Department of Otorhinolaryngology, Otemae Hospital, Otemae, Chuo-ku, Osaka, Japan.
Department of Otorhinolaryngology, Otemae Hospital, Otemae, Chuo-ku, Osaka, Japan;Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Yamadaoka, Suita, Osaka, Japan.
J Int Adv Otol. 2021 May;17(3):278-280. doi: 10.5152/iao.2021.8695.
This report presents the case of a patient with forceful eyelid closure syndrome (FECS) who did not have an otologic history of facial paresis. The patient was an 11-year-old girl. She complained of a click noise in the left ear simultaneous with eyelid closure and was referred to our department. A microphone in the external auditory canal captured a click noise simultaneously with eye blinking. Impedance audiometry of the left ear showed a slight compliance reduction simultaneously with eye blinking, whereas a pure-tone audiogram, tympanogram, computed tomography (CT), magnetic resonance imaging (MRI), and movement of the palate and pharynx were normal. Her previous otologic history was unremarkable and did not include facial paresis. She was diagnosed with FECS due to contraction of the tensor tympanic muscle. Treatment with an anticonvulsant for 2 months showed no effects on her tinnitus and she was bothered by her drowsiness and dizziness. Behavioral therapy (BT) was started, and the tinnitus was remarkably reduced in 7 months. BT for patients with muscular tinnitus, including FECS, may be a preferred choice rather than surgical procedure and medication including an anticonvulsant and muscle relaxant.
本报告介绍了一例患有强睑闭合综合征（FECS）但无面神经麻痹耳病史的患者。患者为 11 岁女孩，主诉左侧耳内有咔嗒声，与眼睑闭合同时出现，并被转至我科。外耳道内的麦克风捕捉到与眨眼同时出现的咔嗒声。左侧耳的阻抗测听显示眨眼时顺应性略有降低，而纯音听阈测试、鼓室图、计算机断层扫描（CT）、磁共振成像（MRI）以及腭咽运动均正常。她既往的耳病史无异常，不包括面神经麻痹。由于鼓膜张肌收缩，她被诊断为 FECS。抗惊厥治疗 2 个月后，耳鸣无改善，且困倦和头晕困扰着她。开始行为治疗（BT），7 个月后耳鸣显著减轻。对于包括 FECS 在内的肌源性耳鸣患者，BT 可能是优于手术和药物治疗（包括抗惊厥药和肌肉松弛剂）的选择。
