High Pitched Pulsatile TMJ — Heard by a Friend

Hello friends

I have winged here a few times about my tinnitus and high pitched pulsatile tinnitus that I can modulate with jaw and head movements.

Previously I have had a couple of friends (around 35 years old) put their ears to my ear out of curiosity to see if they could hear what I could hear, sort of forming a compressed air-tight ear to ear connection. Both said they could hear nothing.

Today a younger friend (22 years old) listened to my ears as I moved my jaw left and right to make the tinnitus as loud as I could, to my surprise she said I can clearly hear what she described as a river sound pulsating at a high pitch. She described pretty much the noise that I can hear. Obviously her ears are much more sensitive than my slightly older friends - plus she hasn't trashed her ears!

I am guessing that with the lateral jaw movements and jaw clenching I am compressing some vessels close to the ear. Interestingly when I rotate my head left/right and then push the jaw in the same direction the sound is reduced. I can make both ears produce the noise audible to her.

Previously I thought I had somatic pulsatile tinnitus (Levine) but now that someone else can actually hear the blood flow on both sides it has me wondering if it is more to do with TMJ.

I will go and buy a small condensor microphone and insert it into my ear and connect to an amplifier to see if I can actually hear the sound.

Anyone else who has access to 'younger' ears to listen to their high pitched pulsatile tinnitus hiss might actually have a result.

Just for a side note, GP/Neuro/ENT used their stethoscopes to listen for 'bruit' type pulsatile tinnitus which is what they are trying to find, but you are talking 45+yr old ears with a much lower frequency range that can miss this high pitched pulsatile thing that quite a few people seem to have here.

I would be interested if anyone has anything similar!

 

I find the insertion of a small microphone very interesting.

Right now mine is whining in the right ear.

I hate that.

M-Bob

 

I think that maybe Levine and Shore among others are correct. There are no case studies where jaw activism itself without DCN input from muscle and neck nerves relates to PT.

Try pressing your hand under your ear besides behind the jaw joint and open and close mouth several times and see if PT slows. Try icing your neck. Stretch the neck. It a matter of finding the DCN input that associates with your neck.

http://www.tinnitushome.com/resources/The Link between Tinnitus and Myofascial Trigger Points.pdf

 

Hello Greg,

Do you know anyone that had success with Trigger Point Treatment?
On top of my "regular" tinnitus I have a Pulsatile tinnitus that fits very well on the Dr Levine description.
However, I have some doubts about his treatments, and in fact, I never read any post or heard from anyone cured after doing the suggest trigger points treatment.

 

@nuno1976 Let me review your posting history this evening and I will get back to you with hopefully at least some ideas to discuss with doctors. I may have questions to ask as well.

It will be needed to try to established some possible cause to your regular T. More important is the time lapse period from onset of regular T to PT because more than likely there's a connection. I will need your age if you haven't provided it in your history. This would be for any possible degenerative condition with systematic associations.

Talk to you soon.

 

@nuno1976 Your history is very complete with everything to know. We had talked a couple of times before such as about loudness of MRIs, but I don't remember reviewing your history.

I highly suspect for PT that it's the sided facial nerve that connect to the operated bone in the middle ear. It not your jaw directly and it never is with PT. The jaw, TMJ and or neck does relate to tinnitus about 20% of the time as physical. A jaw motion can decrease or increase PT, but the facial nerves are also in motion. It's the sided facial nerve with bone connection to the middle ear that causing PT.

As to what cause your first onset of tinnitus it could be your jaw, TMJ, again the facial nerve, noise exposure or infection. If it was TMJ, then neck C1 and C2 probably has involvement unless major stress started you clench your teeth.

I would continue with TMJ treatment - mouth guard
Any discomfort at all in neck arising then a neck X ray.

Read this - treatment is listed.
http://www.michiganear.com/ear-services-facial-nerve-problems.html

 

@Greg Sacramento I have made 10 TMJ physiotherapy sessions without great result.

But it was a "traditional" TMD physiotherapy, focused on my jaw, looking for notches on facial muscles (my masseter was a strong candidate) and doing the stretching exercises.
It's the first time I hear about a possible relation with facial nerve and I doubt the TMJ physio it's the best to treat a damaged or irritated nerve, as you described.

Shouldn't I look for a specialized acupuncture professional?
What you think?

Many thanks for your help!

 

@nuno1976 I doubt that it's best to treat TMJ for relation to PT, that's my point. A thin semi soft mouth guard though is recommended for TMJ.
Here is some more support that TMJ isn't probably a factor.
https://scarysymptoms.com/2018/05/can-tmj-disorder-cause-pulsatile-tinnitus/

There's lots of studies where it's said that specialized acupuncture may help with this. Will it help you? I don't know.
I would research the hypoglossal treatment in Michigan Ear link above.

