Dr. Syed Peerzada Tehmid Ul Haque
Otolaryngology (E.N.T)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I have had an ear problem for the last 16 months and, I experience tinnitus that appears while protruding and clenching the jaw. I had an audiometry test which appeared normal. I also saw my stomatologist seven months ago, who fitted me with a nightguard, and I have had 10 sessions of physiotherapy. What could be causing this? Kindly help.
Hello,
Welcome to icliniq.com.
The causes of tinnitus are often poorly understood. You have a history of 16 months; therefore, local conditions like otitis externa or wax do not seem likely to be the cause. Now that jaw movements accentuate this, the temporomandibular joint might be the cause. You might have been examined by some ENT (ear, nose, and throat) doctor. Did he find any abnormality with your eardrum, like retraction? How is your hearing? Is there any vertigo or dizziness? What is the nature of tinnitus? Is it pulsatile or non-pulsatile? Does it happen all the time? Please reach back with details so that I can guide you better. Regards.
Patient's Query
Hi doctor,
Thank you for the reply. The ENT doctor found that the eardrum was fine, and I do not have any problems with my hearing. I also do not experience vertigo or dizziness. I notice tinnitus when I am in a calm environment, but I can also feel clicking on the jaw joint. It is seen more when I stretch the jaw. Yes, the symptoms are accentuated by jaw movements, but I also receive ear fullness when my jaw is motionless.
Hi,
Welcome back to icliniq.com.
From your mentioned history, I can see that you already have had 10 sessions of physiotherapy, has there been any improvement? Also, you have said that you have tinnitus even when you are actively moving your jaw; therefore, tinnitus cannot be related to TMJ syndrome as tinnitus has a very diverse and vague etiology. Since hearing tests, clinical tests all seem to be normal, your tinnitus seems more likely to be functional, with TMJ aggravating it. Have you tried any medications like Amitriptyline or Benzodiazepines?
Patient's Query
Hi doctor,
I appreciate your concern. I have not noticed any improvement after the physiotherapy, but I have heard that it can take a long time to show improvement. Can I buy these medications you mentioned online? Will it take a long time before these sounds are eradicated? Thank you.
Hi,
Welcome back to icliniq.com.
Yes, tinnitus may take time to be eliminated or may not go totally. I suggest trying treatment through multimodalities, as a single measure often gives a slower response. Behavioral therapy, tinnitus retraining therapies, masking devices, pink noises, and medications can be taken simultaneously. One critical approach is to understand the benign nature of tinnitus in most cases and learn to live with it as it progressively improves over time. So an essential part of rehabilitation is ignoring it to the extent possible while exploring other treatment options. I hope this helps. Thank you.
Patient's Query
Hello doctor,
Thank you for your reply. Would you suggest that I try behavioral therapy, tinnitus retraining therapies, masking devices, pink noises, and medications to be taken together, and is there any chance it will completely go away over time? Many thanks.
Hi,
Welcome back to icliniq.com.
It does not have to be all of them, but yes, whatever is feasible you should try. Of course, there is always a chance that it can go completely. Many patients come to me who have had tinnitus for years, and then they have recovered completely. Thanks and regards.
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Otolaryngology (E.N.T)
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