title: Patulous Eustachian tube in spontaneous intracranial hypotension syndrome.
abstract: A 48-year-old slender woman presented with a rare case of spontaneous intracranial hypotension syndrome manifesting as patulous Eustachian tube. The patient complained of sudden onset of ear fullness and nasal voice as well as typical orthostatic headache. Patulous Eustachian tube was identified by observation of synchronous movement of the tympanic membrane with respiration and swallowing. The diagnosis of spontaneous intracranial hypotension was confirmed by negative cerebrospinal fluid pressure, and typical magnetic resonance imaging and radioisotope cisternography findings. All symptoms completely resolved within a few days after epidural blood patch treatment. Changes in the venous blood distribution led by collapse of the dural sac of the cervical spine in the standing position presumably caused decreased size of the pterygoid venous plexus around the Eustachian tube.
authors.affiliation: Department of Neurosurgery, University of Yamanashi, Yamanashi, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Horikoshi
authors.forename: Shunichi
authors.initials: S
authors.lastname: Imamura
authors.forename: Zensei
authors.initials: Z
authors.lastname: Matsuzaki
authors.forename: Takako
authors.initials: T
authors.lastname: Umeda
authors.forename: Mikito
authors.initials: M
authors.lastname: Uchida
authors.forename: Kentaro
authors.initials: K
authors.lastname: Mitsuka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kinouchi
mesh_terms: D017217:Blood Patch, Epidural; D015170:Cerebrospinal Fluid Pressure / Q000502:physiology; D005064:Eustachian Tube / Q000098:blood supply / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006261:Headache / Q000209:etiology* / Q000503:physiopathology; D034381:Hearing Loss / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D019585:Intracranial Hypotension / Q000150:complications* / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D012039:Regional Blood Flow; D013577:Syndrome