The experience of hearing your own breathing, voice, or even chewing sounds echoing loudly inside your head is known as autophony. This sensation involves the amplification of internal noises, often making them loud enough to be distracting or disruptive. This specific symptom points to a mechanical issue within the body’s auditory system. This article will explore the physical mechanism and the underlying condition responsible for hearing your own breath in your ear.
How the Eustachian Tube Works Normally
The Eustachian tube is a narrow passageway connecting the middle ear space to the back of the nose and upper throat, an area called the nasopharynx. Composed of both bone and cartilage, its primary function is to serve as a pressure-regulating valve for the middle ear.
Under healthy conditions, the Eustachian tube remains closed, acting as a protective barrier. This closed state prevents unwanted sounds, bacteria, and secretions from the nasopharynx from entering the middle ear. The tube only opens briefly during actions like swallowing, yawning, or chewing.
This momentary opening allows air to pass, equalizing the pressure between the middle ear and the outside atmosphere. This pressure balance is necessary for the eardrum to vibrate efficiently and transmit sound properly. When the tube works correctly, it also helps dampen the intensity of your own voice and breathing sounds, preventing autophony.
Patulous Eustachian Tube: The Main Cause
The sensation of hearing your own breathing loudly is most often caused by Patulous Eustachian Tube (PET). In PET, the Eustachian tube remains abnormally open, or “patent,” for extended periods. This chronic opening creates a direct channel between the nasopharynx and the middle ear.
This open passage allows acoustic energy generated in the lower respiratory tract to travel directly to the middle ear space. Sounds from breathing and vibrations from the voice are immediately transmitted up the tube. When these internal sounds strike the eardrum from the inside, they are perceived as abnormally loud, resulting in autophony.
The mechanism often causes the eardrum to move visibly in sync with the patient’s breathing, which may be observed during a medical examination. This movement is a physical manifestation of pressure changes being transmitted directly to the middle ear. PET is frequently associated with factors such as significant or rapid weight loss, which can lead to a loss of the fatty tissue padding that normally helps keep the tube closed.
Other potential triggers include severe dehydration, hormonal fluctuations (such as during pregnancy or while taking certain medications), or intense physical exercise. Symptoms of PET can also include a feeling of aural fullness or a roaring tinnitus synchronized with respiration.
Diagnosis and Management of the Condition
Diagnosis of Patulous Eustachian Tube typically begins with a detailed patient history focusing on autophony and aural fullness. A physical examination may include visualizing the eardrum moving in and out as the patient breathes or sniffs. This visible movement synchronized with respiration is a strong indicator of the condition.
Specialized tests like tympanometry can confirm the diagnosis by measuring eardrum movement in response to nasal pressure changes. In some cases, a clinician may use a flexible scope to directly examine the opening of the Eustachian tube in the nasopharynx, looking for continuous visibility.
Management generally starts with conservative strategies aimed at increasing the bulk of the tissues around the tube, encouraging it to close. Increasing hydration and avoiding nasal decongestant sprays, which shrink tissue, are often recommended. Relief can sometimes be found by lying down or placing the head between the knees, as this positioning increases venous pressure and may cause the surrounding tissue to swell.
If conservative methods fail, medical interventions may be considered, ranging from nasal drops or topical medications to more involved procedures. For persistent and severe cases, surgical options may be explored. These include injecting bulking agents near the tube’s opening to narrow the passage or performing a minor procedure to manipulate the eardrum to reduce its sensitivity to internal sounds.