Palatal botulinum toxin as a novel therapy for objective tinnitus in forced eyelid closure syndrome

Kaffenberger, Thomas M.; Mandal, Rajarsi; Schaitkin, Barry M.; Hirsch, Barry E.

doi:10.1002/lary.26191

Cited by 4 publications

(1 citation statement)

References 10 publications

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“…The large effect of eye blinking on the middle ear admittance suggested that the admittance change resulted from the TTM contraction (the admittance change related to SM contraction alone is much smaller—Kim et al., 2015). This phenomenon has been described in the literature is called the forced eyelid closure syndrome and can be associated to tinnitus ( Kaffenberger, Mandal, Schaitkin, & Hirsch, 2017 ; Kim et al., 2015 ; Lee et al., 2012 ; Ohki & Kato, 2012 ; Rock, 1995 ). The mechanisms of the forced eyelid closure syndrome are unclear.…”

Section: A Pathophysiological Model Of Tttsmentioning

confidence: 99%

An Integrative Model Accounting for the Symptom Cluster Triggered After an Acoustic Shock

et al. 2018

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Acoustic shocks and traumas sometimes result in a cluster of debilitating symptoms, including tinnitus, hyperacusis, ear fullness and tension, dizziness, and pain in and outside the ear. The mechanisms underlying this large variety of symptoms remain elusive. In this article, we elaborate on the hypothesis that the tensor tympani muscle (TTM), the trigeminal nerve (TGN), and the trigeminal cervical complex (TCC) play a central role in generating these symptoms. We argue that TTM overuse (due to the acoustic shock), TTM overload (due to muscle tension), and ultimately, TTM injury (due to hypoxia and “energy crisis”) lead to inflammation, thereby activating the TGN, TCC, and cortex. The TCC is a crossroad structure integrating sensory inputs coming from the head–neck complex (including the middle ear) and projecting back to it. The multimodal integration of the TCC may then account for referred pain outside the ear when the middle ear is inflamed and activates the TGN. We believe that our model proposes a synthetic and explanatory framework to explain the phenomena occurring postacoustic shock and potentially also after other nonauditory causes. Indeed, due to the bidirectional properties of the TCC, musculoskeletal disorders in the region of the head–neck complex, including neck injury due to whiplash or temporomandibular disorders, may impact the middle ear, thereby leading to otic symptoms. This previously unavailable model type is experimentally testable and must be taken as a starting point for identifying the mechanisms responsible for this particular subtype of tinnitus and its associated symptoms.

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Section: A Pathophysiological Model Of Tttsmentioning

confidence: 99%

An Integrative Model Accounting for the Symptom Cluster Triggered After an Acoustic Shock

et al. 2018

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Pharmacotherapy of Tinnitus

Kleinjung

Langguth

2020

Current Topics in Behavioral Neurosciences

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Tinnitus Related to Forceful Eyelid Closure: A Case Report

Dong

Chang

et al. 2023

Ear Nose Throat J

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Tinnitus is a common complaint in the clinical setting and can be classified into sensorineural and objective tinnitus. The sources of objective tinnitus may either come from para-auditory structures, such as myogenic or vascular structures, or the middle ear muscles. One type of objective tinnitus of muscular origin is known as forceful eyelid closure syndrome (FECS). We present an additional case of a 22-year-old woman with unilateral FECS. The auricles and external auditory canals were normal bilaterally; we examined her tympanic membrane under an endoscope, the left tympanic membrane was retracted simultaneously with the closure of her eyelids. Both tympanograms were of type A. However, small cut trace associated with tympanic membrane movement were obtained during blinking. The patient was managed by behavioral therapy and medication treatment conservatively, and the condition became well-controlled. Here, we present this rare case and review the literature.

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Palatal botulinum toxin as a novel therapy for objective tinnitus in forced eyelid closure syndrome

Cited by 4 publications

References 10 publications

An Integrative Model Accounting for the Symptom Cluster Triggered After an Acoustic Shock

An Integrative Model Accounting for the Symptom Cluster Triggered After an Acoustic Shock

Pharmacotherapy of Tinnitus

Tinnitus Related to Forceful Eyelid Closure: A Case Report

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