Dr. Achanta Krishna Swaroop
Dentistry
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Patient's Query
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, 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 gaurd from the dentist. Any thoughts on the above tests or what you may advise?
Hi, Welcome to icliniq.com.
The oceanic noise which 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 aggravate the ear condition but if you feel that it is worsening continuosly it would signify an inner ear infection (like an infection of the ear canal that requires evaluation and treatment by the ENT specialist). It is highly recommended that you wear your mouth guard regularly especially in the nights or whenever you are at rest and not talking or chewing.
The Probable causes
Investigations to be done
Probable diagnosis
Treatment plan
Patient's Query
Hi doctor,
Thanks for the reply.
I did have vertigo before the pulse tinnitus began. I was doing neck exercises for vertigo. Then pulse tinnitus came. Also, before this started, I was diagnosed with Demodex and rosacea, probably because I have an autoimmune disease and take immunosuppressants. They told me to put a cream of Ivermectin on my skin twice a day for a few weeks. Now my mind is getting out of control. Do you think the Demodex mites could have gone in my ears and causing this? I have no symptoms of it except pulse tinnitus. Thank you.
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 looks in your inner ear, they can place a medicament or give you a suitable prescription or ear drops to treat the infection. Do follow all the advice listed in the points previously, and you will find your tinnitus bearable and reduced to an extent. Good sleep, multivitamin therapy, and proper oral hygiene, along with steam inhalation every day, will 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 it as usual. Vertigo as well exaggerates the symptoms sometimes, so do visit the ENT specialist for specific medications. I hope this helped.
Regards.
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