Ear Congestion and Tinnitus: Causes and Solutions

Ear fullness followed by tinnitus?

Hello Doctor: One morning I woke up and suddenly felt a blockage in my left ear.
I visited an ENT clinic, and everything appeared normal; they did not perform an endoscopy.
Later, I went to Taipei Medical University for a consultation, where an endoscopy revealed that I have acute sinusitis.
I took antibiotics for two weeks, but I did not have any yellow nasal discharge, which seemed odd for sinusitis.
Nevertheless, I continued taking the medication, using nasal sprays, and employing a nasal irrigation device.
My ear blockage improved somewhat, but then I developed tinnitus.
This issue started after a dental appointment, during which I experienced significant discomfort and soreness in my mouth, but I didn't pay much attention to it, thinking it would resolve on its own.
Later, I visited a dentist who took X-rays and indicated that my temporomandibular joint (TMJ) was slightly displaced.
They recommended massage and heat therapy, suggesting that it would gradually improve.
Can TMJ issues lead to tinnitus? This has been troubling me for two months, and I am concerned about the possibility of serious conditions like a neuroma or nasopharyngeal cancer.
Do you have any recommendations? Thank you.

Mr. Yan, 30~39 year old female. Ask Date: 2017/11/23

Dr. Li Jiaxuan reply Otolaryngology

Displacement of the temporomandibular joint may compress the trigeminal nerve, potentially causing tinnitus.
However, tinnitus should gradually improve after the displacement of the temporomandibular joint is alleviated.
Currently, the possibility of a neuroma or nasopharyngeal carcinoma cannot be ruled out.
It is necessary to visit an otolaryngology clinic for a nasopharyngoscopy (as sinusitis and nasal discharge may obscure the view of the nasopharynx) and an audiometric evaluation to establish a differential diagnosis.
Wishing you good health.

Reply Date: 2017/11/23

More Info

Ear congestion and tinnitus can be distressing symptoms that often lead to a search for underlying causes. Based on your description, it seems you have experienced a series of events that may be interconnected, particularly involving your ear, nose, and throat (ENT) health.

Firstly, the sudden onset of ear congestion upon waking can be attributed to several factors. One common cause is Eustachian tube dysfunction, which can occur due to changes in pressure, allergies, or infections. The Eustachian tube connects the middle ear to the back of the nose and helps equalize pressure. When it becomes blocked or fails to function properly, it can lead to a sensation of fullness or pressure in the ear.

Your diagnosis of acute sinusitis (nasal sinus infection) could also contribute to your symptoms. Sinusitis can cause inflammation and swelling in the nasal passages, which may affect the Eustachian tube's ability to function correctly, leading to ear congestion. The fact that you did not have yellow nasal discharge does not rule out sinusitis, as it can present in various forms, including viral sinusitis, which may not always produce purulent discharge.

The development of tinnitus (ringing or buzzing in the ear) following your dental visit raises an interesting point. Dental issues, particularly those involving the temporomandibular joint (TMJ), can indeed lead to ear-related symptoms. The TMJ is located near the ear, and dysfunction or displacement of this joint can cause referred pain or sensations in the ear, including tinnitus. The discomfort you experienced in your jaw could be related to this joint, and it is not uncommon for TMJ disorders to manifest as ear symptoms.

Given that you have been experiencing these symptoms for two months, it is understandable to be concerned about more serious conditions such as a nerve tumor or nasopharyngeal cancer. However, these conditions are relatively rare, especially in the absence of other significant symptoms such as persistent pain, weight loss, or neurological deficits. It is essential to communicate your concerns with your healthcare provider, who may recommend further evaluation, such as imaging studies (CT or MRI) if warranted.

In terms of management, addressing the TMJ issue may help alleviate your symptoms. This can include physical therapy, jaw exercises, heat application, and possibly the use of a dental splint to reduce strain on the joint. Additionally, continuing with nasal saline irrigation and any prescribed medications for sinusitis can help improve your nasal and ear symptoms.

If your symptoms persist or worsen, seeking a second opinion from an ENT specialist may be beneficial. They can perform a thorough examination, including endoscopic evaluation of the nasal passages and ears, to rule out any underlying conditions that may require specific treatment.

In summary, your symptoms of ear congestion and tinnitus may be related to Eustachian tube dysfunction, sinusitis, and TMJ issues. While serious conditions are less likely, it is crucial to monitor your symptoms and seek further evaluation if necessary. Taking proactive steps in managing your TMJ and sinus health can lead to improvement in your overall condition.

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