Skip to main content
SpringerLink
Log in

Das Syndrom der klaffenden Tube – neue chirurgische Therapieansätze

The patulous eustachian tube—novel surgical approaches

  • Übersichten
  • Published:
HNO Aims and scope Submit manuscript

Zusammenfassung

Eine klaffende Tube kann insbesondere durch Autophonie, atemsynchrones Ohrgeräusch, Druckgefühl und gestörten Höreindruck zu einer belastenden Einschränkung der Lebensqualität führen. Insbesondere im Zusammenhang mit dem sog. „sniffing“ kann die Entstehung von Cholesteatomen begünstigt werden. Aufgrund eines z. T. diffusen Beschwerdebilds ist die Diagnose der klaffenden Tube oft schwierig. Deshalb ist eine strukturierte Untersuchung mit Erhebung der Symptome, Befunde und apparativer Untersuchung zur sicheren Diagnostik dieser Erkrankung von größter Wichtigkeit. Neben genauen Angaben zu Beschwerden und deren Beeinflussbarkeit sind eine Ohrinspektion mit Beobachtung der Trommelfellbewegung und eine Reflex-decay-Messung in der Tympanometrie besonders hervorzuheben. In dieser Publikation wird die aktuelle Literatur zum Syndrom der klaffenden Tube zusammengefasst und dabei besonderes Gewicht auf die Diskussion möglicher chirurgischer Therapieansätze, wie z. B. die „patulous eustachian tube reconstruction“, den „Kobayashi plug“ oder die Unterspritzung des Torus tubarius mit Vox®-Implants gelegt.

Abstract

A patulous eustachian tube (tuba aperta) may lead to an enormous reduction in quality of life. A patulous eustachian tube can cause symptoms such as autophony, breath synchronous tinnitus, pressure sensation in the ear, and hearing loss. In combination with so-called “sniffing”, it can trigger the development of cholesteatoma. Due to the diffuse symptoms the correct diagnosis of this disease can be challenging. A patulous eustachian tube can be best diagnosed through a well-structured examination including patient history, physical examination with thorough observation of movements of the tympanic membrane, and tympanometry with reflex decay. This publication reviews recent literature on the patulous eustachian tube. We focused on the evaluation of the different surgical strategies such as the patulous eustachian tube reconstruction, the Kobayashi plug or the injection of Vox® implants into the torus tubarius.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5
Abb. 6
Abb. 7

Literatur

  1. Chen DA, Luxford WM (1990) Myringotomy and tube for relief of patulous eustachian tube symptoms. Am J Otol 11(4):272–273

    CAS  PubMed  Google Scholar 

  2. Cheng PW, Young YH, Lou PJ (1999) Patulous eustachian tube in long-term survivors of nasopharyngeal carcinoma. Ann Otol Rhinol Laryngol 108(2):201–204

    CAS  PubMed  Google Scholar 

  3. Doherty JK, Slattery WH 3rd (2003) Autologous fat grafting for the refractory patulous eustachian tube. Otolaryngol Head Neck Surg 128(1):88–91

    Article  PubMed  Google Scholar 

  4. Dyer RK, McElveen JT (1991) The patulous eustachian tube: management options. Otolaryngol Head Neck Surg 105:832–835

    PubMed  Google Scholar 

  5. Grimmer JF, Poe DS (2005) Update on eustachian tube dysfunction and the patulous eustachian tube. Curr Opin Otolaryngol Head Neck Surg 13(5):277–282

    Article  PubMed  Google Scholar 

  6. Henry DF, DiBartolomeo JR (1993) Patulous eustachian tube identification using tympanometry. J Am Acad Audiol 4(1):53–57

    CAS  PubMed  Google Scholar 

  7. Ikeda R, Oshima T, Oshima H et al (2011) Management of patulous eustachian tube with habitual sniffing. Otol Neurotol 32(5):790–793

    Article  PubMed  Google Scholar 

  8. Kikuchi T, Oshima T, Hori Y et al (2009) Three-dimensional computed tomography imaging of the eustachian tube lumen in patients withpatulous eustachian tube. ORL J Otorhinolaryngol Relat Spec 71(6):312–316 (Epub 2009 Dec 17)

    Article  PubMed  Google Scholar 

  9. Kikuchi T, Oshima T, Ogura M et al (2007) Three-dimensional computed tomography imaging in the sitting position for the diagnosis of patulous eustachian tube. Otol Neurotol 28(2):199–203

    Article  PubMed  Google Scholar 

  10. Kirsch CF, Suh JD, Lufkin RB, Canalis RF (2007) False-positive positron-emission tomography-CT of a Teflon granuloma in the parapharyngeal space occurring after treatment for a patulous eustachian tube. AJNR Am J Neuroradiol 28(7):1371–1372

