The tensor tympani (TT) is a muscle within the middle ear, located in the bony canal above the bony part of the auditory tube, and connects to the malleus bone. Its role is to dampen loud sounds, such as those produced from chewing, shouting, or thunder.
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, forming 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.
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.
A 43-year-old male with a history of coronary artery disease, generalized anxiety disorder, arthritis, and hypertension present to the clinic with a three-year history of non-pulsatile, "fluttering" tinnitus that is often accompanied by neuropathic pain of the cheek, ear, and temporomandibular joint (TMJ) area. It can be random but is, at times, provoked by loud noises. It has become much more common and bothersome in the past two months. During history taking, it is uncovered that he had multiple medications adjusted for his aforementioned medical problems right around the time that his symptoms intensified. Otoscopy during a symptomatic period shows the movement of the tympanic membrane. Which medication change caused the worsening of his symptoms?
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https://radiopaedia.org/articles/tensor-tympani-muscle-1?lang=us
Keidar E, De Jong R, Kwartowitz G. Tensor Tympani Syndrome. [Updated 2021 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519055/
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