Chewing-Related Swelling and Ear Ringing: A Medical Inquiry

Swelling (tinnitus) occurs after chewing between the upper edges of both ears and the temples?

The symptom of swelling between the upper jaw and the temples after chewing started occurring about ten years ago during a meal.
Initially, there were bloodshot eyes and difficulty chewing.
I thought it would improve over time, but the symptoms have persisted.
Whenever I chew food, swelling occurs, but it subsides within ten minutes after I stop chewing.
The swelling looks quite unusual, and I have consulted multiple hospitals without receiving any helpful advice or solutions.
I would like to know what the problem might be and which specialty I should visit for a comprehensive examination and treatment.
Additionally, I have been experiencing continuous tinnitus in my right ear since around that time, and after multiple examinations at large hospitals, the doctors suggested that I would need to pay out of pocket for a CT scan, which I decided to forgo.

Another issue is a lump under the skin of my lower jaw.
A few years ago, it was about 3mm in size and round, but now it has grown to approximately 5mm and consists of two connected round masses.
Is it possible to remove this? Will there be a noticeable scar?

Zhu Yao, 40~49 year old female. Ask Date: 2011/03/06

Dr. Ding Xianwei reply Neurosurgery

Your issue cannot be resolved online.
I recommend that you come to the outpatient clinic for further advice.

Reply Date: 2011/03/06

More Info

Your inquiry about the swelling and ear ringing after chewing, as well as the growth in your mouth, raises several important medical considerations. It seems that you have been experiencing these symptoms for quite some time, and I understand how frustrating it can be when multiple medical consultations do not yield satisfactory answers.

Chewing-Related Swelling and Ear Ringing
The swelling you experience after chewing could be related to several factors, primarily involving the temporomandibular joint (TMJ), which connects your jaw to your skull. TMJ disorders can cause pain and swelling in the jaw area, and they may also lead to symptoms like ear ringing (tinnitus) and discomfort in the surrounding areas. The fact that the swelling subsides after you stop chewing suggests that it might be related to the mechanical stress placed on the joint and surrounding tissues during chewing.

Additionally, the presence of ear ringing could indicate that the TMJ is affecting the auditory system. The TMJ is located very close to the ear, and inflammation or dysfunction in this joint can lead to referred pain or sensations in the ear, including tinnitus. It is also possible that the swelling is a result of inflammation in the muscles or ligaments around the jaw, which can be exacerbated by chewing.

Given your history of these symptoms, it would be advisable to consult with a specialist in oral and maxillofacial surgery or a dentist who specializes in TMJ disorders. They can perform a thorough examination, which may include imaging studies like X-rays or MRIs to assess the condition of your TMJ and surrounding structures. A comprehensive evaluation will help determine if there is any structural damage or inflammation that needs to be addressed.

Growth in the Mouth
Regarding the growth you mentioned in your mouth, it is essential to have any oral lesions evaluated by a healthcare professional. The increase in size from 3mm to 5mm over the years suggests that it may require further investigation. While many oral lesions are benign, such as fibromas or mucoceles, others may require biopsy or excision to rule out more serious conditions.

If you decide to have the lesion removed, the procedure is typically performed under local anesthesia, and while there may be some scarring, skilled practitioners can minimize this. The extent of the scar will depend on the location of the lesion and the technique used for removal. Discussing your concerns about scarring with your oral surgeon can help you understand what to expect and how to care for the area post-surgery to promote optimal healing.

Recommendations
1. Consult a Specialist: Seek out an oral and maxillofacial surgeon or a dentist with experience in TMJ disorders for a comprehensive evaluation of your jaw and ear symptoms. They can provide targeted treatment options based on their findings.

2. Oral Lesion Evaluation: Schedule an appointment with an oral surgeon or a dentist to assess the growth in your mouth. They may recommend a biopsy if there are any concerns about the nature of the lesion.

3. Document Symptoms: Keep a detailed record of your symptoms, including when they occur, their duration, and any associated factors (like specific foods or activities). This information can be invaluable for your healthcare provider.

4. Consider Imaging: If you haven't already, ask about imaging studies that can provide a clearer picture of your TMJ and any potential issues with your ear structures.

5. Explore Treatment Options: Depending on the diagnosis, treatment options may include physical therapy, bite guards, medications for inflammation, or surgical interventions if necessary.

In conclusion, your symptoms warrant a thorough investigation to identify the underlying causes and appropriate treatment. Don't hesitate to seek a second opinion if you feel your concerns are not being adequately addressed. Your health and well-being are paramount, and finding the right specialist can make a significant difference in your quality of life.

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