Somatic Tinnitus Causes (TMJ, Neck, etc.): Is There a Way to Tell?

How did you determine HF hearing loss? Did you have an extended audiogram done? What dosages do you take?

 

I am very curious if part of my ringing is indeed tied to TMJ inflammation. The only steroid packs I have been on were the 10 mg 48 pack and the 4 mg prednisone pack, 6 day taper. Seeing other threads makes me wonder if doing a high dosage with taper... 60mg a day would tell me indeed if it is related to inflammation. I can see it helps at least temporarily for hearing damage.

@just1morething have you tried this route to see if yours is related to inflammation/TMJ, or just do the steroid shots? My tinnitus seems to be getting louder and higher in frequency.

Ken

 

Hello @KWC, I don’t have much good news to offer as my noise is all over my head now. Thinking neck muscles or nerves in neck could be affecting my noise. I cancelled my cervical laminectomy and fusion for the time being. Maybe it is just inner ear damage but that don’t explain the good days.

I have tried steroid taper packs in the past with mixed results. I think I’ll see if they can do left TMJ injection sooner than the end of November. Sure is nasty to have weird noises in head.

 

@KWC - Ken - your tinnitus is getting louder and higher in frequency because of your neck exercise methods. LOL - I have mentioned this to you several times. I mentioned outward extension therapy - moving fingers gently externally under jaw to under ears. Then to slightly move neck muscle backwards on sides of neck with fingers. Your non TMJ side is not centered and your joint space is wide and deep on your TMJ side. You also have neck muscle mass and this will pressure your joint space with twisting/turning neck repeatedly or with pressing hard on your neck.

 

I hope you improve. This is a beast. We are all fighting.

 

This is what the spinal surgeon was going to do:

Posterior Cervical Laminectomy and Fusion

 

Wow! Thoughts with you.

 

I also have been tapering off Klonopin the past month and have read that it can cause spikes as well.

 

@Greg Sacramento @just1morething I spent more time reading other threads about MRI versus CBCT for TMJ.

Greg I saw you have dialogue regarding this in another thread. With the splints my pain has definitely reduced but all I have had is a CBCT. I am wondering if I should try to push to get an MRI done. Not sure what value I will gain from it. Right on the outside of my right condyle I can feel a lump/knot in that area. Not sure if the disc can be displaced laterally as well. When I open my jaw I feel the lump/knot move. Not really sure. No one has given me a clear answer on this. I do not have it on my left side. That's why I'm wondering if I should pursue an MRI, and even if I had one, what would be done differently.

Ken

 

I slept in a spare bedroom last night and was on my right side and now my noise is very loud in left ear. I’m thinking left TMJ and possibly neck muscles. I’m going back to physical therapy and see if that helps. I would prefer to have a steroid injection to my left jaw ASAP to again see if there is more immediate relief.

 

Is the lump hard or soft?

 

I would say in between. When I gently press down on it and open my mouth it feels like it moves (almost like lower jaw condyle moving over or under it) and I can feel the indentation at the TMJ area while mouth open. It does not hurt. With mouth open I do not feel it in that area. When I press and hold and open jaw, as noted, I feel movement... If I hold pressure down when I close my mouth I do not feel it return. When I press down in this area I can can make it click by doing this. That's what was making me think it was the disc I am feeling. If so, I'm not sure what can be done.

 

Found this article which references LDD.

If I have that, what is the treatment?

Disc displacement and changes in condylar position

 

I hope you can get it.

 

@KWC

Your allergies - that you recently mentioned - need details - history.
Is this problem isolated or is allergy problem being enhanced from infection somewhere else - such as from immune system - colds - causing a generalized traveling infection from lungs? Is allergies still ongoing and if so, are they seasonal? What did your CBCT note about sinuses?

Your nodule near ear, cyst in mouth may be caused by infection. Your jaw may be getting infected from traveling infection.

I mentioned what the link discusses to you yesterday and before - including... a steep mandibular plane and palatal vault, so this makes it easier for bacteria to collect. As in your link, I also mentioned that your posterior joint space is wide. On your scans, your TMJs are smooth and rounded without defects - but any ongoing present infection can change that - this may be happening. You don't have wisdom teeth.

I don't think that any of the 5 medications that you had used is cause of tinnitus. It may be infection.

Do you have blood work? How often do you get facial pain? Headaches or eye pain? Sorry for all the questions.

I still think that you should discuss Amoxicillin 250 mg 3X/day with your dentist. If your jaw starts to lock, then steroid injections will also be needed.

 

@Greg Sacramento, have you heard of a laminectomy? It supposed to take pressure off of nerves. My noise is bad and wondering if laminectomy would help the noise. Doctor's assistant thought it could cause headaches and perhaps tinnitus.

 

Yes I have seasonal allergies all year long. Oak, grass, mold, etc. I take Allegra, Flonase, and Astepro. Sinuses are clear on all scans.

Blood work was good. Facial/TMJ pain has improved in the last month since starting splints 5 months ago. (7/8 to a 1/3). Headaches have improved too. Sleep is terrible. Tinnitus has gone from an eeee to more of a higher pitch static. I also had right ear itching in December.

Main symptoms now are slight pain (TMJ, headaches sometimes, and area under ear along neck on jawline) as well as feeling the lump/knot at right TMJ area.

