this is Alex Ashford I would like to
present an interesting patient from my
clinic this 55 year old woman of Native
American descent presented to my clinic
with the lifelong history of
intermittent left-sided pulsatile
tinnitus which she described as either a
shotgun sound or fluttering sounds in
her left ear
the left ear coming into view under the
microscope there's a large perforation
of the tympanic membrane inferior ly we
see the UM bow of the malleus quite
clearly in the center of the screen the
middle ear mucosa and residual tympanic
membrane is inflamed and we have several
direct views of abnormal motion of the
eardrum and the manubrium of the malleus
which is caused by an abnormal dystonia
of the tensor tympani muscle in the
middle year it is frequents that I have
patients who complain of sounds whether
it be shotguns crickets fluttering or
you name it in the ear and oftentimes we
leave with our head scratching however
in this case we can see quite clearly
that the patient indeed is not crazy and
does have abnormal movement