Tonic Tensor Tympani Syndrome: What Is It? (Symptoms & Causes)

What is Tonic Tensor Tympani Syndrome?

Tonic tensor tympani syndrome is an abbreviation of TTTS, this is a disease of tensor tympani muscle. It is a condition related to anxiety that can drastically affect a person’s ability to hear.Tonic Tensor Tympani

It is an anxiety-based, involuntary condition, in this condition the tensor tympani muscle activity is reduced, which causes the frequent spasm. This condition can trigger aural symptoms from tympanic membrane tension, trigeminal nerve irritability, and the middle ear ventilation alteration. TTTS also causes the Distinctive symptoms of Acoustic shock, which develops after the exposure to an unexpected loud sound. Aural pain and the blockage without underlying the pathology has been noted in the people who suffer from the tinnitus or the hyperacusis.

Some statistics saying that it occurs in only 1 out of every 100,000 people. The tensor tympani muscle, from which TTTS gets its name, is one of the two tiny muscles in your middle ears and the other is the stapedius muscle. The word “tonic” in this syndrome name describes the pulsing action of the tensor tympani muscle.

Tensor Tympani Muscle

Tensor Tympani Muscles

This is a muscle in the ear, which is located above the osseous portion of the auditory tube in the body canal. This tube is helpful to dampen the loud sound. The reaction time of this muscle is not fast enough, that’s the reason that the muscles cannot protect against the hearing damage caused by sudden and loud explosions or the sound produced from the gunshots.

What is Hyperacusis?

Hyperacusis is a debilitating hearing disorder characterized by an increased sensitivity to certain frequencies and the ranges of the volume of the sound. The person with the severe Hyperacusis has difficulty in tolerating everyday sounds, some of which may seem unpleasantly or painfully loud to that person but not to the others. Hyperclausis is often coincident with tinnitus, while both the conditions have a prevalence of about 10-15% and cause Hearing Loss as the major risk factor

Impact Of Tonic Tensor Tympani Syndrome

Tensor tympani muscle protecting the inner ear from loud sounds. The middle ear, located between the eardrum and the inner ear. It has three tiny bones known as the ossicles. The job of the tensor tympani muscle is to pull the tiny malleus (hammer) bone away from the eardrum (tympani), thus tensing the eardrum. Tensor tympani Syndrome is involuntary.

When the muscles contract in response to the potentially damaging sound, the tiny bones of the middle ear (ossicles or tinny bone) move to tighten the eardrum.

Whenever sound enter the ear the ossicles vibrate and sound increase, the more these bones will vibrate. It’s one major function of Tensor Tympani Muscle. It also contracts a to reduce the volume of sounds produced when you chew your food. This muscle reacts sudden loud sounds, it’s called the startle reflex.

If any person suffers from hyperacusis and misophonia increased activity develops in the tensor tympani muscle as a part of the startle response to some sounds, this is called Tonic Tensor Tympani Syndrome.

  • Hyperacusis is the condition of hearing noises abnormally loudly
  • Misophonia is simply called haters of sound
  • Tinnitus is simply mean ringing of sound

What are The Symptoms?

  1. Nausea,
  2. Dizziness or Unsteadiness,
  3. A sensation of pressure in the ear,
  4. A headache,
  5. Feeling of fullness,
  6. Impaired hearing,
  7. Tinnitus,
  8. Muffled or fluctuating hearing,
  9. Disordered or Vertigo,
  10. Sharp pain,

Causes of Tensor Tympani Syndrome

  • TTTS is associated with anxiety, specifically, the anxiety related to tinnitus and hyperacusis.
  • Tonic Tensor Tympani Syndrome is a psychosomatic condition.

People who are suffering from, misophonia, phonophobia, tinnitus, or hyperacusis are at higher risk for developing TTTS. When someone experiences decreased sound tolerance, the everyday sound seems to be loud. The exposure to triggering sound, increase in tinnitus or hyperacusis may occur, as well as the increased anxiety. The increase in anxiety in response to sound can lead to increased activity of the tensor tympani muscle.

Some people who suffer from severe hyperacusis or misophonia, they don’t need to hear a sound in order for their tensor tympani muscle to contract. The muscle activated by itself by making the perception or anticipation of loud sound and can contract just by thinking about a specific or the loud sound.

