Pau Hans Wilhelm, Punke Christoph, Zehlicke Thorsten, Dressler Dirk, Sievert Uwe
Klinik und Poliklinik für Hals-Nasen-Ohrenkrankheiten, Kopf- und Halschirurgie, Rostock, Germany.
Acta Otolaryngol. 2005 Nov;125(11):1168-75. doi: 10.1080/00016480510012408.
The results of this study show that in clinical practice it will not be easy to diagnose tonic contractions of the tensor tympani muscle and only a combination of findings will be helpful. Based on these experimental results a clinical study will be started which should clarify the diagnostic relevance of indicators of tonic tensor muscle contractions.
There are indications from the literature and from personal experience that tonic contractions of the tensor tympani muscle may play a role in some ear symptoms, such as fullness, certain cases of tinnitus, slight hearing loss or Ménière's disease-like findings. In order to prove this theory we looked for indicators, either visual or functional, to help clinically diagnose the functional state of the muscle, particularly its tonic contraction.
Experiments simulating tensor contractions were carried out on temporal bone specimens. Traction was applied either to the isolated muscle, to its tendon or to the malleus neck. Effects were observed either visually via an endoscope or by impedance audiometry using multiple-frequency tympanometry.
During simulated tensor traction the aspect of the tympanic membrane changed slightly, i.e. there was some inward movement of the umbo. However, such effects were only identifiable during the pulling action or by directly comparing the "contracted" and "relaxed" states. Tympanometry revealed a decrease in the peak amplitudes and a shift in the middle ear resonance towards higher frequencies during contractions.
本研究结果表明，在临床实践中，诊断鼓膜张肌的强直性收缩并非易事，只有综合各项检查结果才会有所帮助。基于这些实验结果，将开展一项临床研究，以明确鼓膜张肌强直性收缩指标的诊断意义。
从文献及个人经验来看，有迹象表明鼓膜张肌的强直性收缩可能在某些耳部症状中起作用，如耳闷、某些类型的耳鸣、轻度听力损失或类似梅尼埃病的表现。为了证实这一理论，我们寻找了视觉或功能方面的指标，以帮助临床诊断该肌肉的功能状态，尤其是其强直性收缩。
在颞骨标本上进行模拟鼓膜张肌收缩的实验。分别对分离出的肌肉、其肌腱或锤骨颈部施加牵引力。通过内窥镜进行视觉观察，或使用多频鼓室导抗测试法进行声导抗测听，观察其效果。
在模拟鼓膜张肌牵引过程中，鼓膜外观略有变化，即鼓膜脐部有一些向内移动。然而，这种效应只有在牵引过程中或通过直接比较“收缩”和“松弛”状态才能识别。鼓室导抗测试显示收缩过程中峰值振幅降低以及中耳共振向高频偏移。
