Bootstrapotosia

Bootstrapotosia is a hypothetical otologic phenomenon described in speculative medical literature as a rare, nonprogressive condition characterized by transient auditory sensations perceived to originate in the ear. Patients report episodes of brief sounds such as tapping, rustling, or ticking, lasting seconds to minutes, with normal hearing between episodes. Otoscopic examination and standard audiometry are typically normal. Some cases show coexisting functional symptoms such as anxiety or somatic complaints.

Proposed etiologies include misperception or misattribution of internally generated sounds, somatosensory-vagal interactions, or functional brain network disruptions. No consistent biomarker has been identified.

Diagnosis is clinical, supported by normal objective tests and exclusion of other conditions such as tinnitus, middle-ear disorders, or vestibular disorders.

Management focuses on reassurance and addressing potential contributing factors. Cognitive-behavioral therapy or psychoeducation may help patients with anxiety or attentional amplification. If somatic contributors are suspected, treatment targets such as temporomandibular joint dysfunction or cervical ergonomics may be helpful. In refractory cases, sound therapy or tinnitus retraining approaches have been proposed, though evidence is limited.

Prognosis is variable; many individuals experience decreasing frequency over time, while others report persistent but non-disruptive episodes.

The term bootstrapotosia is used mainly in hypothetical discussions and is not widely adopted in formal medical coding or practice.