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Boric acid and PET
Forum: Patulous Eustachian Tube (PET)
Last Post: Caravaggio
05-17-2019, 09:34 PM
» Replies: 0
» Views: 759
Swallowing Ear Pressure
Forum: Patulous Eustachian Tube (PET)
Last Post: david62
02-04-2019, 11:21 PM
» Replies: 0
» Views: 1,333
Copper: The intermediate ...
Forum: Patulous Eustachian Tube (PET)
Last Post: Matt
02-01-2019, 11:29 PM
» Replies: 7
» Views: 4,169
What is Eustachian Tube D...
Forum: Eustachian Tube Dysfunction (ETD)
Last Post: Caravaggio
01-28-2019, 07:55 PM
» Replies: 0
» Views: 1,197
What is Patulous Eustachi...
Forum: Patulous Eustachian Tube (PET)
Last Post: Caravaggio
01-28-2019, 07:44 PM
» Replies: 0
» Views: 2,081

 
  Boric acid and PET
Posted by: Caravaggio - 05-17-2019, 09:34 PM - Forum: Patulous Eustachian Tube (PET) - No Replies

Quote:SHAMBAUGH, G. E. (1938)
CONTINUOUSLY OPEN EUSTACHIAN TUBE
Archives of Otolaryngology - Head and Neck Surgery, 27(4), 420–425

https://sci-hub.tw/10.1001/archotol.1938.00650030431004

In this article the doctors treat the PET by insufflation of salicylic acid and boric acid into the eustachian tube.

This caused an inflammatory swelling which closed the tube. Sodium chloride seems to have the same effect.

But I suppose the boric acid works in a different way. Boric acid is known to be antifungal.

So what if we have a chronic fungal/yeast infection in the nasopharyngeal space? Maybe Candida auris?

https://www.cdc.gov/fungal/candida-auris...stant.html

https://www.nytimes.com/2019/04/06/healt...auris.html

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  Swallowing Ear Pressure
Posted by: david62 - 02-04-2019, 11:21 PM - Forum: Patulous Eustachian Tube (PET) - No Replies

Does anybody have as their only symptom ear strong,pulse pressure when swallowing?

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Shocked Copper: The intermediate cause of PET?
Posted by: Caravaggio - 01-29-2019, 08:03 PM - Forum: Patulous Eustachian Tube (PET) - Replies (7)

In my previous hypothesis I claimed acetylcholine as the cause of PET but this is just one of 3 steps to the root cause.

Now I probably found the 2nd step: copper.

When acetylcholine is the train then copper is the damaged railway.

When you have a damaged railway you slow down the trains (stop drinking coffee because that raises ACh).

I don't know if this nerve damage is a cause of too low or too high copper but it's most likely a lack because copper is needed in the formation of myelin.


Quote:EFFECTS OF COPPER DEFICIT ON MYELINATION
J -M Matthieu, A W Zimmerman, R H Quarles & R O Brady
Pediatric Research volume 9, page 865 (1975)

https://www.nature.com/articles/pr1975325

You can imagine the nerve as a copper wire where myelin would be the plastic insulator.

[Image: attachment.php?aid=5]
https://beyondthedish.wordpress.com/2015...pulations/

[Image: attachment.php?aid=6]
https://commons.wikimedia.org/wiki/File:...ert_en.svg
Marekich [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons


[Image: attachment.php?aid=7]
https://www.rchsd.org/health-articles/bells-palsy-3/

Now you maybe remember that scientist Luigi Galvani that experimented with death frogs and electric current.

"The beginning of Galvani's experiments with bioelectricity has a popular legend which says that the Galvani was slowly skinning a frog at a table where he and his wife had been conducting experiments with static electricity by rubbing frog skin. Galvani's assistant touched an exposed sciatic nerve of the frog with a metal scalpel that had picked up a charge. At that moment, they saw sparks and the dead frog's leg kicked as if in life. The observation made the Galvanis the first investigators to appreciate the relationship between electricity and animation—or life."
https://en.wikipedia.org/wiki/Luigi_Galvani

A damaged myelin sheath in the area of the eustachian tube could innervate the levator veli palatini and/or tensor veli palatini muscle.

Like you would get an electric shock from a damaged electrical cable.

Copper and estrogen

There are many women who report worsened PET after taking a contraceptive pill containing estrogen (Ethinylestradiol for example).

Estrogen increases serum copper but it also seems to deplete liver copper which is the copper storage of the body.