Found this link:

http://portlandtmjclinic.com/tmj-disorders/symptoms

I think my tinnitus possibly occurred with TMJ inflammation and allergies impacting ETD. Not sure if stopping allergy shots in December contributed to this as well.

Ken

 

Yes - Development that occurs after injury - with discs.
Can't pinpoint your problems without seeing neck X-rays and CT views or radiologist notes foremost.
Need this information, before discussion of a laminectomy.

It does not seem that you have a vascular problem, so it may be position of C spine from muscle pressure that may also be pressuring nerves. Problem with C spine or Associations to C spine may tell what is going on.

Your tinnitus does seem to be somatic and it's very possible that something is signaling either your brain stem or auditory nerve. Possible eight, third or fourth cervical nerve, nerve root infiltration per cuneate nucleus of cervical spine causing hearing loss.

Questions that I never asked you - Does your tinnitus increase when lying on back with head to pillow or increase within 30 minutes after getting up. Also does your tinnitus sometimes ease up after being up for several hours opposed to increasing?

https://painneck.com/laminectomy/

@KWC, I believe that your problem started with infection fluid traveling from sinuses or ET.

 

Thanks @Greg Sacramento.

I’ll try to get some of my reports together. I cancelled my laminectomy/fusion a day before my surgery. I don’t think the surgeon liked that too well as he picked up the phone when I was talking to his assistant.

 

@Greg Sacramento you are probably right.

 

Hey @Greg Sacramento, hope you are doing as well as can be.

Curious on your take.

On my right TMJ condyle space I can feel a "soft" lump over the space (I do not have this on the left side). When I open my mouth I feel movement of the lump. Not sure if the lump is moving or my right condyle is moving over it when I open my mouth. Is it possible or are you aware of the disc being laterally displaced?

I found this article on NIH:

"Although the disc can be displaced in any direction (i.e., anterior, posterior, lateral, or medial), posterior and pure sideways displacements seem to be rare, whereas anterior displacement appears to be the most common".

When I press down on that area I can reproduce a click when opening mouth lots of times.

In short I am wondering if the lump I am feeling is the disc itself. And I also wonder if splints can actually help that.

Thanks,
Ken

 

@KWC Hi Ken:

In your closed position (scan view) - your right condyle is anterior to the center of the fossa or (natural resting position) and your left condyle is nearly centered within the fossa. Your mandibular vault is deep which means that your jaw hinges (hangs) a little lower than normal. None of this is concerning at all, as almost half the population has these positionings. But when having these positions, the lower jaw can move a little back from either clenching, arthritis - from getting older, C spine changes, wisdom tooth problems or bacterial infection - like from lungs - a cold or fluid from sinus or ET.

I think your lump is from bacterial fluid movement as well as having made your jaw slightly imbalanced.
To find out if any infection remains, take your temperature to see if it's your normal. Hugs.

 

@Greg Sacramento thank you as always. Will check. So you do not think I am feeling the disc?

@just1morething did your jaw injection improve your tinnitus any?

 

My injection made my noise worse initially but then the next day it was really good. I had some minor static today but after I took a shower I seem pretty quiet again. At least I’m not totally debilitated like I was, knock on wood. I will never be perfect but seem to be able to talk on the phone again without ridiculous background noise. I think neck muscles may have something to do with it also. I have an iPad next to my bed which is a bad idea in regards to posture. Old habits die hard but I need to have better posture definitely and not have computer by my bed. I hope you are doing better!

 

That is great news to hear. I hope it stays that way. I believe you indicated you never really had TMJ pain? My pain is better with splints but no change in tinnitus sound. High pitch static.

Who gave you the TMJ shot and how were you able to get them to do it?

Do you mind indicating the practice who did it and how did you find them?

Ken

 

A pain management doctor - you have some jaw pain so tell them that. I asked them if they injected Dexamethasone and they said yes. I would have to get the doctor's report to know for sure. I don’t like static which you say you have. I always wake up to noise but am not using mouthpiece or CPAP. I just fell asleep and woke up to static .

 

Ah man. So sorry. Did it come back in one ear or both? Hopefully it is not loud. Maybe it is temporary.

 

@KWC

It is always in my left ear where it all started. Someone on Facebook TMD said that steroid injections are hard on the delicate condyle in the TMJ. They recommended I see a surgeon being I have grade 5 internal derangement.

I remember one ENT saying I had a narrow left Eustachian tube so I will probably also look at having a balloon put up that side in case this incredibly loud noise is caused by that. I have to keep trying as living with this is really draining and highly annoying.

I hope you are doing better. I didn’t seem to get an alert on your post.

https://journals.lww.com/otology-ne...term_outcomes_of_balloon_dilation_for.15.aspx

https://www.oto.theclinics.com/article/S0030-6665(19)30007-6/fulltext

Eustachian Tube Balloon Dilation

 

@just1morething

I hope you find relief. I'm not doing well at all. I'm having trembling and pins and needles in hands and feet. I think it is related to Klonopin withdrawal as I continue to taper. Tinnitus is so loud. I agree, I am just surviving each day. I am not sure what to do next.

 

My temperature is normal. Could I be feeling the disc? Thoughts with you.