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Management of middle ear myoclonus

Published online by Cambridge University Press:  29 June 2007

Lydis Badia ,
Abhi Parikh  and
Gerald B. Brookes
Lydis Badia
Affiliation:
From the Royal National Throat, Nose and Ear Hospital, Gray's Inn Road, London WC1X 8DA and the National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG.
Abhi Parikh
Affiliation:
From the Royal National Throat, Nose and Ear Hospital, Gray's Inn Road, London WC1X 8DA and the National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG.
Gerald B. Brookes*
Affiliation:
From the Royal National Throat, Nose and Ear Hospital, Gray's Inn Road, London WC1X 8DA and the National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG.
*
Mr G. B. Brookes, Consultant ENT and Neurotological Surgeon, The Royal National Throat, Nose and Ear Hospital, Gray's Inn Road, London WC1X 8DA.
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Abstract

Tinnitus produced by synchronous repetitive contraction of the middle ear muscles (middle ear myoclonus) is a rare condition.

We present six cases of middle ear myoclonus in whom different management regimes were successful. In two patients, the tinnitus was controlled by conservative measures. In one patient, whose tinnitus was associated with blepharospasm, significant improvement occurred following botulinum toxin injection into the ipsilateral orbicularis oculi. Three patients were cured by tympanotomy with stapedial and tensor tympani tendon section.

The aetiology of this type of myoclonus remains unclear. The diagnosis is based on the history of involuntary and rhythmic clicking or buzzing tinnitus which is invariably unilateral. The primary differential diagnosis is palatal myoclonus whilst other local aural pathologies must be excluded by careful clinical assessment. Surgical section of these muscles via tympanotomy brings guaranteed relief when conservative measures fail.

Keywords

TinnitusMyoclonusMiddle ear
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 108 , Issue 5 , May 1994 , pp. 380 - 382
Copyright
Copyright © JLO (1984) Limited 1994

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References

De Jong, R. M. (1950) The Neurologic Examination. 1st Edition. Harper and Brothers, New York, p 509.Google Scholar
East, C. A., Hazell, J. W. P. (1987) The suppression of palatal (or intratympanic) myoclonus by tinnitus masking devices. A preliminary report. Journal of Laryngology and Otology 101: 1230–1234.CrossRefGoogle ScholarPubMed
Kirikae, L. (1960) The Structure and Function of the Middle Ear, University of Tokyo Press, Tokyo, pp 129–130.Google Scholar
Klochoff, I. (1981) Impedance fluctuation and a ’tensor tympani’ syndrome. Proceedings of the 4th International Symposium on Acoustic Impedance Measurement. (Penha, and Pizarro, , eds.) Universidade Nova de Lisboa, pp 69–76.Google Scholar
Kwee, H. L., Struben, W. H. (1972) Tinnitus and myoclonus. Journal of Laryngology and Otology 86(3): 237–241.CrossRefGoogle ScholarPubMed
Marchiando, A., Per-Lee, J. H., Jackson, R. T. (1983) Tinnitus due to idiopathic stapedial muscle spasm. Ear, Nose and Throat Journal 62: 8–13.Google ScholarPubMed
O’Connor, A. E, Shea, J. J. (1981) Autophony and the patulous eustachian tube. Laryngoscope 91: 1427–1435.CrossRefGoogle ScholarPubMed
Pulec, J. L., Simonton, K. M. (1961) Palatal myoclonus: a report of two cases. Laryngoscope 71: 668–670.CrossRefGoogle ScholarPubMed
Pulec, J. L. (1980) Diseases of the eustachian tube. In Otolaryngology. 2nd Edition. Vol. II, Ch. 14, (Paparella, H. M. and Shrumrick, D. A., eds.), W. B. Saunders and Co., Philadelphia, p 1409.Google Scholar
Rosen, S. (1951) Surgery in Ménière's disease. Annals of Otology, Rhinology and Laryngology 60: 657–667.Google Scholar
Saeed, S. R., Brookes, G. B. (1993) The use of Clostridium botulinum in palatal myoclonus. A preliminary report. Journal of Laryngology and Otology 107: 208–210.CrossRefGoogle ScholarPubMed
Swanson, P. D., Luttrell, C. N., Magladery, J. W. (1962) Myoclonus: a report of 67 cases and review of the literature. Medicine 41: 339–356.CrossRefGoogle ScholarPubMed
Watanabe, W. I., Kamagami, H., Tsuda, T. (1974) Tinnitus due to abnormal contraction of stapedial muscle. Journal of Otorhinolaryngology 36: 217–226.Google ScholarPubMed
Williams, J. D. (1980) Unusual but treatable cause of fluctuating tinnitus. Annals of Otology, Rhinology and Laryngology 89: 239–240.CrossRefGoogle ScholarPubMed