Quote:Adv Exp Med Biol. 1989;258:155-62.
Effect of estrogen on serum and tissue levels of copper and zinc.
Mehta SW, Eikum R.

https://www.ncbi.nlm.nih.gov/pubmed/2626984


Quote:Eur J Clin Nutr. 1998 Oct;52(10):711-5.
Effect of oral contraceptive progestins on serum copper concentration.
Berg G, Kohlmeier L, Brenner H.

https://www.ncbi.nlm.nih.gov/pubmed/9805216


Quote:Contraception. 2013 Jun;87(6):790-800. doi: 10.1016/j.contraception.2012.10.006. Epub 2012 Nov 13.
Relevance of serum copper elevation induced by oral contraceptives: a meta-analysis.
Babić Ž, Tariba B, Kovačić J, Pizent A, Varnai VM, Macan J

https://www.ncbi.nlm.nih.gov/pubmed/23153894

There's also a steep rise in estrogen during pregnany.

[Image: attachment.php?aid=8]
http://www.johnyfit.com/estrogen-levels-...pregnancy/

Copper and cortisol

Cortisol also seems to decrease copper.

It seems to lower ceruloplasmin, the copper transport protein while estrogen raises ceuloplasmin.


Quote:Indian J Med Sci. 2004 Apr;58(4):150-4.
Effect of estrogen on plasma ceruloplasmin level in rats exposed to acute stress.
Ganaraja B, Pavithran P, Ghosh S.

https://www.ncbi.nlm.nih.gov/pubmed/15122050


Quote:Am J Med Sci. 1981 Sep-Oct;282(2):68-74.
Influence of synthetic corticosteroids on plasma zinc and copper levels in humans.
Yunice AA, Czerwinski AW, Lindeman RD.

https://www.ncbi.nlm.nih.gov/pubmed/7325187


Quote:Environ Toxicol Chem. 2003 May;22(5):1122-6.
Effect of cortisol treatment and/or sublethal copper exposure on copper uptake and heat shock protein levels in common carp, Cyprinus carpio.
De Boeck G, De Wachter B, Vlaeminck A, Blust R.

https://www.ncbi.nlm.nih.gov/pubmed/12729223

The other way around a high copper level seems to raise the cortisol level.


Quote:OUTSIDE JEB
COPPER, CORTISOL AND THE COMMON CARP
Katherine A. Sloman
Journal of Experimental Biology 2003 206: 3309

http://jeb.biologists.org/content/206/19/3309


Quote:Aquat Toxicol. 2002 Feb;56(3):167-76.
Stress response to waterborne Cu during early life stages of carp, Cyprinus carpio.
Flik G, Stouthart XJ, Spanings FA, Lock RA, Fenwick JC, Wendelaar Bonga SE.

https://www.ncbi.nlm.nih.gov/pubmed/11792433

But too much estrogen raises cortisol which lowers ceruloplasmin.


Quote:Maturitas. 2008 Dec 20; 61(4): 330–333.
Effects of estrogen versus estrogen and progesterone on cortisol and interleukin-6
Kate M. Edwards, and Paul J. Mills

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2663529/

Copper and soy isoflavones

The soy isoflavones could improve the PET by improving the absorption of copper through the ability of the isoflavones to reduce cupric (divalent) to cuprous (monovalent) copper.


Quote:Oxidative Medicine and Cellular Longevity
Isoflavones Reduce Copper with Minimal Impact on Iron In Vitro
Jana Karlíčková, Kateřina Macáková, Michal Říha, Liliane Maria Teixeira Pinheiro, Tomáš Filipský, Veronika Horňasová, Radomír Hrdina, and Přemysl Mladěnka

https://www.hindawi.com/journals/omcl/2015/437381/

Link between bariatric surgery copper and PET
(thanks to Matt Dawson at the FB group for pointing this out)

Bariatric (weight loss) surgery causes an impaired uptake of copper. And in patients with such a surgery there was a higher count of people getting PET.

I doubt it was just the weight loss that caused a diminishing of the Ostmann's pad of fat around the eustachian tube. Then most people with weight loss would have PET.


