Management of patulous eustachian tube with habitual sniffing

Otol Neurotol. 2011 Jul;32(5):790-3. doi: 10.1097/MAO.0b013e3182184e23.


Objectives: Evaluation of the effect of conservative and surgical treatment in patients with patulous Eustachian tube (PET) associated with habitual sniffing.

Study design: Retrospective case review.

Setting: University hospital otolaryngology department.

Patients: Ninety-seven (23.4%) of 414 PET patients were found to have habitual sniffing to alleviate uncomfortable aural symptoms. Of these, 38 PET patients with sniffing habit were selected.

Interventions: Conservative intervention included instructions to stop sniffing and nasal instillation of saline. Surgical interventions used ventilation tube (VT) insertion to the eardrum and/or transmyringeal insertion of the PET plug (PEP).

Main outcome measures: Relief of uncomfortable symptoms and stopping sniffing.

Results: In 52 (53.6%) of the 97 sniff-positive cases, retraction-type eardrum abnormalities or operated ear due to cholesteatoma were identified, whereas normal bilateral eardrums were observed in 34 (87.2%) of 39 sniff (-) cases. Abnormal findings in the eardrum were significantly more common in the sniff-positive group than in the sniff-negative group (p < 0.0001). Twenty-three patients (65.7%) stopped sniffing with conservative treatment. VT insertion was performed in 8 ears. Subsequent PEP was necessary in 2 of the 8 ears because of PET symptoms. PEP was successful in the other 11 ears, including one ear which needed additional VT insertion because of middle ear effusion.

Conclusion: The management of habitual sniffing is difficult, but blocking the Eustachian tube by nasal instillation of saline and/or PEP could help PET patients to stop sniffing.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Ear Diseases / surgery
  • Ear Diseases / therapy*
  • Eustachian Tube / abnormalities*
  • Eustachian Tube / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sodium Chloride / therapeutic use
  • Treatment Outcome
  • Tympanic Membrane / abnormalities*
  • Tympanic Membrane / surgery


  • Sodium Chloride