2. 58 H.-B. Liu et al. / Clinical Neurology and Neurosurgery 113 (2011) 57–58
treatment until 4 months later. Repeated treatment at 4 months
obliterated tinnitus.
We speculate that local Botox treatment can be used to man-
age tinnitus caused by myoclonus of other muscles, such as tensor
tympani muscles. In this particular case, the perforation of the tym-
panic membrane allowed for direct application of Botox to the site
of myoclonus. Delivering Botox to the site of action represents a
challenge in patients with intact tympanic membrane, but could
be achieved with microinjection.
Conflict of interest
None.
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