Quote:Obes Surg. 2016 Jun;26(6):1335-42.
Copper Deficiency after Gastric Bypass for Morbid Obesity: a Systematic Review.
Kumar P, Hamza N, Madhok B, De Alwis N, Sharma M, Miras AD, Mahawar KK.

https://www.ncbi.nlm.nih.gov/pubmed/27034062


Quote:Otolaryngol Head Neck Surg. 2010 Oct;143(4):521-4.
Patulous eustachian tube in bariatric surgery patients.
Muñoz D, Aedo C, Der C.

https://www.ncbi.nlm.nih.gov/pubmed/20869562


Quote:OBES SURG (2011) 21:1482–1483
Gastric Bypass and Copper Deficiency: A Possible Overlooked Consequence
Denis M. Medeiros

https://sci-hub.se/10.1007/s11695-011-0465-3


Quote:Obesity (Silver Spring). 2009 Apr; 17(4): 827–831.
Acquired Copper Deficiency: A Potentially Serious and Preventable Complication Following Gastric Bypass Surgery
Daniel P. Griffith, R.Ph., David Liff, M.D., Thomas R. Ziegler, M.D., Gregory J. Esper, M.D., and Elliott F. Winton, M.D.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2712481/

So what is the root cause that causes this copper deficiency?

Excess estrogen (can exclude that for me as I'm not a woman and levels are normal)
Gene Mutation that causes low copper
Viral infection that causes low copper
Environmental factors (pesticides [Glyphosate], low copper in food)

Glyphosate can chelate metals and is probably in every non-organic food.

"In aquatic ecosystems, where both heavy metals and glyphosate can co-occur, glyphosate and Roundup can control both the toxicity and the bioavailability of heavy metals, e.g., Cd, Cu, Cr, Ni, Pb, Se, and Zn (Tsui et al. 2005)."


Quote:Environ Sci Pollut Res Int. 2018; 25(6): 5298–5317.
Glyphosate, a chelating agent—relevant for ecological risk assessment?
Martha Mertens, Sebastian Höss, Günter Neumann, Joshua Afzal, and Wolfram Reichenbecher

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5823954/



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Information What is Eustachian Tube Dysfunction?
Posted by: Caravaggio - 01-28-2019, 07:55 PM - Forum: Eustachian Tube Dysfunction (ETD) - No Replies

Treating Auditory Tube Dysfunction
Causes of Pain, Hearing Loss, and "Popping" in the Ears

By Kristin Hayes, RN  | Reviewed by Susan Olender, MD
Updated December 04, 2018


Have you ever felt that your ears were blocked so that you couldn't hear? Have you ever had popping or clicking in your ears or have had trouble keeping your balance?

These are just some of the symptoms associated with auditory tube dysfunction (also known as eustachian tube dysfunction). It can be caused by any number of conditions but is most associated with either an accumulation of mucus or an imbalance of air pressure in the middle ear.

Anatomy

The auditory tube, sometimes called the eustachian tube, is a tiny channel that runs from the middle ear to the back of the throat (nasopharynx). The auditory tube has several important functions:

  • It opens and closes in response to changes in ambient air pressure in order to equalize pressure in the middle ear.
  • It may close in response to loud noises to protect delicate ear structures.
  • It clears mucus from the middle ear, allowing it to drain into the back of the throat.

The auditory tube in children runs at a more horizontal angle than in adults. With age, the tube enlarges and gradually becomes more vertical to facilitate better drainage. This explains why children are more prone to auditory tube problems.

While the auditory tube is normally closed, it does open periodically such as when we swallow, yawn, or sneeze. This explains why we often need to swallow in order to "pop" our ears when driving up a mountain or taking off in an airplane. When you swallow, your auditory tube opens and equalizes the pressure in automatically.

Causes and Symptoms

Broadly speaking, auditory tube dysfunction occurs when the eustachian tube either fails to equalize air pressure or is unable to clear mucus from the middle ear.

If air pressure changes rapidly, it can cause discomfort, pain, and even a ruptured eardrum.

If mucus is not properly cleared, it can lead to middle ear infections (otitis media), fluid in the ear (serous otitis media), or hearing loss caused by changes in the position of the eardrum (middle ear atelectasis). These conditions can result in pain, hearing loss, dizziness, and even ear damage.

Causes range from illness and physiology to changes in atmospheric pressure, including:
  • an auditory tube that is abnormally small (especially children)
  • trauma caused by rapid changes in ambient air pressure (Barotrauma)
  • an auditory tube that is blocked by enlarged tissue (such as the adenoids)
  • nasal congestion caused by allergies or infections
  • infection in the ear itself
  • benign growths or tumors that block the auditory tube

Diagnosis

There are several methods for diagnosing the causes of auditory tube dysfunction. An ENT doctor, as known as an otolaryngologist, is a specialist qualified to diagnose these types of conditions.

