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Such pharmaceutical treatments as are employed are palliative rather than curative, and addressed to the underlying cause if one can be identified, in order to avert progressive damage. Profound or total hearing loss may be amenable to management by cochlear implants , which stimulate cochlear nerve endings directly.
The tympanic nerve (Jacobson's nerve) is a branch of the glossopharyngeal nerve passing through the petrous part of the temporal bone to reach the middle ear. It provides sensory innervation for the middle ear, the Eustachian tube , the parotid gland , and mastoid cells .
Tonic tensor tympani syndrome is a disease of the tensor tympani muscle, described by Klochoff et al. in 1971. [1] [2] The tensor tympani muscle is one of the two middle ear muscles that support the three middle ear bones, called the ossicles.
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.
In severe cases, middle ear hemorrhage or tympanic membrane rupture can result. [16] Tympanic membrane rupture: disruption of the eardrum. This can be caused by a blow to the ear, blast injury, barotrauma, or direct penetration of the tympanic membrane by an object entering the ear. [5]
Conductive hearing loss (CHL) occurs when there is a problem transferring sound waves anywhere along the pathway through the outer ear, tympanic membrane (eardrum), or middle ear . If a conductive hearing loss occurs in conjunction with a sensorineural hearing loss, it is referred to as a mixed hearing loss.
Acoustic trauma is the sustainment of an injury to the eardrum as a result of a very loud noise. Its scope usually covers loud noises with a short duration, such as an explosion, gunshot or a burst of loud shouting. Quieter sounds that are concentrated in a narrow frequency may also cause damage to specific frequency receptors. [1]
Whilst hearing loss is a common symptom in many diseases of the ear, for example in otosclerosis (abnormal bone growth in the ear), [3] the white, chalky patches on the tympanic membrane are fairly characteristic of tympanosclerosis. Cholesteatoma is similar in appearance but the whiteness is behind the tympanic membrane, rather than inside.
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