Abstract
Patulous eustachian tube (PET) dysfunction is a rare complication of weight loss, which can be easily misdiagnosed. We present a case of PET dysfunction after laparoscopic sleeve gastrectomy. A 36-year-old Caucasian female with Class III morbid obesity (131 kg, BMI 46.6 kg/m2) successfully underwent laparoscopic sleeve gastrectomy. At her postoperative follow-up appointment six months later, her weight dropped to 96 kg and she complained of severe autophony (hearing of self-generated sounds), leading to anxiety and insomnia. She was initially misdiagnosed with a sinus infection by her primary care provider and was started on antibiotics. She was subsequently seen by an otolaryngologist who diagnosed her with PET. Weight loss can be a predisposing factor for PET. Our patient did not notice onset of symptoms of PET until significant weight loss (35 kg, 59.5% EWL).
Highlights
Patulous eustachian tube (PET) can be difficult to identify and treat[1]
PET may be caused by rapid weight loss and the consequent wasting of adipose tissue that surrounds the cartilaginous part of the ET, the Ostmann fat pads[2]
The current literature reveals PET can be a complication of bariatric surgery such as Roux-en-Y-bypass and symptoms onset after 20 kg weight loss[3]
Summary
Patulous eustachian tube (PET) can be difficult to identify and treat[1]. PET was first described by H. Common PET symptoms include autophony, aural fullness, and hearing one’s own breathing (aerophony)[1]. The current literature reveals PET can be a complication of bariatric surgery such as Roux-en-Y-bypass and symptoms onset after 20 kg weight loss[3]. A poster at the Sages 2017 annual meeting described a case of PET after sleeve gastrectomy with subsequent loss of 27.2 kg (EWL 70%), with BMI 37.9 kg/m2[5]. We present a case of PET after laparoscopic sleeve gastrectomy and symptoms onset after subsequent weight loss of 35 kg (EWL 59.5%), with BMI 46.6 kg/m2.
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