Lee Jin-Kook, Yeo Cha Dong, Ko Myoung-Hwan, Kim Gi-Wook
Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, Republic of Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Jeonbuk National University Medical School, Jeonju, Republic of Korea.
Medicine (Baltimore). 2025 Jun 27;104(26):e43034. doi: 10.1097/MD.0000000000043034.
Patulous Eustachian tube (PET) refers to condition where the Eustachian tube remains abnormally open or fails to close adequately, leading to autophony, aural fullness, breathing autophony, tinnitus, and hypernasality. This case study reports the acoustic characteristics of a PET patient with hypernasality evaluate the changes in symptoms before and after conservative therapy, and demonstrate the utility of objective assessment through speech evaluation in addition to subjective symptom assessment.
The 40-year-old female presented to the otolaryngology outpatient clinic with complaints of aural fullness and autophony, tinnitus, hypernasality. Otoscopic examination revealed bilateral adhesive tympanic membranes. Despite bilateral ventilation tube insertion performed to address the persistent aural fullness, the patient continued to experience the same symptoms postoperatively.
The patient began evaluation and treatment including speech, physical, and drug therapy were performed, for hypernasality, dyspnea, and swallowing problem with the Department of Rehabilitation Medicine. We assessed nasalance, vocal quality, and questionnaire both before and after the treatment. The acoustic data related to PET and the questionnaire results were then obtained.
Significant improvements were observed in nasalance and vocal quality, questionnaire. Nasalance and jitter, shimmer metrics, questionnaire results gradually decreased. Notably, jitter and shimmer, questionnaire score, which were outside the normal range in the pretreatment assessment, returned to within normal limits following the conservative treatment.
Studies focused on PET with hypernasality changes in acoustic data and questionnaire are extremely rare. This case is significant in that not only was PET with hypernasality improved after conservative therapy, but also changes in nasalance, voice quality, and questionnaire were observed.
咽鼓管异常开放（PET）是指咽鼓管持续异常开放或不能充分闭合的一种状态，可导致自听过强、耳闷、呼吸性自听增强、耳鸣和鼻音过重。本病例研究报告了一名伴有鼻音过重的PET患者的声学特征，评估了保守治疗前后症状的变化，并证明了除主观症状评估外，通过言语评估进行客观评估的实用性。
一名40岁女性因耳闷、自听过强、耳鸣、鼻音过重就诊于耳鼻喉科门诊。耳镜检查显示双侧鼓膜粘连。尽管已插入双侧通气管以解决持续的耳闷问题，但患者术后仍有相同症状。
患者开始接受包括言语、物理和药物治疗在内的评估与治疗，康复医学科针对鼻音过重、呼吸困难和吞咽问题进行治疗。我们在治疗前后均评估了鼻漏气、嗓音质量和问卷调查情况。随后获得了与PET相关的声学数据和问卷调查结果。
鼻漏气、嗓音质量和问卷调查均有显著改善。鼻漏气以及抖动、闪烁指标和问卷调查结果逐渐降低。值得注意的是，在治疗前评估中超出正常范围的抖动、闪烁和问卷调查得分，在保守治疗后恢复到正常范围内。
针对伴有鼻音过重的PET的声学数据和问卷调查变化的研究极为罕见。该病例的重要意义在于，不仅保守治疗后伴有鼻音过重的PET得到改善，而且还观察到了鼻漏气、嗓音质量和问卷调查的变化。
