Risk factors associated with Patulous Eustachian Tube: A National Database Study

Sunday, October 12, 2025

8:42 AM - 8:48 AM EDT

Location: 244

Introduction: To characterize the demographics of patients with patulous eustachian tube (PET) in the US and understand the association with allergic rhinitis (AR), weight loss, gastroesophageal reflux disease (GERD), anxiety and TMJ. Evaluation of association with prior eustachian tube balloon dilation was performed.

Methods: Study

Design: Retrospective cohort study

Setting: National database (TriNetX) sourced from 67 HCOs in the USA

Patients: Subjects were adults diagnosed with PET (ICD-381.7), Controls were adults who were enrolled as normal comparisons and controls in clinical research programs (ICD-10:Z00.6).

Interventions: Evaluation of age, gender, race and association with allergic rhinitis, weight loss, GERD, anxiety, TMJ and prior eustachian tube dilation.

Main Outcome Measures: 1) Mean age, gender, race 2) AR 3) weight loss 4) GERD 5) anxiety 6) TMJ 7) Prior eustachian tube dilation procedures

Results:

Results: 7,683 subjects with PET were identified. Mean age at diagnosis of PET was 57 ± 20 (mean ± SD). The majority were female (60.5%, n = 4648) and white (75.2%, n = 5777). A subset of identified patients underwent comparisons with a propensity-matched cohort of control subjects (after-matching both cohorts were composed of 7440 subjects). Subjects with PET had a greater risk of having a diagnosis of AR (16.3% vs 8.3%, p < 0.0001), TMJ (4.5% vs 0.8%, p < 0.0001) and prior eustachian tube balloon dilation (0.7% vs 0%, p < 0.0001). There was a small difference in anxiety (18.8% vs 17.1%, p < 0.0001) between subjects with PET and controls. There was no significant difference in rates of weight loss (7.5% vs 7.2% p = 0.594) or GERD (23.9% vs 24.0%, p = 0.818) between subjects with PET and controls.

Conclusions:

Conclusions: Patients with PET demonstrated significant associations with allergic rhinitis, TMJ and prior eustachian tube balloon dilation. Interestingly neither weight loss nor GERD had a significant association with PET. Findings have implications for the understanding of the etiopathogenesis of PET.

Presenting Author(s)

Prithwijit Roychowdhury, BS

Medical Student
University of Massachusetts Chan Medical School
Worcester, Massachusetts, United States

Disclosure information not submitted.

Co-Author(s)

Miriam R. Smetak, MD

Fellow, Otology, Neurotology & Lateral Skull Base Surgery
Washington University in St Louis
Saint Louis, MO, United States

Disclosure information not submitted.
Pawina Jiramongkolchai, MD

Neurotology and Skull Base Fellow
UCSD
San Diego , CA, United States

Disclosure information not submitted.
Matthew A. Shew, MD

Assistant Professor
Washington University School of MedicineDepartment of Otolaryngology
St. Louis, MO, United States

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

Jacques A. Herzog, MD

Chief Division of Otology and Neurotology, Professor
Washington University School of Medicine
Creve Couer, MO, United States

Disclosure information not submitted.
Craig A. Buchman, MD

Lindburg Professor and Head, Otolaryngology - Head & Neck Surgery
Washington University in St. Louis
St. Louis, MO, United States

Disclosure information not submitted.

Senior Author(s)

ND

Nedim Durakovic, MD

Assistant Professor
Washington University in St. Louis
Saint Louis, MO, United States

Disclosure information not submitted.