gms | German Medical Science

80th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

20.05. - 24.05.2009, Rostock

Epipharyngeal myoclonus with objective tinnitus – diagnostic impedance measurements in the pressure chamber

Meeting Abstract

  • author Sven Lueck - Hals-Nasen-Ohrenklinik und Poliklinik der Charité, Berlin, Germany
  • corresponding author Masen Dirk Jumah - Hals-Nasen-Ohrenklinik und Poliklinik der Charité, Berlin, Germany
  • Philipp Caffier - Hals-Nasen-Ohrenklinik und Poliklinik der Charité, Berlin, Germany
  • Benedikt Sedlmaier - Hals-Nasen-Ohrenklinik und Poliklinik der Charité, Berlin, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 80th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Rostock, 20.-24.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc09hno030

DOI: 10.3205/09hno030, URN: urn:nbn:de:0183-09hno0308

Published: July 22, 2009

© 2009 Lueck et al.
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Outline

Text

Epipharyngeal palatomyoclonus involves rhythmic contractions of the epipharyngeal muscles that lead to rhythmic opening and closing of the epipharyngeal tube orifice. The mechanism that generates the clicking sound has not yet been clarified. Discussions have focussed on collision of the tube walls (tube closure) or sudden overcoming of surface tension (tube opening). Pathologies associated with gaping tube or chronic tube ventilation disorders are conceivable if pressure regulation of the middle ear is impaired. Tube function measurements in a pressure chamber were performed in a 15-year-old girl with myoclonus and objective tinnitus that persisted for a year. The clicking sounds were documented with a microphone in the outer ear canal. Tube function was determined by continuous impedance measurements during a defined ambient pressure change in a pressure chamber. Clicking tinnitus had a frequency of about 60 per minute. The myoclonus did not lead to full functional tube openings and could be inconstantly suppressed while swallowing or chewing. Tube function was normal with regular constant pressure compensation and passive tube opening. Diagnostic measurements in the pressure chamber excluded a lack of middle-ear protection against negative nasopharyngeal pressure during inspiration. The results show that those affected can learn to actively suppress clonus or at least reduce tinnitus intensity. Complaints are markedly improved by physiotherapy.