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3 results

  • Voluntary contraction of the tensor tympani muscle and its audiometric effects

  • R D Angeli, M Lise, C C Tabajara, T B Maffacioli
  • Journal:
    The Journal of Laryngology & Otology / Volume 127 / Issue 12 / December 2013
    Published online by Cambridge University Press:
    02 December 2013, pp. 1235-1237
    Print publication:
    December 2013
  • Background:

    The tensor tympani muscle is the largest muscle within the middle ear. Its voluntary contraction is a very unusual event. Only a few papers have documented its audiometric effects.

    Objective:

    To report an unusual case of voluntary tensor tympani muscle contraction and describe its audiometric effects.

    Case report:

    A 27-year-old man, who presented complaining of voluntarily evoked bilateral tinnitus, was found to be able to voluntarily contract the tensor tympani muscle in both ears simultaneously. Audiograms were performed under conditions of rest and maximal contraction of the tensor tympani muscle. The most remarkable effects were conductive hearing loss at lower frequencies and an increase in middle-ear impedance.

    Conclusion:

    The importance of the tensor tympani muscle in middle-ear physiology remains unclear. It has been related to the attenuation of sounds produced during the mastication process. Voluntary control over the tensor tympani muscle is an extremely rare event. However, an understanding of the potential audiometric effects of its contraction could aid the diagnosis of hearing disorders.

  • Activation of middle-ear muscles by transcranial magnetic stimulation

  • F G Fiorino, L Bertolasi, F Barbieri
  • Journal:
    The Journal of Laryngology & Otology / Volume 122 / Issue 8 / August 2008
    Published online by Cambridge University Press:
    04 December 2007, pp. 767-772
    Print publication:
    August 2008
  • Objectives:

    To evaluate the reliability of transcranial magnetic stimulation in eliciting admittance changes due to activation of middle-ear muscles.

    Methods:

    Admittance changes induced by transcranial magnetic stimulation at the inion were evaluated in eight normal subjects, two subjects with prelingual deafness and 22 patients suffering from other otological disorders characterised by absence of acoustic reflex.

    Results:

    Responses showed a predominant negative peak in normal ears. Two small positive components, one preceding and the other following the negative deflection, were less consistently elicited. Only a positive wave was detected in otosclerotic subjects. Patients with tympanic membrane perforation or previous tympanoplasty with ossicular discontinuity did not show any response.

    Conclusions:

    Transcranial magnetic stimulation is able to activate both stapedius and tensor tympani muscles. In conjunction with admittance audiometry, it may represent a method of exploring the mechanics of the middle ear when acoustic reflex testing is not reliable. It can be helpful in the confirmation of stapes fixation when a severe to profound hearing loss is present.

  • Reconstruction of the tensor tympani tendon

  • M Bauer, I Vóna, I Gerlinger
  • Journal:
    The Journal of Laryngology & Otology / Volume 120 / Issue 3 / March 2006
    Published online by Cambridge University Press:
    14 December 2005, pp. 240-243
    Print publication:
    March 2006

  • We describe a case in which reconstruction of the tendon of the tensor tympani muscle was necessary for the successful restoration of sound conduction.

    The right ear of a nine-year-old boy was treated for cholesteatoma with staged surgery. During the first operation, the tendon was cut to ensure good visibility in the tympanic cavity. Post-operatively, maintenance of aeration of the middle ear required ventilation tubes at first and Valsalva manoeuvres later on. The position of the reconstructed tympanic membrane varied a great deal, moving between the medial wall of the tympanic cavity and extreme bulging. This made exact measurement of a columella for ossicular reconstruction impossible.

    The preserved handle of the malleus was bound to the cochleariform process with ionomer cement, using a piece of surgical suture material as a substitute for the tendon. This arrangement prevented the tympanic membrane from undergoing excessive lateral movement after inflation and the ossicular chain was replaced with a successful ossiculoplasty with an autogenous bone ‘drum to footplate’ columella. The pre-operative 55.0 dB air–bone gap decreased immediately to 3.3 dB, widening after three years to 15.0 dB.