A case of patulous Eustachian tube associated with dizziness induced by nasal respiration

Abstract

Objective: To determine the relationship between Eustachian tube function and inner ear function in patulous Eustachian tube (pET).

Methods: We encountered a patient with pET accompanied by dizziness that was induced by nasal respiration. Eye movements were recorded using video-oculography, and Eustachian tube function was assessed using a Eustachian tube function analyzer. Horizontal and vertical components of pupil position were assessed to test fixation, positional, and positioning nystagmus. Impedance testing with a Eustachian tube function analyzer was performed to confirm tympanometry results. We recorded these outcomes until the patient's symptoms improved.

Results: When pET improved, the patient's symptoms were alleviated.

Conclusion: The present pET patient had mild vestibular symptoms. Therefore, pET patients with dizziness might be misdiagnosed with, for example, superior semicircular canal dehiscence, psychogenic vertigo, or Ménière's disease. For patients with few clinical symptoms or laboratory findings, clinicians need to consider dizziness-induced pET as a possible diagnosis.

Keywords: Dizziness; Impedance testing; Nasal respiration; Patulous Eustachian tube; Video-oculography.