Hostname: page-component-8448b6f56d-qsmjn Total loading time: 0 Render date: 2024-04-23T17:04:52.277Z Has data issue: false hasContentIssue false

Activation of middle-ear muscles by transcranial magnetic stimulation

Published online by Cambridge University Press:  04 December 2007

F G Fiorino*
Affiliation:
Department of Otolaryngology, ‘Borgo Trento’ Civil Hospital, Verona, Italy
L Bertolasi
Affiliation:
Department of Neurology, University of Verona, Verona, Italy
F Barbieri
Affiliation:
Department of Otolaryngology, ‘Borgo Trento’ Civil Hospital, Verona, Italy
*
Address for correspondence: Dr Francesco Fiorino, Unità Operativa di Otorinolaringoiatria, Ospedale Civile Maggiore, Piazzale Stefani, I-37126 Verona, Italy. Fax: +39 0458122070 E-mail: franco.fiorino@virgilio.it

Abstract

Objectives:

To evaluate the reliability of transcranial magnetic stimulation in eliciting admittance changes due to activation of middle-ear muscles.

Methods:

Admittance changes induced by transcranial magnetic stimulation at the inion were evaluated in eight normal subjects, two subjects with prelingual deafness and 22 patients suffering from other otological disorders characterised by absence of acoustic reflex.

Results:

Responses showed a predominant negative peak in normal ears. Two small positive components, one preceding and the other following the negative deflection, were less consistently elicited. Only a positive wave was detected in otosclerotic subjects. Patients with tympanic membrane perforation or previous tympanoplasty with ossicular discontinuity did not show any response.

Conclusions:

Transcranial magnetic stimulation is able to activate both stapedius and tensor tympani muscles. In conjunction with admittance audiometry, it may represent a method of exploring the mechanics of the middle ear when acoustic reflex testing is not reliable. It can be helpful in the confirmation of stapes fixation when a severe to profound hearing loss is present.

Type
Main Article
Copyright
Copyright © JLO (1984) Limited 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Jerger, J. Diagnostic use of impedance measures. In: Jerger, J, ed. Handbook of Clinical Impedance Audiometry. New York: Dobbs Ferry, 1975;149–74Google Scholar
2Klockhoff, I. Middle ear muscle reflexes in man. A clinical and experimental study with special reference to diagnostic problems in hearing impairment. Acta Otolaryngol Suppl 1961;164:192Google Scholar
3Djupesland, G, Tvete, O. Impedance changes elicited by tactile and electrocutaneous stimulation. Scand Audiol 1979;8:243–5CrossRefGoogle ScholarPubMed
4Mills, K, Murray, N, Hess, C. Magnetic and electrical transcranial brain stimulation: physiologic mechanisms and clinical applications. Neurosurgery 1987;20:164–8CrossRefGoogle ScholarPubMed
5Bickford, R, Guidi, M, Fortesque, P, Swenson, M. Magnetic stimulation of the human peripheral nerve and brain: response enhancement by combined magnetoelectrical technique. Neurosurgery 1987;20:110–16CrossRefGoogle ScholarPubMed
6Barker, A, Freeston, I, Jalinous, R, Jarratt, J. Magnetic stimulation of the human brain and peripheral nervous system: an introduction and the results of an initial clinical evaluation. Neurosurgery 1987;20:100–9CrossRefGoogle ScholarPubMed
7Macabee, PJ, Amassian, VE, Cracco, RQ, Cracco, JB, Anziska, BJ. Intracranial stimulation of facial nerve in humans with the magnetic coil. Electroenceph Clin Neurophysiol 1988;70:350–4CrossRefGoogle Scholar
8Schriefer, TN, Mills, KR, Murray, NM, Hess, CW. Evaluation of proximal facial nerve conduction by transcranial magnetic stimulation. J Neurol Neurosurg Psychiatry 1988;51:60–6CrossRefGoogle ScholarPubMed
9Estrem, SA, Haghighi, S, Levy, WJ, Wertheimer, R, Kendall, M. Motor-evoked potentials of facial musculature in dogs. Laryngoscope 1988;98:1012–15CrossRefGoogle ScholarPubMed
10Rosler, KM, Hess, CW, Schmid, UD. Investigation of facial motor pathways by electrical and magnetic stimulation: sites and mechanisms of excitation. J Neurol Neurosurg Psychiatry 1989;52:1149–56CrossRefGoogle ScholarPubMed
11Schmid, UD, Moller, A, Schmid, J. Transcranial magnetic stimulation excites the labyrinthine segment of the facial nerve. An intraoperative electrophysiological study in man. Neurosci Lett 1991;124:273–6CrossRefGoogle ScholarPubMed
12Schmid, UD, Moller, A, Schmid, J. The excitation site of the trigeminal nerve to transcranial magnetic stimulation varies and lies proximal or distal to the foramen ovale: an intraoperative electrophysiological study in man. Neurosci Lett 1992;141:265–8CrossRefGoogle ScholarPubMed
13Brask, T. Extratympanic manometry in man: clinical and experimental investigations of the acoustic stapedius and tensor tympani contractions in normal subjects and in patients. Scand Audiol 1978;7:1199Google Scholar
14Ralli, G, Magliulo, G, Gagliardi, M. Bell's palsy and stapedial reflex. Clin Otolaryngol 1986;11:261–5CrossRefGoogle ScholarPubMed
15Ochi, K, Ohashi, T, Kinoshita, H. Acoustic tensor tympani response and vestibular-evoked myogenic potential. Laryngoscope 2002;112:2225–9CrossRefGoogle ScholarPubMed
16Metz, O. Studies on the contraction of the tympanic muscles as indicated by changes in the impedance of the ear. Acta Otolaryngol 1951;39:397405CrossRefGoogle ScholarPubMed
17Sheehy, JL. Far advanced otosclerosis: diagnostic criteria and results of treatment; report on 67 cases. Arch Otolaryngol 1964;80:244–9Google ScholarPubMed
18Sanders, JW, Rintelmann, WF. Masking in audiometry. A clinical evaluation of three methods. Arch Otolaryngol 1964;80:541–56CrossRefGoogle ScholarPubMed