Hi

Thanks for the query

The symptoms you have mentioned seem to be of the following conditions:
1. Middle ear myoclonus
2. Tonic tensor tympani syndrome (TTTS).
3. Stapedial myoclonus

Human middle ear has got two muscles namely tensor tympani attached to the malleus bone and stapedius attached to stapes bone. Myoclonus is a short, involuntary twitching of the muscles.

1. Middle ear myoclonus is the tinnitus produced by repetitive contraction of the middle-ear muscles. This is one of the rare conditions of the ear. On otological examination there will be rhythmic involuntary movement of the tympanic membrane. These movements correlate with a rhythmic ‘whistling' or loud noise perceived by the patient.

2. Tonic tensor tympani syndrome (TTTS): In many people with hyperacusis, an increased activity takes place in the tensor tympani muscle as part of the startle response to some trivial sounds. This is due to the lowered reflex threshold for tensor tympani muscle which is also termed as tonic tensor tympani syndrome (TTTS).

3. Stapedius myoclonus is almost similar to the above condition wherein there is stiffening of the ossicular chain following contraction of the muscle.

All the above conditions have to be ruled out by a thorough otoscopic examination and various investigative procedures such as impedance audiometry, stapedial reflex and MRI.

Hope I have answered your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

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