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Is my pulsatile tinnitus due to TMJ issues?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hi doctor,

I have had pulsatile tinnitus for the past three months, 24 hours a day. It is loud, except when lying down. I am so upset. It is not my BP, although it has risen since the beginning of this. They upped my Benicar from 5 mg to 25 mg, so now it is fine.

I have had every test, like MRI of the brain and neck, MRA of the brain and neck, MRV, angiogram, and CT of the brain and neck. All were negative. My jaws hurt intermittently, and I do have bad TMJ.

I have seen two ENT doctors and one neurologist. One otolaryngologist (ENT) doctor said it could be from TMJ (temporomandibular joint). The other two doctors said no. So I just got a mouth guard at night. It has helped with the pain in my jaw. I am so upset.

  1. Do you think it could be from TMJ?
  2. If not, any suggestions on what to do next?

Kindly guide me.

Thank you.

Hello,

Welcome to icliniq.com.

As all the tests, including MRI (magnetic resonance imaging), CT (computed tomography), etc., have turned out to be normal, there is no secondary reason causing the tinnitus. So the problem lies inside the inner ear, and nothing else.

The TMJ (temporomandibular Joint) disease process, especially if inflammatory or infective, may affect the ear, causing tinnitus, but it is not very common. It is your inner ear only that is causing the problem.

And which might be difficult to objectively test for. The thing you have not mentioned is whether the tinnitus is continuous or episodic, and whether you have deafness in any ear or not.

  1. Was the testing for deafness done?
  2. Is there any change in tinnitus over the last three months, if it is improving or worsening?

Kindly answer the questions so that I can guide you accordingly.

I hope this helps.

Thank you.

Patient's Query

Hi doctor,

Thank you for your reply.

The pulsatile tinnitus is 24/7 continuous. I did have a CT of the temporal bone, and nothing showed. There has been no change in pulsing since it began. I did have a hearing test and had some hearing loss. My jaw occasionally aches around the ear area. It is in both ears.

  1. What do you think could be in my inner ear causing this?
  2. Why would it not show up on an MRI or CT of the temporal bone?
  3. Are there other tests I should have?

Kindly give your opinion.

Thank you.

Hello,

Welcome back to icliniq.com.

If you have hearing loss in both ears, then it is more likely the problem is with the ear or the ear's nerve only, as an MRI (magnetic resonance imaging) is not showing any positive findings. An MRI will not show anything when there are such issues. Please ask your ENT about the possibility of Meniere's disease also.

I hope this was helpful.

Thank you.

Medically reviewed byDr. Sushrutha M.

Published At July 13, 2021
Reviewed AtApril 17, 2026

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