The tensor tympani tendon takes a 90-degree turn around the cochleariform process (a small bony pulley in the medial wall of the middle ear), redirecting the tensor tympani force from a horizontal canal direction to a lateral direction to pull the malleus medially. This pulley arrangement is analogous to the superior oblique trochlea in the eye.
Transmits tensor tympani force to tense the tympanic membrane
The cochleariform process and tensor tympani tendon are landmarks in middle ear surgery, identifying the level of the geniculate ganglion of the facial nerve which lies just above the cochleariform process. The tendon is divided in some approaches to the geniculate ganglion for facial nerve decompression.
Involuntary tensor tympani contractions causing rhythmic clicking tinnitus that can sometimes be heard by an examiner with a stethoscope applied to the ear.
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