Middle Ear Myoclonus: Two Informative Cases and a Systematic Discussion of Myogenic Tinnitus

摘要: Background:  The term middle ear myoclonus (MEM) has been invoked to explain symptoms of tinnitus presumably caused by the dysfunctional movement either two muscles that insert in ear: tensor tympani and stapedius. MEM characterized through heterogeneous case reports otolaryngology literature, where clinical presentation is variable, phenomenology scarcely described, pathogenic muscle usually not specified, natural history unknown, presumptive definitive treatment, or stapedius tendon lysis, inconsistently effective. It surprising no unique acoustogenic mechanism pathophysiologic process identified MEM, one several descriptive diagnoses associated with complicated disorders myogenic tinnitus. Methods:  Here, we explore from neurologist’s perspective. Following detailed descriptions informative cases our clinic, systematically evaluate different mechanisms disorder phenomena could lead a diagnosis MEM. Results:  From functional neuroanatomic perspective, how best explained as form peritubal tinnitus, similar related essential palatal tremor. discuss symptomatology may reflect mechanical neurologic processes. We emphasize diagnostic imperative recognize when consistent psychogenic origin. Discussion:  Both individual patient care further elucidation will rely on more characterization well multidisciplinary input neurology, otolaryngology, dentistry.