Bariatric Surgery as a Potential Risk Factor for Patulous Eustachian Tube: A Comprehensive Literature Review

Patulous Eustachian tube (PET) is a condition characterized by abnormally persistent patency of the Eustachian tube, resulting in symptoms such as autophony, aural fullness, and otalgia, with weight loss increasingly reported as a potential risk factor. This review aimed to evaluate the association between bariatric surgery and PET. PubMed, Google Scholar, and Scopus were searched from inception to August 2026 for studies addressing PET, bariatric surgery, weight loss, and Eustachian tube dysfunction. Available evidence, predominantly from small observational studies and case reports, demonstrates an association between PET and rapid weight loss following bariatric surgery. Additionally, similar reports following glucagon-like peptide-1 (GLP-1) agonists and severe malnutrition were observed. Bariatric surgery cannot currently be established as an independent cause of PET. Prospective studies using standardized diagnostic criteria, objective Eustachian tube assessment, and serial weight measurements are required to determine whether the rate of weight loss predicts PET development.