What is Patulous eustachian tube, the disorder affecting Celine Dion?

TORONTO The hearing condition that has caused Quebec pop star Celine Dion to cancel some upcoming Las Vegas shows is known as Patulous eustachian tube. So just what is it and why does it occur?

Patulous eustachian tube is a disorder in which the channel that runs between the middle ear and back of the nose and throat stays open. Normally, these eustachian tubes remain closed and open only occasionally to regulate air pressure around the ear drum. A valve near the opening into the middle ear controls this process.

Sneezing, swallowing or yawning causes the valve to open, which keeps air pressure and fluid from building up inside the ears. Descending in an aircraft can also affect the function of the valves and eustachian tubes, leading to a pressure build-up that muffles hearing and sometimes causes pain.

Dr. Vincent Lin, a surgical otologist at Sunnybrook Health Sciences Centre in Toronto, said the exact cause of Patulous eustachian tube is unknown.

“We know that there’s a little bit of fat around the valve and people who, for example, lose a massive amount of weight will also lose fat,” he said Thursday. “And that fat pad, if you lose a lot of weight, it can almost pull open the valve and it becomes almost floppy.”

Dion is “a pretty thin lady,” Lin said. “She is the kind of typical person who has these kind of symptoms.”

Other risk factors for Patulous eustachian tube include pregnancy, fatigue, stress, exercise and temporomandibular joint syndrome in the jaw. Some cases have been linked to medications such as oral contraceptives or diuretics (water pills) that increase urine secretion. Stroke, multiple sclerosis and motor neuron disease also have been implicated.