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Reflexogenic vertigo treated by tensor tympani transection.

J M Epley

    Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
    |September 1, 1981
    PubMed
    Summary

    Severe vertigo triggered by hiccups or belching in two patients resolved after tensor tympani transection. This suggests a reflex mechanism involving middle ear muscle contraction affecting the vestibular system.

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    Area of Science:

    • Otolaryngology
    • Neuroscience
    • Vestibular System

    Background:

    • Vertigo is a common symptom with diverse etiologies.
    • Reflexive middle ear muscle contractions can potentially influence vestibular function.

    Observation:

    • Two patients presented with severe vertigo episodes linked to eructation or hiccups.
    • One patient had a history of poststapedectomy surgery, the other idiopathic cochlear degeneration.
    • Hennebert's test reproduced symptoms in the affected ear for both patients.

    Findings:

    • Surgical transection of the tensor tympani muscle provided immediate relief from vertigo in both cases.
    • A concomitant endolymphatic sac procedure was performed in one patient.

    Implications:

    • The findings suggest a novel reflex pathway where tensor tympani contraction, triggered by eructation/hiccups, may cause stapes displacement.
    • This displacement, potentially exacerbated by adhesions, could stimulate vestibular endorgans, leading to vertigo.
    • This study highlights a potential link between middle ear reflexes and vestibular symptoms, offering new diagnostic and therapeutic insights.

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