Usually the Eustachian tube is closed except briefly while swallowing (which allows pressure in the middle ear to equalize with atmospheric pressure). A patulous tube is open most of the time and can result in a number of clinical findings.
A key finding of the patulous Eustachian tube is autophony (amplified sound of one’s own voice).
This may become worse:
(1) while standing
(3) with nasal decongestants
(4) with exercise or anxiety
(5) with caffeine
It may improve:
(1) if supine or if the head is held between the knees
