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Tinnitus / TMJ / Nerve / Teeth Problem

newell at hrbeam.csc.ti.com newell at hrbeam.csc.ti.com
Fri Sep 20 07:17:14 EST 1996

I have suffered from a particular type of loud "clicking" or
"snapping" subjective tinnitus in my right ear for 12 years.
I suspected it was muscular in nature due to the spasmodic start/stop
pattern and slow maximum frequency of about 1 to 8 cycles per second.
There were two separate noises, one of a sharper timbre, and one with
a duller timbre, both partially but not totally synchronized with each
other.  In 1992, without looking too hard into the cause, because at
that time there were too many possible causes, I had both the stapedius
muscle and the tensor typani tendon sectioned in separate operations on
advice from my ENT.  The stapedius section showed no effect, thereby
eliminating this cause.  The tensor typani section had a definite but
subtle effect on the tendency of the noise to activate,
but no change in the noise or noise pattern itself.

Until I again picked up my research this year into this problem, I 
had suspected loud rock music from headphones had somehow damaged
the nerve supply to an ear muscle.  With the stapedius muscle gone,
that left only the tensor typani and the tensor palati muscles 
( helps open the E-tube ) as the culprits.  Upon seeing the location
of the tensor typani itself in a bony canal above the bony part
of the E-tube, I immediately suspected the sharper noise was from
a spasm of this muscle via bone conduction.  The location of the
tensor palati on the cartilaginous portion of the E-tube fits the
duller noise.  Upon investigating the nerve supply, I found that both
the tensor typani and tensor palati were fired by a motor branch of
the trigeminal nerve on its way to the medial pterygoid muscle.  Upon
looking where the medial pterygoid muscle was, I saw this muscle is
anchored in back of the jaw, and then, finally, I suspected that somehow
the normal extraction of my lower wisdom teeth (non-impacted) was the
cause I had been looking for.  I had these teeth out and
was on my back in pain for two days, but otherwise OK, approximately
1 1/2 months before the noise began.  I do not have classic TMJ
otherwise.  Somehow, I suspect that this seemingly routine extraction
or healing process damaged or compressed the nerve supply to these
muscles and is the cause of my tinnitus.

This is a long story, but I was wondering if anyone else has a
similar problem or treatment.  One possible treatment I am investigating
is the surgical removal of the tensor typani.

Brian Newell

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