Associated condition with AUTOPHONY is AUTOIMMUNE DISEASE

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Hi all,

Interesting reading if your voice is too loud but you cant hear that it is.

Caro.

See: http://www.sheaclinic.com/services_6.asp

or paste below.

> Eustachian Tuboplasty for Autophony

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>

> J. Shea, Jr., M.D.

> R. Emmett, M.D.

> J. Staffel, M.D.

> F. Shea, M.D.

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> AUTOPHONY is a life-spoiling problem usually relieved by EUSTACHIAN

> TUBOPLASTY.

>

> AUTOPHONY is a rare but annoying complaint caused by a continuously open

> Eustachian tube, the narrow passageway between the back of the nose and the

> middle ear. Most of the time the Eustachian tube is closed, except when you

> swallow, during which air passes up the tube into the middle ear. When the

> Eustachian tube is open most of the time, as in AUTOPHONY, air goes up the

tube into

> the middle ear with each breath, causing an annoying roaring noise in the

> ear. In addition, when you speak, your own voice reverberates in your middle

> ear in such an annoying way you don't want to speak above a whisper, so as not

> to cause this reverberating noise in your ear. Patients with AUTOPHONY, which

> literally means " hearing your voice in your own ear " , begin to speak out in

> a normal way, but when the annoying noise of their own voice appears in their

> ear, they drop their voice to a whisper. The condition can become so

> annoying as to make you reclusive, not wanting to be around others and

required to

> speak. Some patients have it so bad outside sounds are also annoying to the

> affected ear, but less so than the patient's own voice. Singing is especially

> annoying to those with AUTOPHONY.

>

> The cause of AUTOPHONY is not known since there have been no ear bones

> examined after death with this condition. Careful CAT scans of the Eustachian

tube

> in patients with AUTOPHONY show atrophy of the soft tissues of and

> surrounding the tube, so it remains open most of the time. One of the peculiar

> diagnostic features of AUTOPHONY is it is always relieved by lying on the

back, or

> bending forward at the waist, both of which close the tube. Some patients with

> severe AUTOPHONY will hold the tip of the finger against the side of the

> neck on the affected side, which closes the end of the tube and gives relief.

> Other patients will " sniff " continuously to close the end of the tube in the

> nose to get relief.

>

> The typical history preceding the onset of AUTOPHONY is weight loss, which

> presumably causes the loss of fat and connective tissue in and surrounding the

> tube, leaving it open most of the time.

>

> Another important associated condition with AUTOPHONY is AUTOIMMUNE DISEASE

> of other parts of the body, the most important being of the urinary bladder

> (Interstitial Cystitis), facial nerve (Bell's Palsy), lungs (Wegener's

> Granuloma), inner ear (Meniere's Disease), central nervous system

(Guillain-Barre

> Syndrome), the intestines (Crohn's Disease), and the joints (Rheumatoid

> Arthritis). Just how autoimmune disease, in which you become allergic to your

own

> tissues and your immune system attacks them, relates to AUTOPHONY is not

known.

>

>

> Whether it causes or contributes to the atrophy of the walls of the

> Eustachian tube, so that it remains open most of the time, is not known, but

> presumably it must. Only about one-third of patients with AUTOPHONY have

autoimmune

> disease.

>

> Most patients have AUTOPHONY on one side only, but rarely is it in both, and

> it is more common in women then men, middle age or older.

>

> Through the years, there have been many treatments for this condition. As

> the pathology of AUTOPHONY as become better understood, reducing the size of

> the Eustachian tube, which gives immediate relief to most patients, has become

> the treatment of choice. Since the Eustachian tube is too large, too wide

> open, and does not close between swallows, it is possible to reduce the size

of

> the Eustachian tube by inserting a length of silicone tubing, 1mm in

> diameter, into the middle ear end of the tube, past the narrow place

(isthmus). For

> those with a very large Eustachian tube, it may be necessary to partially

> block the tube by inserting a rod of silicone sponge, as used in scleral

buckling

> operations, into the tube. The patient awakens from anesthesia with complete

> relief, often crying for joy. Some patients need a temporary ventilation

> tube in the drum to prevent fluid accumulation in the middle ear.

>

> For those patients with associated autoimmune disease of the urinary bladder

> (Interstitial Cystitis), facial nerve (Bell's Palsy), lungs (Wegener's

> Granuloma), inner ear (Meniere's Disease), central nervous system

(Guillain-Barre

> Syndrome), the intestines (Crohn's Disease) or the joints (Rheumatoid

> Arthritis), etc., these conditions should be treated in the usual way, usually

with

> steroids and other anti-inflammatory drugs. Strangely enough, large doses of

> steroid and anti-inflammatory drugs, usually beneficial to the associated

> autoimmune disease, do not help AUTOPHONY, apparently because these drugs

cannot

> reverse the atrophy of the Eustachian tube, which is present in AUTOPHONY.

>

> As we have learned more about the normal function and pathology of the

> middle ear and Eustachian tube, annoying diseases like AUTOPHONY lend

themselves

> to reasonable treatment, such as narrowing the Eustachian tube with silicone

> tubing or sponge, known as EUSTACHIAN TUBOPLASTY.

>

> Two typical case reports will explain the loss of quality of life-style from

> AUTOPHONY, and the relief gained by successful operation.

>

> One of my first patients with AUTOPHONY successfully treated was a 73-year

> old man with heart failure, accompanied by weight loss and AUTOPHONY. He was

> so sick his own doctor gave him no more than a 50% chance to survive the

> anesthesia for the operation, but he was so miserable with the AUTOPHONY, he

> accepted the risk gladly. Fortunately, he survived the operation and got a

good

> result from EUSTACHIAN TUBOPLASTY, and lived many more years with heart

> disease, but no more AUTOPHONY.

>

> Another younger patient, a mother with two children, has severe Interstitial

> Cystitis (inflammation of the bladder), an autoimmune disease, and then

> developed AUTOPHONY. She was so miserable with the AUTOPHONY she held her hand

to

> the side of her neck all the time to close the Eustachian tube, to get

> relief from her AUTOPHONY. After EUSTACHIAN TUBOPLASTY, she got complete

relief

> from her AUTOPHONY and has been able to deal with her Interstitial Cystitis

> without removal of her bladder, which had been offered to her as an alternate

> treatment.

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