Vibratory Tinnitus and Palatal Myoclonus

Abstract

1. Two female patients with vibratory tinnitus and spontaneous palatal myoclonus are reported. One male patient with vibratory tinnitus and voluntary palatal myoclonic movements is described.

2. The tinnitus was heard only when the palatal muscles and salpingo-pharyngeus muscles contracted and the tubal orifices are closed. The tinnitus can be heard both by the patient and by other persons.

3. No common etiology could be determined.

4. No specific treatment has been delineated.

SUMMARY

Fowler has classified head noises into two groups: vibratory tinnitus and non-vibratory tinnitus. Vibratory tinnitus is caused by actual vibrations from any source reaching the end organ of the cochlea — non-vibratory tinnitus is caused by factors other than vibratory.

Some vibratory tinnitus can be heard both by the patient and by other persons. Instances of this kind have been observed in association with palatal myoclonus. The latter phenomenon is recognized as usually rapidly repeated spontaneous and involuntary contractions of the velum and sometimes of the superior constrictor and salpingopharyngeus muscles. A “click” is heard when the muscles contract and the orifice of the auditory tube is closed. However, the exact source of the sound has not been identified.

In three patients pure tone audiometry established normal thresholds for all frequencies. No active otorhinolaryngological disease was discovered. No neurological disease was found.

It is suggested that palatal myoclonus may differ from other myoclonic manifestations observed in varieties of central nervous system diseases.

No specific treatment is recommended. Therapy may necessarily be individualized consistent with the underlying cause of the palatal myoclonus in each patient.