Clinical characteristics and therapeutic response of objective tinnitus due to middle ear myoclonus: A large case series

Abstract

4.

Objective Tinnitus

“…Tinnitus secondary to middle ear myoclonus is very rare, and consequently there are very few reports of it in the English literature [8][9][10][11][12]. It has been suggested that the crackling or buzzing sounds reported are caused by repetitive and abnormal tensor tympani and stapedial muscles contractions [11].…”

“…These myoclonic movements are thought to be a form of segmental myoclonus involving brainstem innervated muscles. Vascular, infectious and demyelinating disorders as well as anxiety, trauma and neoplastic disease have all been implicated in the etiology of segmental myoclonus [9,11,12]. In a previous report of the largest case series of middle ear myoclonus, 58 enrolled patients had a mean age of 29.8 years (range, 6-70 years) and 20.7% (n=12) were less than 10 years old [12].…”

“…Vascular, infectious and demyelinating disorders as well as anxiety, trauma and neoplastic disease have all been implicated in the etiology of segmental myoclonus [9,11,12]. In a previous report of the largest case series of middle ear myoclonus, 58 enrolled patients had a mean age of 29.8 years (range, 6-70 years) and 20.7% (n=12) were less than 10 years old [12]. Stressful events or noise exposure were frequently associated with the onset of middle ear myoclonic tinnitus, which indicates that a possible pathological mechanism of the middle ear myoclonic tinnitus could be brain reorganization due to stress, noise or brain lesions.…”

“…Stressful events or noise exposure were frequently associated with the onset of middle ear myoclonic tinnitus, which indicates that a possible pathological mechanism of the middle ear myoclonic tinnitus could be brain reorganization due to stress, noise or brain lesions. Middle ear myoclonic tinnitus can also be associated with vigorous contractions of the eyelid, called forceful eyelid closure syndrome [14], or with palatal myoclonus [12].…”

“…In addition, more than 75% of patients exhibited complete or partial remission of their symptom using combination medical therapy [12]. Other therapeutic options like white band noise masking devices were also successful in treating middle ear myoclonus [16].…”