A Beginner’s Guide To Tensor Tympani Syndrome

diagram of inner ear showing tensor tympani muscle

Have you ever heard a thumping or clicking noise in your ears when your anxiety levels were running particularly high? Though uncommon, you may be experiencing a rare condition known as tensor tympani syndrome (TTS). And while TTS isn’t dangerous, it does cause significant distress and frustration for sufferers, which only serves to worsen the problem. 

What Is Tensor Tympani Syndrome? 

Located in the middle ear, the tensor tympani muscle is attached to very small bones called ossicles. Whenever sounds hit the eardrum, these ossicles vibrate; the louder the sound, the greater the vibration. As sounds get louder, the tensor tympani muscle contracts to help stabilize the ossicles so they don’t overreact, thus reducing perceived volume. You can think of the muscle as a kind of internal calming mechanism to ensure that you’re able to stabilize volume and better react to fluctuations in noise. 

And it’s not just loud sounds that the tensor tympani helps protect against; the muscle is also triggered by physiological actions, like talking, chewing, swallowing, or even being startled. 

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Sometimes, the muscle can experience a spasm and contract even without loud sounds provoking a reflex. This hyper-reaction may be caused by anxiety resulting from tinnitus or hyperacusis (a perception of sounds being much louder than they actually are), since people who suffer from either condition tend to stay in a persistent, low-level state of anxiety, fearing the sudden onset of noises or ear pain. The tensor tympani muscle contraction can also be caused by general anxiety.

Contraction of the tensor tympani may result in a variety of sounds – like thumping, clicking, or even a sense of fluttering in the ears. The related stress may also produce a feeling of pain or burning around the ear, as well as dizziness, headaches, and nausea. 

Dr. Ben goes in depth about Tensor Tympani Syndrome, and whether it can cause tinnitus.

Treatment Options

There’s currently not a lot of research about TTS, but we do know that all these sensations are generally more prevalent in and exacerbated by those with hyperacusis or tinnitus. It’s unclear if the symptoms of TTS happen to simply overlap with symptoms of hyperacusis, or if there may be some relationship between the two conditions. 

Nevertheless, if you think you may be experiencing TTS, it’s important to talk to your doctor first. Auditory discomfort can have numerous root causes, and may be symptomatic of anything from stress to infection to perforation of the eardrum. It’s always best to rule out potential medical problems before seeking a singular course of treatment. You can visit an Ear, Nose & Throat (ENT) doctor in your local area.

Whether rooted in a medical condition or just a run-of-the-mill case of TTS, we strongly urge you to incorporate relaxation strategies into your care plan. Calming techniques can include a wide variety of strategies like meditation, yoga, or cognitive behavioral therapy. While these exercises don’t eliminate TTS, they change the way our brains react to the pain of a flare-up or the fear that another TTS episode is just around the corner by helping us co-exist with the temporary discomfort. And bonus: as you integrate stress relief measures into your daily life, you’re likely to both reduce the occurrences of TTS and reap other health benefits, including better sleep and improved mental health.

Another course of treatment is sound therapy. Again, the intervention isn’t designed to eliminate TTS or other ear maladies, but can be effective in providing relief by normalizing sounds through controlled amplification or variation of noise. Sound therapy is administered by specially-trained audiologists and is a safe, evidence-based way to help you better control how you react to flare-ups. 

Lastly, while there’s no known medical treatment for TTS, we encourage you to partner with your care team (ENT and audiologist) as you explore ways to find relief. An ENT physician can help you understand and navigate the range of options, keep tabs on what you’ve tried and how it’s worked, make sure you’re aware of emergent therapies, and act as a coordinator of care as you navigate therapies with your audiologist to find the right course of treatment.

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