For myself I suspect that the relationship within this link under Introduction and figure 2 is part of my cause as well for @Thelastleaf as her teeth are moving back and feel different. A thin mouth guard may help her.
https://onlinelibrary.wiley.com/doi/full/10.1002/brb3.619

 

were you diagnosed with pusatile tinnitus?

This sounds like actual tinnitus

 

@Greg Sacramento
Thank you Creg for tagging me to your post.
I do have jaw clicking and my teeth are moving back and my bite is definatly off to where it was. I went to the ENT and audiologist today and he/she said my hearing was perfect and that I hadn't had any hearing loss at all. I would only let them test low frequency and would not let her do the other test she wanted which is the Tympanometry test, as I heard that it shouldn't be done. The ENT said my inner and outer ear looked fine but that maybe it could be the tube and he gave me some flonase and also said I should get a night guard and see if that helps me.
I mean do I get that or do I go back to the dentist and get a replacement retainer that wont be the right one as my teeth have since moved. I don't want anymore movement to affect me if that is what it is. Ugh...so many options right?! Wonder which path to choose

 

@Thelastleaf I have your same problem. The biology behind this is very complex. The jaw and facial are the most complicated parts of the human body as it's also part of the nervous system. The online library link that I provided above is complex and it only tells part of the story.

With myself my jaw/teeth condition has caused facial problems, soreness in the throat, larynx, glands, salvia glands, discomfort under jaw leading to the neck and most biology in the link that I provided you.

How did this all happen? It could relate to injury, whiplash- neck and jaw, C1 and C2 and lower disc, neck muscles, bad posture, dental treatment, having mouth open to wide, clenching of teeth, twisting jaw and/or tongue while sleeping or being awake. From any of this joints receive trauma. Often the teeth will lose dental height and the joints will then set back. Inflammation can set in. Heredity may also play a part.

What is the treatment answers? The neck and c spine, posture control by not walking with head bend forward and all kinds of physical therapy. Injections into facial or the jaw can be dangerous. Some medications usually benzos might help a little, but I don't want to go there.

Keeping the teeth apart might help. A soft thin mouth guard helps me just a little. I have a good understanding of biology, but I have no real answers to this complex problem as it involves so many processes - the entire spine, shoulders and anything and everything above the shoulders.

 

Hi Greg,

I think the benzo test is a good way to determine if PT is somatic type or a real vascular issue. This is just my own opinion and I don't think any medico would use it. But in my mind it makes sense that if your PT/Somatic PT subsides somewhat with a benzo than it is unlikely it is a real vascular issue and more likely the Somatic type described by Levine. The change in BP from a benzo is pretty minimal and doesn't explain the reduction in Somatic PT.

If it were an actual diagnostic method to determine real PT from a vascular issue versus nerve/somatic it would save people a lot of the wasted effort and stress trying to locate the cause.

I would be curious if other people who believe they have somatic pulsatile tinnitus have reduction in the PT when they take a benzo - and I don't mean a relaxed don't care about the PT reduction. I mean an actual significant reduction in the PT to zero or near zero.

 

@melbournejeremy I think that your thoughts should be considered.

My story:
After dental with pressure to my front jaw my c spine straighten from neck muscle spams. Forward pressure of cervical mandibular. I received somatic and PT. The PT became unnoticeable. Now PT is back in force and sounds like boom boom boom, then boom boom, then boom - over and over. It has a rhythm like the rhythm of 'Jack in the Box' a toy for children where a clown eventually pops out of a box. I also hum this sound to myself by thought, not vocal.

I've had all the tests that you have mentioned at first onset. You have great knowledge per testing. Even with degenerative conditions within neck and damage to jaw, nothing showed a connection to my PT other than maybe my thyroid from a color ultrasound. I just had all the tests done again and the same results. My tests were reviewed both times by a neuro cervical and mandibular radiologist that has a specialization with tinnitus.

My PT started again, being louder than it was before about a month ago when I was watching a football game. It started immediately after a touchdown was made by my favorite team. No doubt I experienced hypertension.

I had taken benzos for a time after first onset. They did not help with somatic volume, but did with perception. There are some comments here and there from research studies that benzos can actually lower PT sound up to 60%.

I do think that maybe my PT is caused from an artery, vein or nerve where hypertension as in excitement causes a blood pressure reaction. Over time, I think that my brain has programmed the PT as I hum the sounds to myself in my mind - non voice. It's becoming less not to hear PT for a few seconds up to a few minutes.

My real agony is my jaw where my teeth are moving back causing my bite and teeth height to be off. I also have cut nerves from my dental procedure.