Patulous eustachian tube is a benign but symptomatically troubling condition in which the eustachian tube stays open most of the time. The eustachian tube is the tube that runs between the middle ear and throat and regulates the ear pressure around the ear drum. Under normal circumstances, it remains closed most of the time, opening only on occasion to equalize air pressure between the middle ear and the exterior environment. Major symptoms include distorted autophony (hearing one's own voice or breathing), echoing which may interfere with speech production, wave-like sounds, and a sensation of fullness in the ear. In severe cases, vertigo and hearing loss may occur. Over time, individuals with patulous eustachian tube may develop serious and even extreme responses to the abnormal sounds and other findings.

In most cases, the cause of patulous eustachian tube is unknown. Weight loss and pregnancy may be predisposing factors. Neurologic disorders that cause muscle atrophy such as stroke, multiple sclerosis, and motor neuron disease have been implicated in some cases of patulous eustachian tube. Other cases may be associated with medications such as oral contraceptives or diuretics. Other predisposing factors include fatigue, stress, anxiety, exercise, and temporomandibular joint syndrome.

Many treatments have been proposed, however none have shown consistent effectiveness.

• Weight loss (sometimes cause by a chronic illness)
• Pregnancy
• Neurological disorders that cause muscle loss (stroke, multiple sclerosis)
• Scarring and joining of tissues in the nasopharynx following adenoidectomy or radiation therapy
• Certain medications (birth control pills, diuretics)
• Exhaustion
• Stress and anxiety
• Exercise
• Temporomandibular joint syndrome

While no standard treatment has been found to work for every patient, there are several options that have been used to successfully manage the symptoms in a number of individuals. Patients are often advised to recline or lower the head between the knees when symptoms occur. They may also be advised to avoid diuretics and/or increase weight. Nasal sprays, drops, or topical nasal administration of medications containing anticholinergics, estrogen, diluted hydrochloric acid, chlorobutanol, or benzyl alcohol may work in reducing symptoms in some patients. Surgical treatment may be indicated in some cases.