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Clinical characteristics and therapeutic response of objective tinnitus due to middle ear myoclonus: A large case series

Authors

  • Shi-Nae Park MD, PhD,

    Corresponding author
    • Department of Otolaryngology–Head and Neck Surgery, The Catholic University of Korea, College of Medicine, Seoul, South Korea
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  • Seong-Cheon Bae MD,

    1. Department of Otolaryngology–Head and Neck Surgery, The Catholic University of Korea, College of Medicine, Seoul, South Korea
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  • Guen-Ho Lee MD,

    1. Department of Otolaryngology–Head and Neck Surgery, The Catholic University of Korea, College of Medicine, Seoul, South Korea
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  • Jee-nam Song MD,

    1. Department of Otolaryngology–Head and Neck Surgery, The Catholic University of Korea, College of Medicine, Seoul, South Korea
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  • Kyoung-Ho Park MD, PhD,

    1. Department of Otolaryngology–Head and Neck Surgery, The Catholic University of Korea, College of Medicine, Seoul, South Korea
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  • Eun-ju Jeon MD, PhD,

    1. Department of Otolaryngology–Head and Neck Surgery, The Catholic University of Korea, College of Medicine, Seoul, South Korea
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  • Young Soo Park MD, PhD,

    1. Department of Otolaryngology–Head and Neck Surgery, The Catholic University of Korea, College of Medicine, Seoul, South Korea
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  • Sang-Won Yeo MD, PhD

    1. Department of Otolaryngology–Head and Neck Surgery, The Catholic University of Korea, College of Medicine, Seoul, South Korea
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  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Associate Professor, Department of Otolaryngology–HNS, The Catholic University of Korea, College of Medicine, 505 Banpo-dong, Seocho-gu, Seoul 137-701, South Korea. E-mail:

Abstract

Objectives/Hypothesis

To evaluate the clinical characteristics and therapeutic response of tinnitus due to middle ear myoclonus (MEM) and to suggest appropriate diagnostic methods.

Study Design

Retrospective chart review.

Methods

This study included 58 patients with tinnitus diagnosed with MEM, who were seen from January 2004 to July 2011. Clinical and audiological characteristics were investigated. The therapeutic responses to counseling, medical therapy, and surgical therapy were evaluated.

Results

Patients had a mean age of 29.8 years (range, 6–70 years), 20.7% (n = 12) were <10 years old, 39.7% (n = 23) were <20 years old, 74.1% (n = 43) were <40 years old, and 5.2% (n = 3) were ≥60 years old. Remembered stressful events or noise exposure were associated with the onset of MEM in 51.8% (n = 30) and 27.6% (n = 16) of patients, respectively. The most frequent nature of the tinnitus was a crackling sound. MEM associated with forceful eyelid closure was observed in 15% of patients. Impedance audiogram and otoendoscopic examinations of the tympanic membrane were helpful tools for diagnosing MEM. With medical therapy, more than 75% of patients exhibited complete or partial remission of their tinnitus. Patients with intractable MEM who underwent sectioning of the middle ear tendons had very good outcomes.

Conclusions

Tinnitus due to middle ear myoclonus seems to occur in young patients and to be related to stress or noise. Information about the clinical characteristics and therapeutic response of this less-common type of tinnitus will help to ensure early and appropriate diagnosis and treatment of these patients. Laryngoscope, 123:2516–2520, 2013

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