Optimal Eustachian Tube Plugging Method for Patulous Eustachian Tube Disorder

Abstract

Introduction Patulous Eustachian tube disorder (PET) causes disabling symptoms due to abnormal tubal patency. Eustachian tube plugging is a surgical option, but the optimal surgical position and plug material remain undetermined. To evaluate the success rate and complications of Eustachian tube plugging according to surgical position (sitting vs. supine) and plug material (silicone vs. angiocatheter).Methods This retrospective study included 50 ears from 42 patients who underwent Eustachian tube plugging between May 2019 and May 2025. Surgical outcomes and complications were assessed up to 3 months postoperatively.Results The overall complete remission (CR) rate was 70.0%, and 88.0% of patients experienced clinical improvement. Obstructive Eustachian tube dysfunction occurred in 14.6% of ears, exclusively in CR cases. No tympanic membrane perforation was observed. The sitting position showed a higher CR rate (80.0%) compared to supine (60.0%) in short-term outcome.Conclusion Sitting-position surgery may improve CR outcomes due to real-time symptom feedback. Angiocatheters are effective but prone to extrusion. Plugging is a promising procedure for PET with a favourable safety profile.