Clicking and Tinnitus

[Neenie]

Hi,
I have unilateral tinnitus which appeared suddenly one day 8 months ago. At the same time I developed a clicking crackling sound in the same ear which is audible to others and happens when I talk or yawn. It is uncomfortable and the tinnitus is also. I have an a few various feeble attempts at an explanation for this and it seems as though no one is listening to me. So far I have had specialists say its my TMJ joint clicking (it's not my jaw, its in my ear), a palatal myoclonus (again, its not in my mouth its in my ear), some other myoclonus, possibly the stapedius muscle contracting (this cant be because it doesnt occur in response to loud sounds). I think it's my Eustatian tube and when I say this the specialists say it isnt but dont provide me with an answer either way. Because tinnitus isn't life threatening, no one cares. Well, not in Australia anyway. I feel that if I could solve the clicking, I will resolve the tinnitus because they both happened at the same time and it's too coincidental to not be related. Because tinnitus is a symptom, I really want to find the cause. And especially because its unilateral, I feel as though it can be solved. Do you have any ideas as to what this clicking is? Oh, on a side note. When I do exercise, this same side fully blocks for the entirety of the session and then subsides once I stop exercising. Many thanks for going to the effort to read this. I greatly appreciate any help or ideas. Kind Regards, Nina

 

[Dr. Nagler]

Hi @Neenie -

I have given a lot of thought to your question.

First of all, the TMJ (temporomandibular joint) is in close proximity to the auditory canal - so it would not be at all unusual to perceive TMJ clicking as a sound in your ear. Palatal myoclonus also most commonly presents as a sound in the ear - even though it originates in the roof of the mouth. The fact that the clicking occurs when you talk or yawn as well as the fact that it can be detected by somebody else favors a TMJ origin.

But here's the thing. In my opinion none of that matters. (And I assume that the reason you posted your question in the Doctors' Corner is because you wanted my opinion, right?)

So based upon the details in your question as well as what you have written in some of your earlier postings, this is what I think is going on ...

I do not think your tinnitus has anything to do with your temporomandibular joint clicking. In fact, I suspect that your TMJ has been clicking for years - but that you only became aware of it because eight months ago you developed tinnitus in the ipsilateral ear for some reason and as the result of your developing tinnitus, you developed a heightened awareness of any and all phenomena in the region of that ear. Lots of people have TMJ clicking. It's a joint. Joints can click. I think that the reason you have become even more focused on the clicking is because you are now sensitive to a whole lot of somatic stimuli. Indeed, in an earlier post you described how you hair bothers you, your skin oil bothers you, your clothes bother you, etc.

You wrote in your question that you feel that if you could solve the clicking, your tinnitus will resolve. You may be right, but for the reasons I stated in the paragraph above I suspect that you are not.

Hope this helps more than confuses.

Dr. Stephen Nagler