Autophony

Specialty: Otolaryngology.

• Resonance of one's own voice
• echo of the voice
• tympanophony
• hearing one's own breathing

Why it occurs

• Patulous Eustachian tube characterized by a persistent and abnormal opening of the tubal lumen
• Serous otitis media due to altered acoustic reflex and abnormal fluid conduction
• Dehiscence syndrome of the superior semicircular canal that promotes bone transmission of internal noises
• Incomplete earwax plug or mobile foreign body that rubs against the tympanic membrane and acts as a direct acoustic conductor

Initial workup

Dynamic otoscopy under a microscope visualizing the movements of the tympanic membrane synchronized with the patient's breathing, long-term tympanometry to monitor pressure fluctuations, tonal audiometry with determination of bone conduction and high-resolution CT of the petrous bones with sagittal and coronal reconstruction of the semicircular canals.

Standard management

• Nasal saline solution instilled in Trendelenburg position — formula to promote temporary edema of the tubal mouth and facilitate its closure
• Very limited topical nasal alpha-adrenergic agonists — to induce local vasoconstriction, although they can worsen the pathology if their use becomes chronic.
• Estrogens in nasal solution (master formulas used to discreetly hypertrophy the mucous membrane of the tube and reduce its patulous lumen).