Clicking in Ears from TMJ?

Hello!

Do both of your ears click? Do you hear it when you stand still or lie on your back? Do you just hear the clicks or do you feel your jaw move as well?

I can feel and hear a dull bone like sound on my left side when I move my jaw. I can also sometimes hear a sharp and loud click when I open my mouth wide open. I think I might have TMJ but I have not had it diagnosed. It may or may not be related to my other ear problems. I will see an ENT doctor by the end of the month. Hopefully he will be able to rule out TMJ.

You can have TMJ diagnosed by a dentist or an ENT doctor. My guess is that it's easier to get an appointment for a dentist than an ENT. In such case I would go to the dentist, but I would not rule out seeing an ENT doctor as well since clicking ears can be a sign of ear aliments as well. I don't know how it is in other countries, but in Sweden at least not all dentists can properly diagnose TMJ. Dentists are highly trained in Sweden but it's not uncommon that they consult a medical specialist when diagnosing TMJ.

 

Can you elaborate on that "glue feeling"? What do you mean by that?

Breath induced clicking would suggest a nose problem I would say.

I would say that ear fullness has the greatest number of possible causes, more than any other type of ear problem. But these are often easiest to diagnose, and in most people it's caused by ear wax and other type of blockage of the ear canal and the ear drum. The second in place in terms of possible causes are the clicks. I think clicks are the hardest to diagnose because they are often subjective and accompany tinnitus.

What kind of nose surgery did you have?

I think ETD can be diagnosed using CT and MRI/FMRI imaging. Perhaps tympanometry can be used as well to see if you have fluid in the middle ear. That's usually accompanied with ETD. It's needless to say that imaging is central today in diagnosing many types of medical conditions. Medical imaging has completely revolutionized medical sciences.

 

As I see it, the biggest problem with diagnosing ear problems in general is that there are not a lot of objective test methods. Hardly any! Everything is subjective! Beginning with the standard hearing test!

Now tympanometry is a great little test that can be easily done and it can help diagnose many ear problems, and the measurements are objective. It makes me wonder why so many audiologists don't appear to offer this test willingly when they do the first assessment of a patient's condition. It's objective, quick, and reliable. Less money for them, I guess...

I am of the opinion that the more data you can collect, which includes using objective measurements whenever possible, the better (more accurate) diagnosis you can set. I would like to see less talk and more science in this field. It's difficult enough that you can't explain to an observer what kind of sound you hear that the observer cannot. I know that science is kind of lost when it comes to things like tinnitus. But maybe that's the problem, they need to refocus, get back to basics and start doing science again.

 

Hi! I don't know your full story, but it's good that you do the tympanometry test if you have not done it yet. It only takes a few seconds and it's painless to do. As I said, it gives us objective measurements for the workings of the middle ear. As you probably know the Eustachian tube connects to the middle ear. If the tube is not working properly the fluid in the middle ear starts to accumulate.

Using a tympanometer requires very little training. In my opinion, it should be used by default as part of the standard toolkit when meeting with an ENT for a first assessment. Very much like the otoscope is a standard tool. There is more to tympanometri than one might think. I don't mean to advertise, but Interacoustics has lately developed a 3D version or wideband typanometer.

Introducing a revolution - Wideband Tympanometry

So you had difficulties breathing through the nose due to a deviated septum I presume, and you had a corrective surgery to help you breath better. Is it after this operation that you started hearing these clicks? Does it sound like it's coming from the nose? And when you hear these clicks you also feel like something is being glued or twisted in your ear? Is it only one ear or both? You have tinnitus as well?

I started having problems with my left ear only recently, in July last year. Or at least I started noticing it more around that time. I have had middle ear muscle spasms. I believe I had TTTS. It has almost completely subsided by now. But I do get it sometimes at night when laying in bed, and especially when I lie on my right side. I experienced a short period of TTTS last night actually. It's only my left ear that has the problem.

I have also had clicks in my left ear. These clicks may have to do with the TTTS and/or possible ETD. These clicks have become less frequent now. It may have to due to subsided TTTS. My original hypothesis was that I had some kind of ossicular chain disruption and that it was one of these small bones clicking in my ear. I later started working on a new hypothesis that the clicks may have to do with ETD. When these symptoms were the worst, these clicks were very faint and it really felt like it was coming somewhere from my middle ear. It not only sounded but also felt like something being glued together as you described, or squashed together and then taken apart. Some soft tissue or something.

The reason I suspect ETD in my case is because I started having problems breathing through the nose when laying on my back at night. I went to an ENT and it turned out I had developed some small polyp in my right nostril. So I started taking Nasonex and rinsing my nose every night before bedtime. This was helping me manage the polyps, and right now I barely have any problems breathing through my nose. But the long term use of Nasonex and nasal rinses may have affected my Eustachian tube.

Clicking ears don't always have to be a subjective thing. It should not be neglected or explained away, which is common if one also has tinnitus. There are sometimes mechanical causes for these clicks and they should be investigated thoroughly and seriously.