinflation. In unaffected individuals, closure of the eustachian tube is maintained by luminal and extraluminal factors, which include intrinsic elasticity of the tube, surface tension of moist luminal surface, and extraluminal tissue pressure. Muscle tone of tensor veli palatini dilates the lumen; damage to tensor veli palatini following cleft palate surgery may produce a patulous tube. Weight loss can also lead to abnormal patency caused by reduced tissue pressure and loss of fat deposits in the eustachian tube region. Pregnancy alters opening pressures of the eustachian tube because of the change in surface tension; estrogens acting on prostaglandin E affect surfactant production. Scarring in the postnasal space following adenoidectomy may result in traction of the tube in a patent position.

    Clinical:

    History

    Major symptoms of patulous eustachian tube include fluctuating aural fullness, roaring tinnitus synchronous with nasal respiration, audible respiratory sounds, distorted autophony (ie, the abnormal perception of one’s own breath and voice sounds) with echoing occasionally severe enough to interfere with speech production, and sensation of plugged ear. Autophony is the most frequent symptom associated with patulous tube.

    Vertigo and hearing loss can also occur because patulous eustachian tube allows excessive pressure changes to occur in the middle ear; these pressure changes are then transmitted to the inner ear through ossicular movement. Some patients may have difficulty eating because the noise of chewing is transmitted to the ear. Patulous eustachian tube is often misdiagnosed because symptoms mimic those of middle ear effusion. Symptoms may relate to cyclical changes occurring in the mucosa of the eustachian tube. Some patients find relief from the associated increased mucosal congestion by lying down, by putting the head between the knees, or during upper respiratory tract infection. Compression of the jugular veins produces peritubular venous congestion and may relieve symptoms. Patients sometimes sniff repetitively to close the eustachian tube, and this may lead to long-term negative middle ear pressure. Decongestants or a ventilation tube in the drum can worsen symptoms.

    Diagnosis can often be made based on history alone.
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  2. #2
    I am Powerlifter the next arnold's Avatar
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    the next arnold is offline
    stick with the old doctor and the AB. this new doc sounds like a smacktard
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  3. #3
    Banned scrilla's Avatar
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    scrilla is offline
    Im skipping his hearing test since i dont have any hearing problems

    Though i do have a different apt with a different ENT on tuesday. I'll see what this guy has to say

    Dam!
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