Definitive diagnosis and management of Patulous Eustachian tube (PET) is unsatisfactory. Several different treatment methods are currently used for PET which itself indicates no satisfactory solution. The objective of this study was to compare the outcomes of two different treatment strategies for PET. Traditionally paper patching is usually used as one of the diagnostic techniques for PET. It involves placing cigarette paper over the most mobile quadrants of the tympanic membrane. The authors, however, recommend this as a treatment option. The objective of this study was to retrospectively compare the outcomes of this form of treatment with nasal saline irrigation with or without ipratropium bromide nasal spray. Retrospectively, medical records were reviewed for resolution of PET symptoms as with a minimum follow-up of three months. A total of 23 patients underwent paper patching of the tympanic membrane and 16 patients were treated with saline irrigation with or without ipratropium bromide nasal spray. A greater percentage of patients reported complete remission of aural symptoms in the paper patching group at one month (83%) and three months (65%) than in the nasal irrigation group which was one month (6%) and three months (25%) after treatment (p< .05). Immediately after undergoing paper patching, 20 of the 23 patients (87.0%) reported complete remission, hence useful for diagnosis. The obvious issue is the need for repetitive paper patching which seems like an unlikely solution. The major limitations of the study are that it is a retrospective review with a short duration of follow-up. However, it is certainly worth a read.