Some evidence is also there which indicates that TTTS can also be the result of TMJ problems or the upper cervical spine problems caused by whiplash.

How to Diagnose Tonic Tensor Tympani syndrome surgery

It is quite difficult to diagnose the TTTS because very there are very few people who heard about it. Even the physicians don’t know much more about the TTTS.

Tonic Tensor Tympani Syndrome Surgery

In this surgery, an ear surgeon cuts the tensor tympani muscle to relieve the spasms. For some people this surgery is helpful, but mostly it makes the hyperacusis worse.

As the surgeon cuts the tensor tympani muscles, you have less protection from the loud sound, which in result causes the sound sensitivity to be worse. Due to the noise trauma, these muscles become over-protective because of which reacts abnormally, that’s why many believe that cutting the muscles will solve the problem. but, simply cutting the muscles will not solve the root problem. While the root problem is the inner ear damage which causes because of the sound.

The surgery will stop the spasms, but many people refuse this surgery because it makes their hyperacusis worse. And many people also report that it makes their tinnitus worse. Apart from this, some people have great success with this surgery.

This surgery will potentially work for you if your TTTS is not caused by the noise trauma, but it is also important to note that you may get hearing damage without the tensor tympani muscles to protect the ear. This is because the tensor tympani muscle is a protective reflex, similar to the blink reflex.

Is Tensor Tympani Syndrome Connected To Jaw Joints Dysfunction?

TTTS can be results of TMJ problems. TMJ can produce a brief spasm of the tensor tympani muscle. If the muscle of in your jaw tight and tense, it can result in your ear

Treatments for the tensor tympani syndrome surgery

Analysing or treatment for Tensor Tympani Syndrome often involves the use of sound therapy to treat the tinnitus or hyperacusis. Sound therapy overcomes the effect of loud noise.

Some forms of sound therapy, Distraction(this is the process of diverting the attention of an individual), Habituation(helping a person to learn to ignore the ringing).The hyperacusis and tinnitus become under control, the Tonic Tensor Tympani Syndrome is likely to resolve.

The Three treatments which work for the TTTS problems are as follows:-

Sound Therapy

Many people get the tensor tympani syndrome from the acoustic trauma. One of the most successful treatments of TTTS is the sound Therapy. Sound Therapy is the form of a habituation therapy designed to help people who suffer from the tinnitus or the hyperacusis which is caused by the acoustic trauma.

The sound therapy method requires patience and the extreme self-discipline. This method takes about 6-12 months on an average for the complete treatment. This method is one of the best treatment options for both the tinnitus and the hyperacusis. Sound therapy is done by the audiologist, while many audiologists do not provide this treatment. One can also use this method from home, the sound generator for the sound therapy is available online, from where you can order and an online audiologist will guide you the treatment process.

Tonic tensor treatment syndrome Magnesium

Low level of magnesium can cause people to suffer from the problem of anxiety disorder, which is one of the major cause of the tonic tensor treatment syndrome. Many people with tensor tympani syndrome had an anxiety disorder. High-quality magnesium supplements reduce stress and also improves the sleep.

One of the main reason for losing the magnesium from the body is the loud sound, especially when exposed to the loud sound or a long period of time. According to a study in February 2001  in the “Occupational Medicine” journal which concluded that exposing people to the loud sound regularly causes their body to lose the magnesium. One of the best form of magnesium to take for his problem is Magnesium Citrate.

TMJ Treatment

TMJ can produce the Continuous spasm of the tensor tympani muscle along with the ear pain, tinnitus and the other symptoms. The muscles which we use to chew are near to some of the muscles that lead into the middle ear, which may cause hearing problems that lead to tensor tympani syndrome and tinnitus.

If the muscles in the jaw become tight with the tension, then the ear become sensitive. It is best to consult the doctor, chiropractor, or the dentist to find out if you have TMJ. Massaging the Jaw, neck,  and cold packs, gentle stretches of the neck, stress reduction and avoiding chewing gum are some of the home treatment of TMJ.

Natural Remedy
  • Ginkgo Biloba and Vinpocetine herbs that help to increase the blood flow in the inner ear, which relax the tensor tympani muscle. It’s a good remedy for this syndrome.
  • One of the best ways to fix problems with nerves are B vitamins(B-complex vitamin) B-complex is a vegetable capsule.


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