OBJECTIVES: Evaluation of the effect of conservative and surgical treatment in patients with patulous Eustachian tube (PET) associated with habitual sniffing. STUDY DESIGN: Retrospective case review. SETTING: University hospital otolaryngology department. PATIENTS: Ninety-seven (23.4%) of 414 PET patients were found to have habitual sniffing to alleviate uncomfortable aural symptoms. Of these, 38 PET patients with sniffing habit were selected. INTERVENTIONS: Conservative intervention included instructions to stop sniffing and nasal instillation of saline. Surgical interventions used ventilation tube (VT) insertion to the eardrum and/or transmyringeal insertion of the PET plug (PEP). MAIN OUTCOME MEASURES: Relief of uncomfortable symptoms and stopping sniffing. RESULTS: In 52 (53.6%) of the 97 sniff-positive cases, retraction-type eardrum abnormalities or operated ear due to cholesteatoma were identified, whereas normal bilateral eardrums were observed in 34 (87.2%) of 39 sniff (-) cases. Abnormal findings in the eardrum were significantly more common in the sniff-positive group than in the sniff-negative group (p < 0.0001). Twenty-three patients (65.7%) stopped sniffing with conservative treatment. VT insertion was performed in 8 ears. Subsequent PEP was necessary in 2 of the 8 ears because of PET symptoms. PEP was successful in the other 11 ears, including one ear which needed additional VT insertion because of middle ear effusion. CONCLUSION: The management of habitual sniffing is difficult, but blocking the Eustachian tube by nasal instillation of saline and/or PEP could help PET patients to stop sniffing.
OBJECTIVES: Evaluation of the effect of conservative and surgical treatment in patients with patulous Eustachian tube (PET) associated with habitual sniffing. STUDY DESIGN: Retrospective case review. SETTING: University hospital otolaryngology department. PATIENTS: Ninety-seven (23.4%) of 414 PET patients were found to have habitual sniffing to alleviate uncomfortable aural symptoms. Of these, 38 PET patients with sniffing habit were selected. INTERVENTIONS: Conservative intervention included instructions to stop sniffing and nasal instillation of saline. Surgical interventions used ventilation tube (VT) insertion to the eardrum and/or transmyringeal insertion of the PET plug (PEP). MAIN OUTCOME MEASURES: Relief of uncomfortable symptoms and stopping sniffing. RESULTS: In 52 (53.6%) of the 97 sniff-positive cases, retraction-type eardrum abnormalities or operated ear due to cholesteatoma were identified, whereas normal bilateral eardrums were observed in 34 (87.2%) of 39 sniff (-) cases. Abnormal findings in the eardrum were significantly more common in the sniff-positive group than in the sniff-negative group (p < 0.0001). Twenty-three patients (65.7%) stopped sniffing with conservative treatment. VT insertion was performed in 8 ears. Subsequent PEP was necessary in 2 of the 8 ears because of PET symptoms. PEP was successful in the other 11 ears, including one ear which needed additional VT insertion because of middle ear effusion. CONCLUSION: The management of habitual sniffing is difficult, but blocking the Eustachian tube by nasal instillation of saline and/or PEP could help PET patients to stop sniffing.
Authors: Matthew E Smith; Yemisi Takwoingi; Jon Deeks; Cuneyt Alper; Manohar L Bance; Mahmood F Bhutta; Neil Donnelly; Dennis Poe; James R Tysome Journal: PLoS One Date: 2018-11-08 Impact factor: 3.240