Ear Clicks in Pharyngeal Opening of Eustachian Tube Tremor Caused by Myoclonus of the Tensor Veli Palatini Muscle: A Case Report

Onishi, Waka; Negoro, Atsushi; Tsuji, Kojiro; Muto, Toshihiko; Nozaki, Ryuhei; Sakagami, Masafumi

doi:10.5631/jibirin.97.1049

Cited by 3 publications

(5 citation statements)

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“…If these findings are interpreted as no movement, as found in the literature, then all movements correspond to findings of the soft palate in patients with objective tinnitus reported to date. 1,[3][4][5][6]9,10,12 Buckling of the eardrum was observed in three patients. It has been reported that apart from the eustachian tube, the ossicular muscle can cause muscular objective tinnitus.…”

Section: Discussionmentioning

confidence: 99%

“…We obtained various results that are consistent with previous results. 1 3 4 5 6 7 8 9 10 11 12 13 The findings included various soft palate movements ( Fig. 3 ), eardrum movements, voluntary movements, and myoclonus ( Table 5 ).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…buckle the eardrum, 11 patients without soft palatal movements or eardrum buckling, 1,12 and patients with no history of facial palsy who develop objective tinnitus due to blinking 13 have been reported. However, these reports were all case reports consisting of a few patients, and the underlying cause has not been elucidated.…”

Section: Introductionmentioning

confidence: 99%

“…Besides muscular objective tinnitus, which develops centrally, objective tinnitus has been associated with soft palate myoclonus, 3 4 5 6 middle ear myoclonus presenting buckling of the eardrum, 4 7 and pharyngolaryngeal myoclonus. 8 Patients who voluntary perform soft palate vibrations, 9 10 patients who voluntarily buckle the eardrum, 11 patients without soft palatal movements or eardrum buckling, 1 12 and patients with no history of facial palsy who develop objective tinnitus due to blinking 13 have been reported. However, these reports were all case reports consisting of a few patients, and the underlying cause has not been elucidated.…”

Section: Introductionmentioning

confidence: 99%

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A Study of Muscular Objective Tinnitus Caused by the Eustachian Tube

Mizuta

Endo

Arai

2022

International Journal of Practical Otolaryngology

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Objective tinnitus that originates in muscles can be heard by others as well as by the patient. Although there have been many reports of objective tinnitus, each report has been limited to a small number of cases that have varied from one another, with some being accompanied by such findings as voluntary and/or involuntary movement of the soft palate and eardrum, as well by blinking, and the etiology has remained unclear. We analyzed 16 cases of objective tinnitus synchronous with the opening and closing of the eustachian tube. The voluntary and involuntary movements of the soft palate and eardrum were consistent with the findings in previous reports. The 16 cases included 11 cases of patulous eustachian tube and in 10 of them the patient voluntary induced tinnitus to prevent the symptoms of a patulous eustachian tube. These patients created an opportunity to close the patulous eustachian tube by repeating opening and closing. The sound of the opening and closing of the eustachian tube became an objective tinnitus. The tinnitus was heard only voluntary in seven cases and voluntary and involuntarily in nine cases; one of patients was tentatively diagnosed with middle ear myoclonus and another was diagnosed with pharyngolaryngeal myoclonus. Patulous eustachian tube was first described as one of the causes of objective tinnitus. We speculated that the soft palate and eardrum movements were initially voluntary, but that some of them became involuntarily. If this involuntary movement is seen at the time of examination, it may be diagnosed as myoclonus. Psychological factors may be involved in the transitions from voluntary to involuntary, but further research will be necessary to assess this possibility.

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