First report on a case series of Patulous Eustachian tube following GLP-1 receptor agonist-induced weight loss.

OBJECTIVE

To describe seven cases of patulous Eustachian tube (PET, "Tuba aperta") arising in adult patients undergoing significant weight loss with GLP-1 receptor agonists (semaglutide [Ozempic®] or tirzepatide [Mounjaro®]).

METHODS

Retrospective descriptive case series of patients presenting to our otolaryngology clinic between June 2024 and June 2025 with symptoms of autophony, aural fullness, and audible breathing. All had initiated GLP-1 agonist therapy ≥ 3 months prior and achieved ≥ 8% body-weight reduction. Diagnosis of PET was confirmed by patient symptoms, otoscopy, digital volume tomography, reflex decay tympanometry and tubomanometry.

RESULTS

Seven patients (5 female, 2 male; age 28-56 years) developed bilateral (n = 5) or unilateral (n = 2) PET after 4-10 months of GLP-1 therapy. Weight loss ranged from 8.2 to 18.7% of baseline. Common symptoms were autophony (7/7), intermittent aural fullness (6/7), and hearing one's own breathing (5/7). Conservative management led to symptom improvement in one patient; six required injections of VOX-Implants® into the affected Eustachian tubes with resolution of symptoms.

CONCLUSION

Significant weight loss from GLP-1 receptor agonists may predispose susceptible individuals to PET. Clinicians should be aware of this potential otologic side effect and consider early conservative measures.