title: Successful treatment of autophonia with botulinum toxin: case report.
abstract: OBJECTIVE
  We sought to treat autophonia due to a patulous eustachian tube using botulinum toxin.
  
  
  METHODS
  Because we assumed that the patulous eustachian tube was caused by abnormal activity of paratubal muscles (tensor and levator veli palatini muscles and salpingopharyngeus muscle), paralysis was performed via injection of botulinum toxin type A in a 45-year-old female professional musician who had had chronic unilateral autophonia for 20 years. In addition to a patient interview, an endoscopic examination of the nasopharynx (posterior rhinoscopy), ear microscopy, and impedance audiometry were performed to verify the diagnosis and the outcome after treatment.
  
  
  RESULTS
  The autophonia disappeared 1 week after treatment. Normalized tympanic ventilation was verified by impedance audiometry after 8 weeks. The period of symptom relief was 9 months.
  
  
  CONCLUSIONS
  The administration of botulinum toxin type A provides a new option in the treatment of patulous eustachian tube. The reliability of this method and the effect of repeated injections remains to be proved in future studies.
authors.affiliation: Department of Phoniatrics and Pedaudiology, University of Göttingen, Göttingen, Germany.
authors.forename: Arno
authors.initials: A
authors.lastname: Olthoff
authors.forename: Rainer
authors.initials: R
authors.lastname: Laskawi
authors.forename: Eberhard
authors.initials: E
authors.lastname: Kruse
mesh_terms: D000158:Acoustic Impedance Tests; D001301:Audiometry, Pure-Tone; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D004724:Endoscopy; D005064:Eustachian Tube / Q000187:drug effects / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007273:Injections, Intramuscular; D008875:Middle Aged; D010160:Palate, Soft / Q000187:drug effects*; D014012:Tinnitus / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D019274:Botulinum Toxins, Type A