Ear Pain

Some of the most common symptoms reported by patients seeking care with facial pain problems relate to the ear. On a daily basis, patients from NYC and Long Island come to me with the following complaints:

• “My ear hurts.”
• “My ear feels full or stuffy.”
• “Something is dripping in my ear.”
• “I have pressure in my ears.”
• “My ears are ringing, hissing, and buzzing.”

Certainly, the malfunctions of the jaw, facial muscles or Temporomandibular Joints (TMJ’s) are not always the causes of ear pain, but many are!

The reason for the close relationship between facial pain, temporomandibular problems, and the causes of ear pain can be traced to human growth and development. About the same time that the structures of the face and jaw are being formed, those of the ear are being created, coincidently, from the same batch of start-up cells! As a result, ear symptoms often occur when facial and jaw structures are not functioning normally.

When ear symptoms first arise they prompt patients to see their internist and/or an ear, nose and throat specialist as they search for treatment. In the absence of specific infection, fluid in the ear, inflammation of ear structures, and the like, it is quite possible that these causes of ear pain are originating with the muscles of the face and jaw or tissues associated with the Temporomandibular Joints (TMJ’s).

Though at times ear symptoms caused by muscle and TMJ problems are only experienced or increased during eating, talking, open or closing of the mouth, at other times the ear symptoms are constant in their presence and intensity. In both of these scenarios symptoms will continue until the causes of the ear pain (muscles and joints) are addressed, and will not respond to treatments specifically focused on the ear.

Ringing in the Ear

One of the most difficult problems to diagnose is Tinnitus or ringing in the ear. This condition, which can be terribly disabling, has remained a mystery for the medical community throughout the world. Though Tinnitus can be due to medical disease, or the trauma of loud sounds being experienced on one or multiple occasions (battlefield induced, loud music over the course of a lifetime, the sound of a dental drill over a career, etc…), the true mechanisms that lead to this problem in the absence of these past exposures remains unknown.

In a small percentage of patients, the Tinnitus may be related to the function of the Temporomandibular Joints (TMJ’s). Clues leading to this diagnosis are: increased Tinnitus during opening, closing, or forward shift of the jaw; ringing that is not constant but related to jaw function. It is our estimation that Tinnitus is associated with the jaw structures only 10% of the time.

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*If the ear symptoms persist during treatment despite the muscles and Temporomandibular Joints feeling better, it is likely that your ear symptoms have a separate origin, and referral back to the appropriate medical specialist will be made.