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03.04.2014

Tensor tympani myoclonus ear, ringing in ears never hear frequency again - PDF Review

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Cartoon of the middle ear showing muscles that attach to ossicles (ear bones), and ear drum.
The stapedius is more sensitive to sound than the tensor tympani, and is thought to be the "dominant sound generated reflex in humans). It sometimes results in visible contractions of the ear drum, and sometimes even produces sounds audible to the examiner. Some practices such as the authors, Chicago Dizziness and Hearing, have the ability to make audio recordings using a microphone placed within the ear canal. There should not be movement of the ear drum in the stapedius myoclonus syndrome, as the stapedius does not insert onto the eardrum but rather onto the stapes.
Bance M, Makki FM, Garland P, Alian WA, van Wijhe RG, Savage J.Effects of tensor tympani muscle contraction on the middle ear and markers of a contracted muscle.
Brigo F, Storti M, Lochner P, Nardone R.Transitory stapedial myoclonus in a patient with benign fasciculation syndrome.


The stapedius is attached to the stapes (of course -- horseshoe object above), while the tensor tympani is attached to the ear drum.
It's two roles are thought to be reduction of sound through modulation of middle ear impedance, and prevention of masking of speech through high-pass filtering of low frequency sound (background noise). Patients usually indicate that it makes a "thumping" noise -- like a tympani drum ! According to Bance, tensor tympani function can be measured by detecting changes in middle ear impedence.
The stapedius is innervated by the 7th nerve, and is therefore part of a different circuit than the tensor tympani (5th nerve).
The tympanomeatal flap is elevated to the level of the malleus but is not separated from the malleus.
Thus contractions of the tensor tympani may also be accompanied by contraction of the palatal muscles.


The tensor tympani courses through a bony canal in the wal of the anterior middle ear, and attaches to the neck of the manubrium.
As TT myoclonus often can be elicited by a loud noise, an adaptation of this technique (not in use to the author's knowledge) would be to record just after a loud noise.
It seems to us that the TT muscle requires considerable local irritation to develop myoclonus, and medications that affect the whole body are unable to reduce such intense local spasms. Hieronymus Fabricius, an Italian (1533-1619) was the first to propose theories on tensor tympani function. The tensor tympani is innervated by a branch of the mandibular division of cn V, via the otic ganglion.



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