title: Simple mass loading of the tympanic membrane to alleviate symptoms of patulous eustachian tube.
abstract: BACKGROUND
  Patulous eustachian tube (PET) has a major impact on a patient's quality of life. The purpose of this study was to understand mechanisms behind the symptoms, develop treatments based on these, and develop and use a questionnaire to measure changes in PET symptoms with a novel intervention. Our hypothesis is that PET symptoms can be addressed at the level of the eardrum more easily than at the level of the eustachian tube.
  
  
  METHODS
  In a population of 14 PET subjects and 6 fresh temporal bones, several investigations were performed. Nasal audiometry was used to measure frequencies preferentially transmitted to the ear in PET subjects. An intervention consisting of mass loading of the eardrum was devised in the temporal bones to damp these frequencies. This was then applied to subjects with PET. A questionnaire was developed and administered to measure the response to this intervention. This questionnaire included the more common symptoms associated with PET, such as echoing sounds, increased environmental sounds, and a plugging sensation in the ear. Mass loading of the eardrum was performed with Blu Tack, a clay-like, nontoxic substance.
  
  
  CONCLUSIONS
  Low frequencies are preferentially transmitted in PET, and eardrum vibrations to these can be mitigated with mass loading. Mass loading in human subjects significantly reduced major symptoms of PET, although temporarily.
authors.affiliation: Department of Surgery, Dalhousie University, Halifax, Nova Scotia. clarkbartlett@gmail.com
authors.forename: Clark
authors.initials: C
authors.lastname: Bartlett
authors.forename: Ronald
authors.initials: R
authors.lastname: Pennings
authors.forename: Allan
authors.initials: A
authors.lastname: Ho
authors.forename: David
authors.initials: D
authors.lastname: Kirkpatrick
authors.forename: Rene
authors.initials: R
authors.lastname: van Wijhe
authors.forename: Manohar
authors.initials: M
authors.lastname: Bance
mesh_terms: D000328:Adult; D004427:Ear Diseases / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D005064:Eustachian Tube / Q000187:drug effects* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D011312:Pressure; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014432:Tympanic Membrane / Q000502:physiology*