Comment on: Trans-Tympanic Cartilage Chip Insertion for Intractable Patulous Eustachian Tube

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J Audiol Otol. 2019;23(3):173-174
Publication date (electronic) : 2019 July 10
doi :
1Brain Research Center for Advanced, Innovative, Interdisciplinary and International Neuromodulation (Brai3n), Ghent, Belgium
2AZ Maria Middelares, Ghent, Belgium
Address for correspondence Michael JO Boedts, MD Brain Research Center for Advanced, Innovative, Interdisciplinary and International Neuromodulation (Brai3n), Jemappesstraat 5, Ghent 9000, Belgium Tel +32-468340844 / E-mail
Received 2018 December 16; Accepted 2018 December 31.

Dear Editor,

We read the report by Jeong, et al. [1], of this promising new technique with great interest. We wonder wether the application of a patch, after having inserted the cartilage, might be a confounding factor. Application of a paper patch, left on the tympanic membrane for about a month without any adjunctive therapy, effectively eliminated autophony; temporarily in 76.2%, and definitely in 50%, in a series of unselected autophony patients [2].

This paper patching treatment is actually a form of mass loading of the tympanic membrane. Since the inclusion criteria in the present series included a positive response to mass loading, one would expect paper patching in the present selected series to give excellent results; temporarily in almost 100% and definitely in a great majority.

A possible way to find out whether part of the results could be the result of the patching only, would be to scan the patient files for the complaint of fullness feeling. Indeed paper patching is only effective when autophony is accompanied by fullness feeling.


Conflicts of interest

The author has no financial conflicts of interest.


1. Jeong J, Nam J, Han SJ, Shin SH, Hwang K, Moon IS. Trans-tympanic cartilage chip insertion for intractable patulous eustachian tube. J Audiol Otol 2018;22:154–9.
2. Boedts M. Paper patching of the tympanic membrane as a symptomatic treatment for patulous eustachian tube syndrome. J Laryngol Otol 2014;128:228–35.

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