    Article  CAS  PubMed  Google Scholar 

  11. Kong SK, Lee IW, Goh EK, Park SH (2011) Autologous cartilage injection for the patulous eustachian tube. Am J Otolaryngol 32(4):346–348 (Epub 2010 May 14)

    Article  PubMed  Google Scholar 

  12. Leuwer R, Schubert R, Wenzel S et al (2003) Neue Aspekte zur Mechanik der Tuba auditiva. HNO 51:431–438

    Article  CAS  PubMed  Google Scholar 

  13. McGrath AP, Michaelides EM (2011) Use of middle ear immittance testing in the evaluation of patulous eustachian tube. J Am Acad Audiol 22(4):201–207

    Article  PubMed  Google Scholar 

  14. Morita M, Matsunaga T (1988) Effects of an anti-cholinergic on the function of patulous eustachian tube. Acta Otolaryngol Suppl 458:63–66

    Article  CAS  PubMed  Google Scholar 

  15. Ohta S, Sakagami M, Suzuki M, Mishiro Y (2009) Eustachian tube function and habitual sniffing in middle ear cholesteatoma. Otol Neurotol 30(1):48–53

    Article  PubMed  Google Scholar 

  16. Olthoff A, Laskawi R, Kruse E (2007) Successful treatment of autophonia with botulinum toxin: case report. Ann Otol Rhinol Laryngol 116(8):594–598

    PubMed  Google Scholar 

  17. Oshima T, Kikuchi T, Kawase T, Kobayashi T (2010) Nasal instillation of physiological saline for patulous eustachian tube. Acta Otolaryngol 130(5):550–553

    Article  PubMed  Google Scholar 

  18. Poe DS (2007) Diagnosis and management of the patulous eustachian tube. Otol Neurotol 28(5):668–677

    PubMed  Google Scholar 

  19. Poe DS, Pfeffer C (2012) Eustachian tube surgery – new horizons. Current Opinion on Otitis Media with Effusion. 247-268. (ISBN 978-89-6278-520-3)

  20. Reiss M, Reiss G (2000) Patulous eustachian tube – diagnosis and therapy. Wien Med Wochenschr 150(22):454–456

    CAS  PubMed  Google Scholar 

  21. Sato T, Kawase T, Yano H et al (2005) Trans-tympanic silicone plug insertion for chronic patulous eustachian tube. Acta Otolaryngol 125(11):1158–1163

    Article  PubMed  Google Scholar 

  22. Stroud MH, Spector GJ, Maisel RH (1974) Patulous eustachian tube syndrome. Preliminary report of the use of the tensor veli palatine transposition procedure. Arch Otolaryngol 99:419–421

    Article  CAS  PubMed  Google Scholar 

  23. Takano A, Takahashi H, Hatachi K et al (2007) Ligation of eustachian tube for intractable patulous eustachian tube: a preliminary report. Eur Arch Otorhinolaryngol 264(4):353–357 (Epub 2006 Oct 24)

    Article  PubMed  Google Scholar 

  24. Virtanen H, Palva T (1982) Surgical treatmet of patulous eustachian tube. Arch Otolaryngol 108:735–739

    Article  CAS  PubMed  Google Scholar 

  25. Yañez C, Pirrón JA, Mora N (2011) Curvature inversion technique: a novel tuboplastic technique for patulous eustachian tube – a preliminary report. Otolaryngol Head Neck Surg 145(3):446–451 (Epub 2011 Apr 26)

    Article  PubMed  Google Scholar 

  26. Young YH, Cheng PW, Ko JY (1997) A 10-year longitudinal study of tubal function in patients with nasopharyngeal carcinoma after irradiation. Arch Otolaryngol Head Neck Surg 123(9):945–948

    Article  CAS  PubMed  Google Scholar 

Download references

Einhaltung ethischer Richtlinien

Interessenkonflikt. S. Schröder, M. Lehmann, H. Sudhoff und J. Ebmeyer geben an, dass kein Interessenkonflikt besteht.

Alle im vorliegenden Manuskript beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethik-Kommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor.

Author information

Authors and Affiliations

  1. Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Klinikum Bielefeld, Teutoburger Str. 50, 33604, Bielefeld, Deutschland

    S. Schröder , M. Lehmann, H. Sudhoff & J. Ebmeyer

Authors
  1. S. Schröder
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Lehmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H. Sudhoff
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Ebmeyer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. Schröder .

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schröder , S., Lehmann, M., Sudhoff, H. et al. Das Syndrom der klaffenden Tube – neue chirurgische Therapieansätze. HNO 61, 1017–1025 (2013). https://doi.org/10.1007/s00106-013-2773-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00106-013-2773-5

Schlüsselwörter

Keywords

Search

Navigation