Therapeutic Effect of Middle Ear Tendon Resection on Middle Ear Myoclonic Tinnitus

Abstract

Objectives: Tinnitus secondary to middle ear myoclonus (MEM) is very rare but troublesome symptom. Recently, we published a paper about the clinical characteristics and the general therapeutic effects of this rare type of tinnitus in a large case series. Here in this study, we evaluated the therapeutic effects of middle ear tendon resection surgery on intractable tinnitus caused by MEM. Methods: This study included 20 patients with intractable tinnitus diagnosed with MEM and treated eventually with surgical resection of middle ear tendons through January 2007 to December 2013. Clinical characteristics and therapeutic response to surgical therapy were thoroughly evaluated. Results: Patients had a mean age of 32.3 years (range, 16-60 years) and the male to female ratio was 10 to 10.The most frequent nature of their tinnitus was crackling sound. Impedance audiogram and otoendoscopic examination of the tympanic membrane were helpful in diagnosing MEM. Postoperatively, tinnitus decreased or even immediately disappeared in all cases of the study. Scores of tinnitus visual analog scale (VAS) and Tinnitus Handicap Inventory were significantly decreased. One of the patients showed delayed facial nerve palsy with complete recovery in 2 weeks. One patient showed the recurrence of symptom of MEM tinnitus within 1 year and was completely recovered by re-operation. Conclusions: Sectioning of the middle ear tendons for middle ear myoclonic tinnitus seems to be safe and effective which can be considered as a promising treatment modality for intractable MEM tinnitus.