Successful treatment of autophonia with botulinum toxin: case report.
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.
Olthoff
Arno
A
Department of Phoniatrics and Pedaudiology, University of Göttingen, Göttingen, Germany.
Laskawi
Rainer
R
Kruse
Eberhard
E
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
D019274:Botulinum Toxins, Type A