An ear spasm is medically known as middle ear myoclonus (MEM) or sometimes Tensor Tympani Syndrome (TTS). This condition involves an involuntary, repetitive contraction of one of the tiny muscles housed within the middle ear cavity. People perceive this spasm as a sound, often described as a fluttering, clicking, thumping, or buzzing sensation originating deep inside the ear. This internal noise is a form of objective tinnitus. While often disruptive, this muscle twitching is typically harmless and comparable to an eyelid twitch.
The Muscles Responsible for Ear Spasms
The middle ear chamber contains two small muscles whose primary function is to protect the inner ear from loud sounds. The larger is the Tensor Tympani muscle, which attaches to the malleus, one of the three small bones of hearing. When this muscle contracts, it pulls the eardrum inward, tensing it to dampen the transmission of vibrations. Spasms of the Tensor Tympani are frequently associated with a distinct clicking or thumping sound.
The other muscle involved is the Stapedius, the smallest skeletal muscle in the human body. It attaches to the stapes bone and works to pull that bone away from the oval window, reducing sound intensity sent to the inner ear. When the Stapedius muscle spasms, the sound is often described as a buzzing, crackling, or fluttering sensation.
Normally, these muscles contract as part of the acoustic reflex to protect the ear from loud noises or sounds generated internally, such as chewing or speaking. However, in middle ear myoclonus, this reflex mechanism misfires. The involuntary contractions can become chronic or intermittent, often triggered by heightened nervous system activity.
Stress and anxiety are frequently cited as factors that can lower the threshold for these muscle contractions, making spasms more likely. Excessive caffeine intake, dehydration, and physical fatigue can also contribute to muscle irritability. Loud noise exposure, sometimes called acoustic shock, can also prime the middle ear muscles to contract inappropriately. This transient myoclonus often resolves once the underlying trigger is addressed.
Neurological and Structural Causes
While many ear spasms originate from the middle ear muscles, some cases stem from nerve issues or structural problems outside the ear chamber. Certain conditions can cause the facial nerve (Cranial Nerve VII), which innervates the Stapedius muscle, to become irritated. One example is Hemifacial Spasm (HFS), typically caused by a blood vessel pressing on the facial nerve near the brainstem.
Hemifacial Spasm usually manifests as involuntary twitching that begins around the eye and spreads to other muscles on one side of the face. In rare instances, this nerve irritation can extend to the Stapedius muscle, causing an associated internal ear spasm. The Trigeminal nerve (Cranial Nerve V), which innervates the Tensor Tympani, can also be involved in complex cases of nerve-related ear spasms.
A common structural cause of ear-related clicking or popping that mimics a spasm is a Temporomandibular Joint (TMJ) disorder. The TMJ is the hinge connecting the jawbone to the skull and is located directly next to the ear canal. Muscle tension or inflammation in this joint can cause referred pain and sound sensations in the ear.
Tension in the jaw muscles, especially those used for chewing, can directly affect the area near the Tensor Tympani muscle, leading to perceived clicking or popping sounds when the jaw moves. TMJ symptoms like a painful jaw, difficulty chewing, or jaw locking often accompany these ear sensations, helping to differentiate them from true middle ear myoclonus.
When to See a Doctor and Treatment Options
While most ear spasms are temporary and resolve with lifestyle adjustments, professional evaluation is warranted if symptoms become persistent or significantly interfere with daily life. Clear red flags include spasms associated with new hearing loss, facial weakness or droop, dizziness, vertigo, or intense pain. An otolaryngologist can perform a thorough examination, including hearing tests, to rule out other causes of tinnitus or ear-related sounds.
Diagnosis often involves ruling out external causes and, in complex cases, may include imaging like an MRI or CT scan to check for nerve compression or structural abnormalities, especially if Hemifacial Spasm is suspected. Treatment for transient spasms begins with conservative measures, such as reducing intake of stimulants like caffeine and prioritizing stress management and sleep hygiene.
For persistent or severe cases, medical interventions may be considered. Certain medications, including muscle relaxants and anti-seizure drugs, can help reduce the frequency and intensity of contractions. When conservative and medicinal options fail, a procedure called tenotomy, which involves surgically cutting the tendon of the spasming muscle, may be performed to eliminate the involuntary movement. Localized injections of botulinum toxin can also temporarily stop the spasm, providing relief for several months and sometimes helping confirm which specific muscle is responsible.