The Japan Otological Society Committee proposed the 2016 diagnostic criteria for patulous Eustachian tube, enabling objective diagnosis of this disease. However, in some cases, the underlying cause is difficult to identify and the condition becomes intractable. Endocrine disorders, autoimmune diseases, and malignant tumors are possible causes of persistent patulous Eustachian tube.
A 37-year-old woman was referred to our hospital complaining of aural fullness. The symptoms worsened with time despite some conservative treatments, such as medication or saline-based nasal drops. As the otological symptom became severe, the patient also developed psychiatric symptoms. As clinical examination revealed exophthalmos and tachycardia, we suspected hyperthyroidism, and the findings of blood examination were consistent with the diagnosis of Graves’ disease. The patient was immediately started on an oral thiamazole (Mercazole®), which led to prompt improvement of the symptoms. Patulous Eustachian tube, improvement of Graves’ disease, or both, could have led to the improvement of the psychiatric symptoms.
