Tensor tympani muscle
{{Short description|Muscle of the middle ear}}
{{Infobox muscle
| Name = Tensor tympani muscle
| Latin = musculus tensor tympani
| Image = File:Gray915.png
| Origin = Auditory tube
| Insertion = Handle of the malleus
| Blood = Superior tympanic artery
| Nerve = Medial pterygoid nerve from the mandibular nerve (V3)
| Action = Tensing the tympanic membrane
}}
The tensor tympani is a muscle within the middle ear, located in the bony canal above the bony part of the auditory tube, and connects to the malleus bone. Its role is to dampen loud sounds, such as those produced from chewing, shouting, or thunder. Because its reaction time is not fast enough, the muscle cannot protect against hearing damage caused by sudden loud sounds, like explosions or gunshots, however some individuals have voluntary control over the muscle, and may tense it pre-emptively.
Structure
File:Tensor tympani-muscle.jpg muscle.]]
The tensor tympani is a muscle that is present in the middle ear. It arises from the cartilaginous part of the auditory tube, and the adjacent great wing of the sphenoid. It then passes through its own canal, and ends in the tympanic cavity as a slim tendon that connects to the handle of the malleus. The tendon makes a sharp bend around the processus cochleariformis, part of the wall of its cavity, before it joins with the malleus.{{Cite book|title=Gray's anatomy : the anatomical basis of clinical practice|editor=Standring, Susan|isbn=9780702052309|edition=41st|location=Philadelphia|oclc=920806541|year=2016|chapter=Middle ear: Tensor tympani|page=637}}
The tensor tympani receives blood from the middle meningeal artery via the superior tympanic branch. It is one of two muscles in the tympanic cavity, the other being the stapedius.
=Nerve supply=
The tensor tympani is supplied by the tensor tympani nerve, a branch of the mandibular branch of the trigeminal nerve.{{Cite book|last1=Vielsmeier|first1=Veronika|chapter-url=https://www.sciencedirect.com/science/article/pii/S0079612320301321|title=Progress in Brain Research|last2=Schlee|first2=Winfried|last3=Langguth|first3=Berthold|last4=Kreuzer|first4=Peter M.|last5=Hintschich|first5=Constantin|last6=Strohmeyer|first6=Lea|last7=Simoes|first7=Jorge|last8=Biesinger|first8=Eberhard|publisher=Elsevier|year=2021|isbn=978-0-12-821586-9|volume=260|pages=355–366|chapter=17 - Lidocaine injections to the otic ganglion for the treatment of tinnitus—A pilot study|doi=10.1016/bs.pbr.2020.08.006|pmid=33637227 |s2cid=226491220 |issn=0079-6123}} As the tensor tympani is supplied by motor fibers of the trigeminal nerve, it does not receive fibers from the trigeminal ganglion, which has sensory fibers only.
=Development=
The tensor tympani muscle develops from mesodermal tissue in the 1st pharyngeal arch.{{cite book|last=Moore|first=Keith|title=The Developing Human: Clinically Oriented Embryology |edition=7th |year=2003|publisher=Saunders|location=Philadelphia, Pennsylvania|isbn=0-7216-9412-8|pages=204–208}}
Function
The tensor tympani acts to damp the noise produced by chewing. When tensed, the muscle pulls the malleus medially, tensing the tympanic membrane and damping vibration in the ear ossicles and thereby reducing the perceived amplitude of sounds. It is not to be confused by the acoustic reflex, but can be activated by the startle reflex.
=Voluntary control=
Contracting muscles produce vibration and sound.{{cite journal |author=Barry DT |title=Vibrations and sounds from evoked muscle twitches |journal=Electromyography and Clinical Neurophysiology |volume=32 |issue=1–2 |pages=35–40 |year=1992 |pmid=1541245}} Slow twitch fibers produce 10 to 30 contractions per second (equivalent to 10 to 30 Hz sound frequency). Fast twitch fibers produce 30 to 70 contractions per second (equivalent to 30 to 70 Hz sound frequency).
