Association Between Weight Loss Interventions and Patulous Eustachian Tube

Saturday, October 11, 2025

9:48 AM - 9:54 AM EDT

Location: 242

Disclosure(s):

Deepthi S. Akella, DO, MS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Alex P. Bogosian, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Michele M. Carr, DDS MD PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Patulous Eustachian tube (PET) is a rare condition where the Eustachian tube fails to close, leading to autophony, ear fullness, and tinnitus. While its exact etiology is unclear, it has been associated with weight loss. With the rising prevalence of obesity and growing use of weight loss interventions, this study examined the relationship between PET and bariatric surgery and pharmacological treatments for obesity.

Methods: A retrospective study using the TriNetX US Network identified patients ≥18 years with a PET diagnosis (ICD-10 H69.00–03) from 1/1/2006 to 12/31/2024. Demographics and comorbidities were extracted. Separate cohorts of patients receiving bariatric surgery, GLP-1 receptor agonists (GLP-1RA), or phentermine were 1:1 age-matched to control groups who had never undergone the respective treatment. PET frequency was compared between each treatment cohort and its matched control group.

Results: 6456 patients with PET were identified (mean age=51.6 years, SD=18.2), and the majority were female (N=3949, 61.2%). Mean BMI was 26.2 kg/m2 (SD=6.2). Common comorbidities included gastroesophageal reflux disease (N=1707, 26.4%), vasomotor and allergic rhinitis (N=1495, 23.2%), chronic sinusitis (N=995, 15.4%), hyperlipidemia (N=1379, 21.4%), overweight or obese (N=1028, 15.9%), and type 2 diabetes mellitus (N=661, 10.2%). A history of abnormal weight loss was noted in 433 (6.7%) patients.

After matching, patients who had undergone bariatric surgery (N=478233) were more likely to experience PET compared to controls (N=172, 0.04% vs. N=111, 0.02%; OR=1.6, 95% CI=1.2-2.0, p<.001). Patients with a history of phentermine use (N=489122) also had increased occurrence of PET (N=110, 0.02% vs. N=69, 0.01%; OR=1.6, 95% CI=1.2-2.2, p=.002). GLP-1RA was not significantly associated with PET (p=.89).

Conclusions: Bariatric surgery and phentermine use were linked to higher PET risk, possibly due to rapid or significant weight loss. GLP-1RA, associated with slower weight loss, showed no significant link to PET. Further research is needed to elucidate underlying mechanisms.

Presenting Author(s)

Deepthi S. Akella, DO, MS

Resident Physician
University of Missouri Department of Otolaryngology
Columbia, MO, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

GV

Gaayathri Varavenkataraman, MA

Research Assistant
Department of Otolaryngology, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
East Amherst, New York, United States

Disclosure information not submitted.
JS

Joshua Sorrentino, BS

Medical Student
Jacobs School Medicine and Biomedical Sciences at the University at Buffalo, United States

Disclosure information not submitted.
Alex P. Bogosian, BS

Medical Student
Touro College of Osteopathic Medicine- Middletown
Buffalo , New York, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

MC

Michele M. Carr, DDS MD PhD

Professor
Department of Otolaryngology, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Williamsville, New York, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.