TENSOR TYMPANI SYNDROME

Course overview

TENSOR TYMPANI SYNDROME, ALSO KNOWN AS THE TENSOR TYMPANI MYOCLONUS, IS A RARE FORM OF OBJECTIVE PULSATILE TINNITUS WHICH INCLUDES TENSOR TYMPANI-ASSOCIATED TINNITUS CAUSED BY THE CONTRACTION OF THE TENSOR TYMPANI (TT) MUSCLE. THE TT MUSCLE IS A STRIATED MUSCLE INNERVATED BY THE MANDIBULAR BRANCH OF THE TRIGEMINAL NERVE AND ATTACHES FROM THE GREATER WING OF THE SPHENOID, FORMS CONNECTIONS WITH THE BONY AND CARTILAGINOUS EUSTACHIAN TUBE, PASSES THROUGH THE COCHLEARIFORM PROCESS AND INSERTS ONTO THE HEAD OF THE MALLEUS IN THE MIDDLE EAR. DURING CONTRACTION, THE TT FUNCTIONS TO OPEN THE EUSTACHIAN TUBE AND PULL THE MALLEUS MEDIALLY, WHICH SUBSEQUENTLY STIFFENS THE TYMPANIC MEMBRANE AND DECREASES THE PROPAGATION OF SOUND THROUGHOUT THE OSSICULAR CHAIN. THE TT MUSCLE, TENSOR VELI PALATINI, AND MUSCLES OF MASTICATION ARE ALL INNERVATED BY THE TRIGEMINAL NERVE. IT IS HYPOTHESIZED THAT DUE TO THEIR ANALOGOUS INNERVATION, THE TT MUSCLE FUNCTIONS TO DECREASE THE INTENSITY OF SOUND DURING CHEWING AND SWALLOWING. TT SYNDROME IS A TYPE OF MIDDLE EAR MYOCLONUS (MEM). BOTH TT AND STAPEDIUS MUSCLES ARE INVOLVED IN THE ACOUSTIC REFLEX, WHICH IS THE INVOLUNTARY CONTRACTION OF THESE MUSCLES FOLLOWING HIGH-INTENSITY SOUNDS AND IS THOUGHT TO PROTECT THE INNER EAR CELLS FROM DAMAGE. THIS ACTIVITY REVIEWS THE EVALUATION AND MANAGEMENT OF TENSOR TYMPANI SYNDROME AND HIGHLIGHTS THE ROLE OF INTERPROFESSIONAL TEAM MEMBERS IN COLLABORATING TO PROVIDE WELL-COORDINATED CARE AND ENHANCE OUTCOMES FOR AFFECTED PATIENTS.