The patulous Eustachian tube and chronic middle ear disease

The function of the Eustachian tube was tested preoperatively by sonotubometry in 100 ears subjected to surgery for chronic ear disease. 36 ears showed no tubal passage for sound during swallowing and the surgical intervention revealed cholesteatoma in 17 of these cases. In 64 cases sonotubometry gave positive results preoperatively and among these cholesteatoma was found in 26 ears. One patient had a continuously patent tube with typical symptoms and only cutting of the tensor veli palatini muscle tendon revealed the symptoms after reconstructive ear surgery. In another patient the tube opened well on swallowing, remained patent for some time, and closed slowly. This finding was unexpected and the patient had no complaints associated with the tubal function. The patulous tube is a rare condition (1-2%) in patients with chronic middle ear disease but should be diagnosed before surgery and followed carefully postoperatively.