autophony

Autophony is the abnormal and often prominent perception of sounds generated by the person themselves, most commonly the voice but also including breathing, chewing, and footsteps. It can be unilateral or bilateral and may occur with or without accompanying symptoms such as aural fullness, tinnitus, vertigo, or hearing loss. Because autophony describes a sensory symptom rather than a disease, its significance depends on the underlying cause.

Most cases arise from conditions that alter the transmission and attenuation of self-generated sounds within the ear. A common cause is a patulous Eustachian tube, in which the tube remains abnormally open and sound energy is transmitted more directly to the inner ear. Another important group includes third‑window disorders, particularly superior canal dehiscence syndrome, where a bony defect in the superior semicircular canal creates abnormal intracranial sound transmission and amplifies internal noises.

Diagnosis relies on clinical history and targeted examination. Audiometry and tympanometry assess hearing and middle-ear function, while imaging (such as CT of the temporal bone) is used when a third-window lesion is suspected. In suspected superior canal dehiscence, specialized tests and MRI may aid evaluation.

Management is cause-specific. Patulous Eustachian tube is typically treated with conservative measures: hydration, avoiding dehydration and caffeine, nasal steroids, and, in some cases, brief use of decongestants; symptom relief may be incomplete. Refractory cases may consider procedures to reduce Eustachian tube patency. For superior canal dehiscence and other third-window causes, surgical repair of the bony defect or canal plugging may reduce autophony and associated vertigo. Prognosis varies with the underlying condition.