["Step-up"surgical treatment strategy for patulous Eustachian tube]

Patients with patulous Eustachian tubes(PET) usually suffer from annoying symptoms, such as tinnitus, autophony and aural fullness, due to the excessive opening of the Eustachian tube. There is no uniform standard of treatment, and conservative therapy combined with"Stepup"surgical intervention strategy is the main treatment. In this article, we reviewed various surgical treatments of patulous Eustachian tube in recent years, including key points of surgical operation, effectiveness, safety and complications. Full communication and evaluation are needed to establish appropriate patients' expectations preoperatively. A "Stepup" treatment strategy will be carried out, including conservative treatment, tympanic membrane surgery, Eustachian tube pharyngeal orifice constriction surgery, Eustachian tube tympanic orifice plug surgery and Eustachian tube muscle surgery, which aims to maintain normal Eustachian tube function and good middle ear ventilation.