After a review of your medical history or symptoms, the doctor will begin to assess the problem with the use of several different instruments:
  • A visual tool called otoscope will be used to look at your eardrum (tympanic membrane). Changes in the appearance or mobility can often indicate fluid in the ear. A ruptured ear drum can also be visually diagnosed.
  • A fiber optic endoscope may be used, the instrument of which is inserted through the nose to see if any enlarged tissues are blocking the auditory tube.
  • A tympanometry is another specialized instrument that can measure the air pressure in the middle ear, with a high pressure reading indicating auditory tube dysfunction.

The tests are pretty straightforward and cause no more discomfort than having your temperature taken in the ear.

If there are any serious concerns, imaging tests such as computerized tomography (CT scans) or magnetic resonance Image (MRI) may be ordered to look for tissues or masses that may be blocking the tube.

If your doctor believes that the dysfunction is caused by allergy, an allergist or may be sought for further investigation.

Treatments

Treatment for auditory tube dysfunction varies and is based largely on the root cause of the problem.

In the case of fluid in the ear, many individuals are able to clear the fluid on their own over time. If the fluid is still present after three to six months, a doctor may choose to drain the excess fluid using ventilation tubes.

If enlarged tissue (such as an adenoid, polyp, turbinate, or tumor) is seen to be the cause, they can be removed using a procedure called endoscopic sinus surgery.

It is important to treat any underlying conditions, including allergies, infections, or growths, that may be causing or contributing to the problem.

Prevention

Prevention is always better than treatment, and, in the case of auditory tube dysfunction, the tools for prevention couldn’t be simpler.

To prevent pain or damage caused by rapid changes in air pressure, swallow or yawn regularly when taking off in an airplane or driving up a steep mountain. If you scuba dive, descend slowly to allow the pressure to equalize gradually.

In some cases, it can help to take a decongestant, such as pseudoephedrine, just before flying or diving. You should also have any underlying allergies or sinus problems treated to prevent barotrauma.

If you do experience air-pressure related ear trauma, give it time to heal. A ruptured ear drum will usually get better by itself in a few days. In more severe cases, surgery may be needed, but this is more the exception than the rule.


Sources:
  • Schilder, A.; Bhutta, M.; Butler, C.; et al. “Eustachian tube dysfunction: consensus statement on definition, types, clinical presentation, and diagnosis.” Clinical Otolaryngology. October 2015; 40(5):407-411.

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Information What is Patulous Eustachian Tube?
Posted by: Caravaggio - 01-28-2019, 07:44 PM - Forum: Patulous Eustachian Tube (PET) - No Replies

Patulous Eustachian Tube Overview

By Kristin Hayes, RN  | Reviewed by Susan Olender, MD
Updated November 30, 2018


Your eustachian tubes, also called auditory tubes, run from your inner ear to the back of your throat. Typically, your eustachian tube is in a closed position, which protects your inner ear from bacteria, viruses, and fluid. In order to equalize pressure and drain any fluid inside the inner ear, your eustachian tube opens once or twice every hour. It will also open when you swallow, yawn, or sneeze and normally will only remain open for 0.3 to 0.5 seconds.

Patulous eustachian tube (PET) occurs when your eustachian tube remains wide open or patulous. It is an uncommon condition only affecting about 3 out of 1000 people.

Causes of Patulous Eustachian Tube

The cause of patulous eustachian tube is usually unknown. However, there are several factors that may predispose you to develop chronically open eustachian tubes, including:

  • radiation therapy (causes scarring to occur)
  • high levels of estrogen (pregnancy, high dose birth control, or hormonal therapy for prostate cancer)
  • nasal decongestants
  • fatigue, stress or anxiety
  • temporomandibular joint syndrome (TMJ)
  • significant weight loss
  • neurological disorders (stroke, multiple sclerosis, trauma to facial nerves)
  • excessive gum chewing or frequently forced nose blowing

Symptoms Related to Patulous Eustachian Tube

If you are suffering from a patulous Eustachian tube you may have one or more of the following symptoms:
  • autophony this is the most common symptom and a classic sign of patulous eustachian tube (more on this symptom below)
  • tinnitus (ringing in the ears)
  • a feeling that the ear is stuffed up or clogged

Autophony

Autophony is a condition where you hear unusually loud feedback of your own voice, breathing, and heartbeats. This is a classic hallmark symptom of a patulous eustachian tube and can be noted in other disorders involving your eustachian tube like superior semicircular canal dehiscence. In order to resolve symptoms of autophony, you will have to discuss treatment options for a patulous eustachian tube with your doctor.

