Abstract
A 64-year-old female was admitted with chief complaints of paroxysmal hemifacial spasm and low-tone noise, which she experienced in the ipsilateral ear synchronously with the spasm. Impedance audiometry performed during spasms showed reduction or disappearance of the acoustic reflex (AR) and elevation of the AR threshold on the affected side. These phenomena could also be elicited by voluntary contraction of the affected side of the face. The patient underwent microvascular decompression of the facial nerve, which abolished both the facial spasm and the low-tone noise. The abnormal AR patterns revealed the spasm as well as synkinesis of the stapedius muscle. The abnormal contraction of the stapedius muscle is believed to have generated the low-tone noise.
