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Q. Why do I get tinnitus when I push the jaw out or clench the chin?

Answered by
Dr. Ranjit Peter
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Feb 09, 2022

Hi doctor,

I have had an ear problem for the last two years, and the tinnitus appears to increase when I push the jaw out or clench the chin. What could be causing this? I had an audiometry test which seemed to be normal. I also saw my stomatologist five months ago, who fitted me with a nightguard, and I have also had about 20 sessions of physiotherapy. Kindly help.

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Hi,

Welcome to icliniq.com.

I understand your concern. However, a few more clarifications would be required as to the nature of your tinnitus. Is it high-frequency (whistling kind of a sound) or a low-frequency hum? Is it pulsatile like a drum beating, or is it continuous?

Considering that your audiometry was reported normal, the possibility of a vascular cause (related to changes in blood flow) would be higher. However, it would be essential to know the particulars that need clarification before suggesting. It would also be good to know any clinical finding reports that would have been mentioned when you went in for the audiometry, such as the otoscopy findings of the status of your tympanic membrane (eardrum).

I would also like to know whether you are on any medications? And have you ever been diagnosed with hypertension?

Thank you.

Hi doctor,

Thank you for the reply.

The audiometry report was quite normal, and the eardrum was fine. The sound is high-frequency and continuous. I notice that the sound increases when I stretch my jaw and open my mouth wide. Kindly help.

#

Hi,

Welcome back to icliniq.com.

I can understand your concern. I would like to know:

1) Is it localized to one particular side (right vs. left), or can it not be made out?

2) Would it be possible to share a photo of your audiogram? Generally, high-frequency sounds originate in the cochlea (inner ear).

3) Does the sound disturb you during the daytime, or is it only at night, apart from the jaw and mouth movements?

4) Have you ever suffered from any episodes of vertigo/nausea/vomiting/fullness in the ear associated with tinnitus?

Thank you.

Hi doctor,

Thank you for the reply.

I have attached my audiometry test with an ENT doctor, and it is localized to the left ear. I perhaps suffer more at night and in a quiet room. I have never suffered from vertigo/nausea/vomiting episodes, but I have fullness in the ear associated with tinnitus.

#

Hi,

Welcome back to icliniq.com.

From the report attached (attachment removed to protect the patient’s identity). I understand your concern. The only probable cause for your tinnitus, based on your audiogram in the left ear, is the possibility of noise exposure causing very early noise-induced hearing loss because of the mild sensorineural hearing loss at 4 KiloHertz frequency (@30dB HL) in the left ear. So I would like to know the nature of your profession and possible exposure to loud noise, noise of machines, prolonged phone use in your left ear etc.

Based on all our discussion and after assessing the degree of severity of your condition (only at night in quiet surroundings), may I suggest the best action forward would be the following:

Preventive actions:

1) Avoid noise exposure.

2) Repeat the pure tone audiogram after six months to look for progression in hearing loss in the left ear.

3) If there is evidence of progression of hearing loss in the left ear (after six months), I would suggest getting a Gadolinium-enhanced MRI (magnetic resonance imaging) of the brain, with the area of focus and interest being left internal auditory meatus and left cerebellopontine angle.

Management options :

1) Tinnitus masking: by biofeedback. In your quiet room, you may use light music or some other low volume of sound in your bedroom so that you will not hear your tinnitus (tinnitus masking).

2) If the tinnitus is getting worse, to affect you during the daytime and disturb your day-to-day responsibilities and activities, you can consider using a tinnitus masking hearing aid at that stage if it happens (but not required currently).

3) I do not suggest any medications currently as they may not improve your condition.

I hope you get well soon.

Hello doctor,

Thank you for the reply.

It is highly irritating hearing the sounds coming out of my ear constantly. I have attached the Gadolinium-enhanced MRI of the brain scan I had done almost a year ago, which the doctors thought was a stroke. Still, the ENT doctor was not particularly concerned about the audiometry test that I previously attached. Kindly help.

#

Hi,

Welcome back to icliniq.com.

I understand your concern.From the report attached (attachment removed to protect the patient’s identity). There is a significant lesion in the frontal lobe that you must follow up with your neurophysician. However, that cannot be attributed to your tinnitus. I would suggest repeating your audiogram as it is already two years. In terms of management, what I mentioned in my previous message would be the final suggestion.

I hope you get well soon.

Thank you.


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