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Larionova et al. Mini-invasive Surg 2020;4:59 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2020.49

Case Report Open Access

Hearing voices and strange noises after sleeve
gastrectomy

Evgeniya Larionova , Scharukh M. Jalisi , Daniel B. Jones 1
1
2
1 Bariatric and Minimally Invasive Surgery, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
2 Otolaryngology/Head and Neck Surgery, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
Correspondence to: Evgeniya Larionova, NP, Bariatric and Minimally Invasive Surgery Department, Beth Israel Deaconess
Medical Center, 330 Brookline Ave, Boston, MA 02215, USA. E-mail: elariono@bidmc.harvard.edu
How to cite this article: Larionova E, Jalisi SM, Jones DB. Hearing voices and strange noises after sleeve gastrectomy. Mini-
invasive Surg 2020;4:59. http://dx.doi.org/10.20517/2574-1225.2020.49
Received: 25 May 2020 First Decision: 22 Jun 2020 Revised: 6 Jul 2020 Accepted: 9 Jul 2020 Published: 1 Sep 2020

Academic Editor: Wah Yang Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Patulous eustachian tube (PET) dysfunction is a rare complication of weight loss, which can be easily
misdiagnosed. We present a case of PET dysfunction after laparoscopic sleeve gastrectomy. A 36-year-old
2
Caucasian female with Class III morbid obesity (131 kg, BMI 46.6 kg/m ) successfully underwent laparoscopic
sleeve gastrectomy. At her postoperative follow-up appointment six months later, her weight dropped to 96 kg and
she complained of severe autophony (hearing of self-generated sounds), leading to anxiety and insomnia. She was
initially misdiagnosed with a sinus infection by her primary care provider and was started on antibiotics. She was
subsequently seen by an otolaryngologist who diagnosed her with PET. Weight loss can be a predisposing factor
for PET. Our patient did not notice onset of symptoms of PET until significant weight loss (35 kg, 59.5% EWL).

Keywords: Sleeve gastrectomy, bariatric surgery, patulous eustachian tube dysfunction, otolaryngology, the
Ostmann fat pads, autophony

INTRODUCTION
[1]
Patulous eustachian tube (PET) can be difficult to identify and treat . PET was first described by H.
[2]
Schwartze in 1864 . PET is defined as a eustachian tube remaining persistently open . Common PET
[1]
[1]
symptoms include autophony, aural fullness, and hearing one’s own breathing (aerophony) . PET may be
caused by rapid weight loss and the consequent wasting of adipose tissue that surrounds the cartilaginous
[2]
part of the ET, the Ostmann fat pads .
© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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