Extensive Turbinate Surgery: A Potential Risk Factor for a Patulous Eustachian Tube.

Area of Science:

• Otolaryngology
• Surgical Complications
• Anatomy

Background:

• Patulous Eustachian tube (PET) is a rare condition characterized by the abnormal patency of the Eustachian tube.
• While various factors are associated with PET, its development following turbinate surgery is not well-documented.

Purpose of the Study:

• To describe patients who developed PET after turbinate surgery.
• To investigate potential anatomical and clinical factors contributing to iatrogenic PET.

Main Methods:

• Retrospective case series of three patients presenting with PET post-turbinate surgery.
• Review of clinical presentation, tympanic membrane mobility, nasal endoscopic findings, and patient history.

Main Results:

• All patients developed autophony weeks to months after surgery.
• Nasal endoscopy revealed postoperative fibrosis/adhesions near the Eustachian tube orifice causing abnormal patency.
• One patient improved after Eustachian tube shim insertion.

Conclusions:

• Turbinate surgery may contribute to PET development, especially with postoperative fibrosis near the Eustachian tube orifice.
• Local anatomical changes post-surgery are critical factors, with weight loss being a potential permissive factor.
• Awareness and careful surgical technique are crucial to minimize the risk of iatrogenic PET.