Patulous Eustachian Tube: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Patulous Eustachian Tube?
An ear, nose, and throat doctor, also called an ENT doctor, usually diagnoses and treats a patulous Eustachian tube. Many people need only an explanation of the condition and some reassurance. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is a patulous Eustachian tube?
The Eustachian tube connects the middle part of the ear to the back of the nose. You have one tube on each side.
Normally the tube is closed. It opens briefly when you swallow. While it is closed, it protects your ear from the sound of your own voice and breathing.
In a patulous Eustachian tube, the tube stays open when it should be closed. The condition is benign, which means it is not dangerous. But it can be very annoying.
Symptoms
Symptoms can include:
- Hearing your own voice or breathing too loudly in your ear. Doctors call this autophony.
- A feeling that the ear is full.
- Popping, discomfort, or pain in the ear.
These symptoms can lower your quality of life. For some people they are very upsetting.
Hearing your own voice too loudly is not always caused by this condition. Other causes include a blocked ear canal, a thin spot in the bone over the inner ear called superior canal dehiscence, and something stuck in the ear, such as hair or wax.
Causes and who gets it
In most cases, doctors do not find a cause. But these have been reported to lead to it:
- Pregnancy.
- Weight loss.
- Radiotherapy, which is radiation treatment for cancer.
- Nerve and brain conditions, called neurological disorders.
- Some medicines, including birth control pills and diuretics, which are water pills.
Anything that keeps the tube from closing at rest can lead to this condition. Do not stop a prescribed medicine on your own. Talk with your doctor first.
How doctors diagnose it
Doctors mostly diagnose it from your symptoms and an exam. There is still no gold standard test for it. The doctor may see your eardrum move in time with your breathing, or may see that it is pulled inward.
Doctors may also check whether symptoms get better when you lie back or when the opening of the tube is blocked, for example with a swab or gel. If they do not, another ear condition may be the cause.
A CT scan taken while you sit up is the test most often used to look at the tube. It is also used before surgery.
Treatment
For many people, an explanation and some reassurance are enough. Doctors also give advice on daily habits. This includes drinking enough fluids, especially in hot weather or after hard exercise, and avoiding weight loss.
Doctors often suggest nasal saline drops as a first step. Saline is salt water. It is the most studied medical treatment, and it has a good safety record. In one study, about two out of three people had their symptoms fully go away, and no side effects were reported. Stopping habitual sniffing may also help.
Research has not shown that estrogen nose cream works.
If you have not improved and your eardrum still moves a lot, other treatments may be tried. These include a paper patch on the eardrum, a small ear tube, and surgery on or in the Eustachian tube, such as a silicone plug or a shim. In one large group treated with a silicone plug, about 83 out of 100 people improved. Side effects can include fluid behind the eardrum or a hole in the eardrum.
No treatment has been shown to work well for everyone, and doctors do not have firm guidelines yet. A step-by-step plan that fits each person is best.
When to see a doctor
See a doctor if you hear your own voice or breathing too loudly in your ear, or if your ear feels full. Other ear conditions can cause similar signs, so a check is worthwhile.
Ask for treatment if the symptoms are upsetting or make daily life hard.
Call 911 or go to the emergency room if you have sudden dizziness, sudden weakness, or a sudden change in vision.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can listen to your symptoms, check your ears, review recent weight loss or medicine changes, and refer you to an ear, nose, and throat doctor.
Common questions
Is a patulous Eustachian tube serious?
No, it is a benign condition, which means it is not dangerous. Still, the symptoms can be very upsetting for some people and can lower quality of life.
Can weight loss cause a patulous Eustachian tube?
Yes, weight loss is one of the reported causes. Doctors also advise people with this condition to avoid weight loss.
Does a patulous Eustachian tube need treatment?
Not always. Many people need only an explanation and some reassurance, and doctors often suggest nasal saline drops as a first step.
Does saline help a patulous Eustachian tube?
Yes, it often does. Nasal saline drops are the most studied medical treatment, and in one study about two out of three people had their symptoms fully go away.
Sources
- PubMed Central - Management of Patulous Eustachian Tube
- PubMed Central - Diagnostic approaches to and management options for patulous eustachian tube
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