Non-Invasive Treatment of Patulous Eustachian Tube

Before receiving treatment, you may find that sniffing or lowering your head can cause some temporary relief of autophony. Mild symptoms may not require any treatment.

However, if the symptoms are severe enough and have persisted for greater than 6 weeks, then you will want to start treatments focused on resolving a patulous eustachian tube. Initial treatments involve proper hydration; drinking sufficient water is essential and can be supplemented with nasal saline drops or irrigation of the nose to help keep your mucous membranes moist.

The most common treatment for a patulous eustachian tube is nasal sprays. Saline is the most common choice in the U.S. However your doctor could recommend a mixture such as: 1 part salicylic and 4 parts boric acid powder, diluted hydrochloric acid, chlorobutanol, or benzyl alcohol with saturated potassium iodide. These alternate nasal spray mixes have not received FDA support yet.

While many inner ear conditions can receive symptom relief from using nasal decongestants or steroids, this practice will likely worsen your symptoms of PET and should not be continued. However, do not stop any medications without consulting your physician. If your physician wants you to stop taking steroids, they will give you a taper schedule. Stopping steroids too quickly can be harmful.

Nasal estrogen creams have a lot of anecdotal support, however, nothing scientific has been done to support or discourage this practice.

Invasive Treatment of Patulous Eustachian Tube

When less invasive methods prove insufficient to resolve symptoms of a patulous eustachian tube, surgical treatments may be more effective. The most common surgical intervention is the placement of a tympanostomy tube. This therapy is only about 50% effective for patients and either helps resolve the symptoms or increases discomfort.

Unfortunately, there is not enough evidence to predict if you will respond positively to the surgical placement of ear tubes. However, ear tube placement is a fairly simple procedure with few side effects and the synthetic tubes can be removed if they do not provide relief for you.


Another less invasive method for treating patulous eustachian tubes is referred to as mass loading. In this procedure, your doctor will mold Blu Tack (a pressure-sensitive adhesive) to your eardrum. You will not require anesthesia for this procedure and it is generally very well-tolerated. This is thought to be helpful by reducing the sensation of echo in your inner ear by thickening your eardrum, which reduces its reaction to low-frequency sounds.

Other more invasive therapies that are continually being studied, and not available in all areas include:
  • injecting the eustachian tube with Teflon, silicon, cartilage, or other filling agents - caution should be exercised, as an accidental injection into the carotid artery can cause severe complications
  • surgical placement of cartilage inside the eustachian tube
  • cauterizing off the eustachian tube
  • manipulation of musculature around the eustachian tube

The procedures listed above are more invasive than having ear tubes placed, however depending on the severity of your symptoms and success of other interventions may be additional options for you.

Inserting a catheter inside the eustachian tube, injecting the eustachian tube, or musculature manipulation, allows for a narrowing of the eustachian tube. While this does not return the normal function of the tube, it reduces the amount of air flow into the middle ear, which helps to reduce the symptoms of autophony.

Surgically placing cartilage inside the eustachian tube has a similar purpose to catheter placement and is used only if the catheter has failed.

As a last resort, you can have a surgery where your otolaryngologist completely closes off the eustachian tube. This procedure alone is insufficient to help manage symptoms, as you lose the ability to regulate pressure in the middle ear. For this reason, your physician will also place ear tubes. You will always require ear tubes if you have this procedure, so it is only used as a last resort.


Sources:
  • Bartlett, C1, Pennings, R, Ho, A, Kirkpatrick, D, van Wijhe, R, & Bance M.(2010). Simple mass loading of the tympanic membrane to alleviate symptoms of patulous eustachian tube. J Otolaryngol Head Neck Surg. 39(3):259-68.

  • Luu, K, Remillard, A, Fandino, M, Saxby, A & Westerberg BD. (2015). Treatment Effectiveness for Symptoms of Patulous Eustachian Tube: A Systematic Review. Otol Neurotol. 36(10):1593-600. doi: 10.1097/MAO.0000000000000900.

  • Patulous Eustachian Tube. National Center for Advancing Translational Services website. https://rarediseases.info.nih.gov/gard/1...esources/1. Updated February 17, 2017. Accessed July 5, 2017.

  • Poe. D & Hanna, B.MN. (2015). Eustachian tube dysfunction. http://www.uptodate.com (Subscription Required). Updated September 21, 2016. Accessed July 5, 2017.

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