Roaring in the ears: patulous Eustachian tube in bulbar amyotrophic lateral sclerosis.

We report a 64-year-old female with predominantly bulbar amyotrophic lateral sclerosis who experienced 'roaring' in her ears. She was diagnosed with patulous Eustachian tube, which is presumed to occur secondary to bulbar weakness. The roaring adversely affected the management of her ALS by impairing her ability to tolerate BiPaP. A review of the relevant literature is reported.