What is Patulous eustachian tube, the disorder affecting Celine Dion?

TORONTO – The hearing condition that has caused pop star Celine Dion to cancel some upcoming Las Vegas shows is known as Patulous eustachian tube. So just what is it and why does it occur?

Patulous eustachian tube is a disorder in which the channel that runs between the middle ear and throat, regulating pressure around the ear drum, stays open. Normally, the eustachian tubes in the ears remain closed and open only occasionally to equalize air pressure between the middle ear and the exterior environment.

Sneezing, swallowing or yawning causes the eustachian tubes to open, which keeps air pressure and fluid from building up inside the ears.

The cause of the Patulous eustachian tube is unknown, but risk factors include weight loss and pregnancy, fatigue, stress, exercise, and temporomandibular joint syndrome in the jaw. Some cases have been linked to medications such as oral contraceptives or diuretics (water pills) that increase urine secretion. Stroke, multiple sclerosis and motor neuron disease also have been implicated.

Symptoms include “distorted autophony” — hearing one’s own voice or breathing, an echoing effect that can interfere with speech — as well as sensations of wave-like sounds that interfere with auditory perception and a feeling of fullness in the ear. In severe cases, vertigo and hearing loss may occur.

There is no standard treatment, but some people are able to temporarily alleviate symptoms with positional manoeuvres, such as lying down or lowering their head between their knees.

Patients may also be advised to avoid diuretics and to increase body weight, says the U.S. National Institutes of Health on its website. Certain nasal medications may help to reduce symptoms in some patients, while surgical treatment may be recommended for others.