Dion’s cancellations throw spotlight on ear condition

TORONTO — The hearing condition that has caused Quebec pop star Céline Dion to cancel some upcoming Las Vegas shows is known as Patulous eustachian tube. So, what is it?

Patulous eustachian tube is a disorder in which the channel that runs between the middle ear and the 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.

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 buildup of pressure 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 the disorder 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. “If you lose a lot of weight, it can almost pull open the valve and it becomes almost floppy.”

Other risk factors 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.

Symptoms include “distorted autophony” — hearing one’s own voice or breathing, an echoing effect that can interfere with speech — as well as sensations of wave-like sounds that interfere with auditory perception and a feeling of fullness in the ear. Vertigo and hearing loss can occur.

Lin said there is no standard treatment. Some people can temporarily alleviate symptoms with positional manoeuvres, such as lying down or lowering their head between their knees. Patients may be advised to avoid diuretics and increase body weight. Nasal medications may help, while surgery may be recommended for others.