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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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