Some individuals can voluntarily produce this rumbling sound by contracting the muscle. According to the National Institute of Health, "voluntary control of the tensor tympani muscle is an
extremely rare event",{{cite journal | url=https://pubmed.ncbi.nlm.nih.gov/24289817/ | pmid=24289817 | year=2013 | last1=Angeli | first1=R. D. | last2=Lise | first2=M. | last3=Tabajara | first3=C. C. | last4=Maffacioli | first4=T. B. | title=Voluntary contraction of the tensor tympani muscle and its audiometric effects | journal=The Journal of Laryngology and Otology | volume=127 | issue=12 | pages=1235–1237 | doi=10.1017/S0022215113003149 | s2cid=26997609 }} where "rare" seems to refer more to the scarcity of test subjects and/or studies than the percentage of the general population who have voluntary control. The rumbling sound can also be heard when the neck or jaw muscles are highly tensed as when yawning deeply.{{cite web |title=Can You Make Your Ear Roar? |date=April 24, 2020 |url=https://nalent.com/can-you-make-your-ear-roar/ |publisher=North Alabama ENT Associates |accessdate=April 14, 2025 |quote=For those who can voluntarily contract the muscle, they will hear a low, thunder-like rumbling in their ears. Essentially, you are hearing the sound of your own muscle.}} This phenomenon has been known since (at least) 1884.cf : Tillaux, Paul Jules, Traité d’Anatomie topographique avec applications à la chirurgie, Paris, Asselin et Houzeau publishers (4°ed. 1884, p. 125 ) In a 2013 case of a 27-year old man who was complaining of tinnitus, otolaryngologists discovered that he was voluntarily contracting the tensor tympani muscles in both ears at the same time.{{cite web |last1=Angeli |first1=R D |last2=Lise |first2=M |last3=Tabajara |first3=C C |last4=Maffacioli |first4=T B |title=Voluntary contraction of the tensor tympani muscle and its audiometric effects |date=December 2, 2013 |url=https://pubmed.ncbi.nlm.nih.gov/24289817/ |work=The Journal of Laryngology & Otology |publisher=National Center for Biotechnology Information |accessdate=April 14, 2025}} In a 2017 study of five volunteers, otorhinolaryngologists found "a low frequency conductive hearing loss."{{cite web |last1=Wickens |first1=Brandon |last2=Floyd |first2=Duncan |last3=Bance |first3=Manohar |title=Audiometric findings with voluntary tensor tympani contraction |date=Jan 5, 2017 |url= https://pubmed.ncbi.nlm.nih.gov/28057076/ |work=Otolaryngology–Head and Neck Surgery |publisher=National Center for Biotechnology Information |accessdate=April 14, 2025}}
= Involuntary control (tympanic reflex) =
The tympanic reflex helps prevent damage to the inner ear by muffling the transmission of low frequency vibrations from the tympanic membrane to the oval window. The reflex has a response time of 40 milliseconds, not fast enough to protect the ear from sudden loud noises such as an explosion or gunshot. File:LDV_AR_measurement_USAARL.png system|alt=|350x350px]] Thus, the reflex most likely developed to protect early humans from loud thunder claps which do not happen in a split second.{{cite book|last1=Saladin|first1=Kenneth|title=Anatomy and Physiology: The Unity of Form and Function|date=2012|publisher=McGraw-Hill|location=New York|isbn=978-0-07-337825-1|page=601|edition=6th}}{{cite journal | last=Jones | first=Heath G. | author-link=Heath Jones|author2=Nathaniel T. Greene|author3=William A. Ahroon | title=Human middle-ear muscles contract in anticipation of acoustic impulses: Implications for hearing risk assessments | journal=Hearing Research | year=2018 | volume=378 |pages=53–62 | doi=10.1016/j.heares.2018.11.006| pmid=30538053 | s2cid=54445405 }}
The reflex works by contracting the muscles of the middle ear, the tensor tympani and the stapedial muscle. However, the stapedial muscle is innervated by the facial nerve while the tensor tympani is innervated by the trigeminal nerve. The tensor tympani pulls the manubrium of the malleus inwards and tightens it while the stapedial muscle pulls the stapes inward. This tightening damps the sound vibration that is allowed to penetrate the cochlea. Withdrawal from drugs such as benzodiazepines had been known to cause tonic tensor tympani syndrome (TTTS) during withdrawal. The tympanic reflex will also activate when loud vibrations are generated by the person themselves. The tensor tympani can often be observed vibrating while shouting at an increased volume, damping the sound somewhat.
Clinical significance
In many people with hyperacusis, an increased activity develops in the tensor tympani muscle in the middle ear as part of the startle response to some sounds. This lowered reflex threshold for tensor tympani contraction is activated by the perception/anticipation of loud sound, and is called tonic tensor tympani syndrome (TTTS). In some people with hyperacusis, the tensor tympani muscle can contract just by thinking about a loud sound. Following exposure to intolerable sounds, this contraction of the tensor tympani muscle tightens the ear drum, which can lead to the symptoms of ear pain/a fluttering sensation/a sensation of fullness in the ear (in the absence of any middle or inner ear pathology).
The mechanisms behind dysfunction of the tympanic tensor muscle and their consequences are hypothesized. However, in a published study, researchers studied the case of an acoustic shock whose mechanisms suggest dysfunction of the tympanic tensor muscle. This study appears to be the first to provide experimental support suggesting that middle ear muscles (MEM) may behave abnormally after an acoustic shock. It is suggested that abnormal contractions (e.g. tonic contractions) of the tympanic tensor muscle may trigger neurogenic inflammation. Indeed, fibers with substances P and CGRP were found in close proximity.Londero A, Charpentier N, Ponsot D, Fournier P, Pezard L and Noreña AJ (2017) A Case of Acoustic Shock with Post-trauma Trigeminal-Autonomic Activation. Front. Neurol. 8:420. doi: 10.3389/fneur.2017.00420Yamazaki M, Sato I. Distribution of substance P and the calcitonin gene-related peptide in the human tensor tympani muscle. European Archives of Oto-Rhino-Laryngology. 2014;271(5):905-911. doi:10.1007/s00405-013-2469-1.
Additional images
File:Gray907.png|External and middle ear, opened from the front. Right side.
File:Gray911.png|View of the inner wall of the tympanum (enlarged)
See also
{{Anatomy-terms}}
- Hearing
- Middle ear
- Ossicles
- Stapedius{{spaced ndash}}the other major muscle in the middle ear
- Acoustic reflex
- Hyperacusis
References
{{Gray's}}
{{Reflist}}
External links
- [http://audilab.bmed.mcgill.ca/~daren/3Dear/mid3.html McGill]
- [http://www.madsci.org/posts/archives/1999-09/937369459.Gb.r.html MadSci Network]
{{Muscles of head}}
{{Auditory system}}
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