Objective tubal tinnitus: a report of two cases.

Two patients with objective tinnitus due to continuous tubal opening are presented. The objective tubal tinnitus was found to be due to clonic spasm of the muscles of the pharynx and eustachian tube and it can be easily differentiated by means of sonotubometry alone. The acoustic events occurring during the clicking sound were analyzed and were similar to the swallowing sound. Movements of the tympanic membrane were not seen in any of these ears. However, the close relationship of the tensor tympani and tensor palati muscles could explain the movement of the tympanic membrane in some cases. I believe that stapedius muscle spasm or a patulous tube as such does not cause the clicking sound, but it can occur in association with palatal myoclonus. The objective tubal tinnitus is heard as a result of the walls of the eustachian tube snapping together. Transection of the tensor veli palatini muscle tendon may be a useful method of treatment if the patient experiences objective tinnitus which is very distressing.