patulous eustachian tube

Patency outside swallowing

Record the circumstances in which inappropriate openness is suspected or demonstrated.

1. What evidence indicates openness at rest rather than a normal opening during swallowing? definition
2. Which ear was observed, over what interval, and was the patient symptomatic? measurement

Criteria and evidence

Record the criteria used, their required observations and any unmet elements.

1. Which published criteria and version did the assessing clinician apply? provenance
2. Which required elements are demonstrated, missing or contradictory? boundary
3. Is this a symptomatic disorder, an incidental observation or an unresolved hypothesis? definition

Voice versus breathing

Preserve the patient's description without treating all autophony as equivalent.

1. Does the affected ear amplify the person's voice, nasal breathing or both? measurement
2. Are other sounds being described as autophony, and do they require a different diagnostic explanation? boundary

Posture and activity pattern

Document observed associations with posture, activity and time of day without assuming causation.

1. How do symptoms change between upright and recumbent positions? measurement
2. What activities precede episodes, and how consistently does the association recur? measurement
3. Which reported conditions could help a clinician assess the ear during a typical episode? action

Breathing-synchronous observation

Capture the observed sign, method and contemporaneous respiratory activity.

1. Was tympanic membrane movement synchronous with breathing observed in the symptomatic ear? measurement
2. If prolonged tympanometry or another functional test was used, what trace and protocol support the interpretation? provenance
3. Could swallowing, patient movement or recording artefact explain the apparent synchrony? boundary

Representative examination

Distinguish failure to demonstrate patency from a sufficiently supported exclusion.

1. Were posture, breathing manoeuvre and symptom presence documented at testing? provenance
2. If symptoms were absent during a negative test, what uncertainty remains about intermittent patency? boundary
3. Would repeat assessment during a typical episode resolve a material diagnostic uncertainty? action

Autophony differential

Record assessment of obstructive dysfunction, canal occlusion, superior canal dehiscence and other relevant explanations.

1. What findings support excessive patency rather than impaired tube opening? boundary
2. What evidence supports or weakens alternative explanations for this person's autophony? boundary
3. Which unresolved alternative would materially change the next clinical decision? action

Contributor timeline

Record candidate contributors as hypotheses supported by a timeline and source.

1. Did onset follow weight change, pregnancy, medication change, irradiation or an ear-related procedure? provenance
2. What evidence supports a causal contribution beyond temporal coincidence? boundary
3. Which potentially modifiable contributor warrants clinician review? action

Management rationale

Connect a proposed action to diagnostic confidence, the suspected mechanism and the person's priorities.

1. Which specific problem is the proposed management intended to improve: breathing autophony, voice autophony, fullness or functional interference? action
2. What evidence and patient-specific reasoning support this option? provenance
3. Has the clinician reconciled the proposed action with evidence for patency versus obstruction? boundary

Paired follow-up

Record symptom change, daily functioning and examination findings over a stated follow-up interval.

1. How did voice autophony, breathing autophony and daily interference change using the same baseline measures? measurement
2. Were new hearing complaints, effusion or signs of impaired ventilation observed after intervention? measurement
3. What recurrence, insufficient benefit or adverse effect would prompt reassessment? action

Check these first

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these check these first hold for the sense of patulous eustachian tube this model covers, and on what evidence? provenance

Kinds and varieties

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these kinds and varieties hold for the sense of patulous eustachian tube this model covers, and on what evidence? provenance

Identifiers and schemes

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these identifiers and schemes hold for the sense of patulous eustachian tube this model covers, and on what evidence? provenance

Real-world use

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these real-world use hold for the sense of patulous eustachian tube this model covers, and on what evidence? provenance

Typical measurements

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these typical measurements hold for the sense of patulous eustachian tube this model covers, and on what evidence? provenance

Failure modes and hazards

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these failure modes and hazards hold for the sense of patulous eustachian tube this model covers, and on what evidence? provenance

Neighbouring kinds and how to tell them apart

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these neighbouring kinds and how to tell them apart hold for the sense of patulous eustachian tube this model covers, and on what evidence? provenance