It has been found that there is definitely an association between pregnancy and patulous ET. One possible explanation for the "pregnancy link" has to do with the general softening of certain connective tissues that occurs during pregnancy. This is a direct result of the hormonal shifts of pregnancy.
There is also a clear association with weight loss. Even weight losses as trivial as 10 pounds or less can cause patulous ET. It is believed that there is some fat surrounding the ET; perhaps this fat helps to keep the ET in its usual (closed) condition. Lose the fat, and the ET flops open.
There is also a relationship with allergy, it is an inverse one. People with allergies report that their patulous ET routinely improved during an allergy season. This may be because allergies cause mucosal edema (swelling of the tissues of the nose and throat) and this will tend to close the opening of the Eustachian tube, which is immediately behind the nasal cavity, high in the throat. Some patients find relief when lying down, putting the head between their knees or taking spirits,during catching cold
Eustachian tube disorders are catergorized into obstructive disorders, and disorders of abnormal patency.
Obstructive disorders can be mechanical or functional. Mechanical obstruction can be due to factors such as mucosal inflammation due to allergy or infection. Extrinsic obstruction can be physiologic such as when the patient is supine, or may be caused by a mass lesion such as a neoplasm or an adenoidal mass.
Functional obstruction results from persistent collapse of the eustachian tube due to increased tubal compliance, an abnormal opening mechanism, or both. Functional obstruction is more common in infants and young children, and in many cases can be related to normal or abnormal developmental factors.
Many medical regimens have been described including using agents that produce intraluminal and extraluminal swelling, including: insufflation of boric acid and salicylate powder, an application of nitric acid and phenol, oral administration of saturated solution of potassium iodide (10 drops in juice TID), premarin nasal spray (25 mg in 30 cc NS).
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