I have pulsatile tinnitus with TMJ disorder. What can help?

Question

Hi doctor,

Can TMJ (Tempromandibular Joint) disorder cause pulsatile tinnitus? I have had pulsatile tinnitus for six weeks. I also have a TMJ disorder. It hurts intermittently inside my ear and sometimes on the sides of my face.

But my concern is about the 24/7 pulsatile tinnitus. I have had every test. MRI without contrast of the head and neck, MRA of the neck with contrast, and MRV (Magnetic Resonance Venography) of the head with contrast (they inadvertently did not do MRA of the head with contrast).

I also had CT (Computed Tomography) angiography of the head and neck with contrast and ultrasound of my neck. I am so upset. They can find nothing wrong.

Instead, I have an ocean noise combined with my pulse in the inner ear. I did order a mouth guard from the dentist.

Any thoughts on the above tests or what you may advise?Kindly help.Thank you.

Answer 1

Hi, Welcome to icliniq.com.

The oceanic noise that you feel you are hearing in your inner ear may have nothing to do with your TMJ (temporomandibular joint) disorder.

TMJ disorders usually produce clicking, grating, or popping sounds along with tinnitus that increases in intensity over time or aggravates the ear condition, but if you feel that it is worsening continuously, it would signify an inner ear infection (like an infection of the ear canal that requires evaluation and treatment by an ENT specialist).

The causes include vestibular disturbance in the ear, meaning temporary degenerative changes in the inner ear, temporomandibular joint infection, or disorders. Systemic links like Klippel-Trenaunay and Maffucci syndrome.

It is highly recommended that you wear your mouth guard regularly, especially at night or whenever you are at rest and not talking or chewing.

Please visit the otolaryngologist as soon as possible in person. In-clinic consultation with your previous reports and medical records is advised, along with a report of your complete blood count (CBC) and blood pressure readings.

A few home remedy tips to help reduce tinnitus are

Avoid coffee (caffeine). Substitute with fresh milk or tea.
Nicotine should be strictly discontinued if you have a smoking habit in any form.
Avoid or limit alcoholic beverages.
Multivitamin therapy is needed as recommended by the general physician. Brands will vary, but vitamin B12 capsules or a multivitamin combination every day after food, along with vitamin C supplements, will greatly help.
Eat fiber-rich foods, and more protein intake is needed.
Do not listen to any loud music or avoid noise in the internal ear canal for a period of two to three months till the tinnitus subsides.
Meditation and yoga poses to promote blood flow to the inner ear and the head region will improve oxygen saturation and help reduce tinnitus.
Sleeping for a minimum of eight to nine hours a night will relieve your stress.
Avoid neck exercises or quick rotational movements strictly, as they can aggravate your tinnitus.

I hope this helps.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

Though it is considered rare that human mites can potentially harm your ear canal, it may be possible for them to thrive in the inner ear. Once your otolaryngologist examines your inner ear, they can administer medication or prescribe suitable ear drops to treat the infection.

Follow all the advice listed in the points previously, and you will find your tinnitus bearable and reduced to some extent. A good night's sleep, multivitamin therapy, and proper oral hygiene, along with daily steam inhalation, can help.

As you rightly said, immunosuppressants can lower your body's immune response, but as your doctor necessarily suggests them, you will need to continue them as usual.

The investigations to be done include:

Blood test (complete blood count).
Ear canal examination.

Vertigo sometimes exaggerates the symptoms, so visit the ENT specialist for specific medications.

I hope this helps.

Please follow-up if you have any doubts.

Thank you.

Regards.