Differential Diagnosis for Autophony

Autophony refers to the abnormal hearing of one's own internal sounds, such as breathing, chewing, or vocalizations. This symptom can be associated with various conditions affecting the ear, nose, and throat, as well as neurological disorders. Here's a differential diagnosis for autophony, categorized for clarity:

• Single Most Likely Diagnosis

  • Patulous Eustachian tube: This condition, where the Eustachian tube remains open, can cause autophony by allowing internal sounds to be heard more clearly than usual. It's a common and relatively benign condition that can be caused by weight loss, nasal decongestants, or other factors that affect the tube's normal functioning.

• Other Likely Diagnoses

  • Middle ear problems (e.g., otosclerosis, ossicular chain disruption): Conditions affecting the middle ear can alter sound conduction and lead to autophony.
  • Nasal congestion or rhinitis: Blockage of the nasal passages can lead to mouth breathing and changes in the way internal sounds are perceived.
  • Temporomandibular joint (TMJ) disorders: TMJ issues can cause clicking or other sounds that might be perceived as autophony.

• Do Not Miss Diagnoses

  • Superior semicircular canal dehiscence (SSCD): A rare condition where there's an abnormal opening in the bone overlying the superior semicircular canal of the inner ear. SSCD can cause a variety of auditory symptoms, including autophony, due to the abnormal transmission of sound and pressure.
  • Brainstem or cerebellopontine angle tumors: Although rare, tumors in these areas can affect auditory pathways and cause unusual auditory symptoms, including autophony.

• Rare Diagnoses

  • Otospongiosis (otosclerosis): While mentioned as a likely diagnosis due to its effect on the middle ear, certain rare forms or presentations could be considered under rare diagnoses if they present with atypical symptoms.
  • Cochlear otosclerosis: A rare form of otosclerosis affecting the cochlea, potentially leading to unusual auditory perceptions.
  • Other rare conditions affecting the auditory system or nearby structures, such as perilymphatic fistula or inner ear anomalies, could also lead to autophony but are less common.