The main symptom of patulous Eustachian tube dysfunction is hearing your own voice too loudly (autophony). This symptom is a result of the open column of air between your sinus cavity and eardrum. People often describe autophony as an inner echo, as if you were talking into a barrel. In autophony, you may also hear breathing and chewing sounds from inside your body.

Other symptoms may include:

• A sense of fullness in the ears
• Frequent sniffing
• Mild hearing loss
• Ringing in the ears (tinnitus)

Patulous Eustachian tube dysfunction symptoms often come and go. Some people report their symptoms worsen with exercise. Others note improved symptoms in the morning or after lying down.

Often, the cause of patulous Eustachian tube dysfunction is not known (idiopathic). But in some cases, the condition may be caused by:

• Allergies
• Gastroesophageal reflux disease (GERD)
• Hormonal changes due to hormone therapy or pregnancy
• Radiation therapy
• Weight loss

To diagnose patulous Eustachian tube dysfunction, your doctor will ask you about your symptoms and what makes them better or worse. Tests your doctor may recommend include:

• Ear exam: Your doctor looks inside your ear using a lighted device called an otoscope. They observe any changes in the shape or movement of your eardrum.
• Nasal endoscopy: This test allows your doctor to look inside your nasal cavity using a thin tube called an endoscope. Your doctor inserts the endoscope into your nose and guides it to the back of your nasal cavity. They look at the opening of your Eustachian tube to see if it is functioning properly and check for signs of swelling or inflammation.
• Tympanometry test: This test uses a probe placed into your ear that gently changes the pressure against your eardrum. A readout from the test helps your doctor determine the pressure inside your ear.