Incidence of Patulous Eustachian Tube Following Bariatric Surgery: An Observational Study at a Single Center.

OBJECTIVE

To evaluate the incidence of Patulous Eustachian Tube (PET) following bariatric surgery using standardized diagnostic criteria.

STUDY

DESIGN

Prospective cohort study.

SETTING

Tertiary academic medical center in northern Mexico.

METHODS

Sixty-four adults undergoing Roux-en-Y gastric bypass or sleeve gastrectomy were enrolled from April 2024 to June 2025. Otological assessments were conducted preoperatively, immediately postoperatively, and at 3 months postsurgery. PET diagnosis was determined using the Japan Otological Society (JOS) criteria. The Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7) was administered at each visit. Weight loss parameters were recorded, and correlated with PET outcomes.

RESULTS

64 enrolled patients, 12 were excluded, and 52 were analyzed. The mean patient age was 39.4 years (SD ± 10.7); 73.1% were women. Mean weight loss at 3 months was 22.8 kg (19.3% of initial body weight). No patients met criteria for definite PET at any time point. The proportion of patients with possible PET increased from 9.6% preoperatively to 23.1% at 3 months (P = .07). ETDQ-7 scores did not change significantly across time points (median 8-9; P = .55). No significant correlation was observed between magnitude of weight loss and PET outcomes.

CONCLUSION

Despite significant weight loss, no confirmed cases of PET 3 months after bariatric surgery. These findings suggest that previously reported high PET incidence rates may reflect inconsistent diagnostic standards rather than true clinical pathology. Symptom-driven evaluation rather than routine PET screening may be more appropriate in the early postoperative period. Larger studies with longer follow-up are needed to assess long-term risk.