The patulous eustachian tube (ET) has a very characteristic clinical manifestation namely, its symptomsappear when the patient is in seated or upright position, while diminished when the patient is in recumbentposition. In the previous study, we reported the difference of CT imaging of the ET lumen and its surroundingtissues between patulous ET cases and normal control cases. In that study, however, there was apitfall that all CT examinations were performed on subjects in recumbent position, in which few felt symptomsduring the examination.
In the present study, we attempted to image the ET and its surrounding tissues in a 76-year-old malewith severe patulous ET in the seated position, by using a newly developed horizontal CT system. A comparisonwas made between the CT findings obtained in the seated position where the patient had symptomsand these in the recumbent position where the patient lacked symptoms of the patulous ET.
In the cartilaginous portion, especially from the pharyngeal orifice to the mid-cartilaginous portion of theET, the air space in the ET lumen was larger in the seated position than in the recumbent position. At theisthmus and the tympanic orifice of the ET, however, there was no significant difference in the findings of theair space in the ET lumen between the two positions.
We suggest that this method will lead to a better understanding of the pathology of the patulous ET, ifmore patulous ET cases are investigated.
