Understanding TMJ Hearing Loss

It's Uncommon, But You Should Know About It

Ear Machine
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TMJ hearing loss is less well known than other TMJ-related symptoms, such as jaw pain, limited jaw movement, and jaw “clicking” or other noises. But if it happens to you or someone you care about, you'll want to be prepared to talk about it.

“TMJ” is short for “temporomandibular joint.” When it comes to discussing the problems it can cause, doctors and researchers typically say, “TMJ disorders.” However, “TMJ” is commonly used alone, as here, to mean the same thing.

Other TMJ symptoms include earache, tinnitus (hearing noises that have no source), a sense of ear fullness, and vertigo (the feeling of whirling around and loss of balance).

Your Remarkable Mandible (Lower Jaw)

Your mandible, or lower jaw, is the largest and strongest bone in your face. It moves both up and down and side to side as you open and close your mouth and chew your food. It’s joined to your skull on either side by – can you guess? -- your temporomandibular joints.

  • Your upper jaw, or maxilla, doesn’t move.

The Temporomandibular Joint Disc (TMJ Disc). A vital feature of your mandible, it’s made up of elastic cartilage (similar to the cartilage of your ears) and positioned between the 2 bones that hold the joint. This little disc divides each joint into two parts and enables your mandible to slide easily as you speak or chew.

Mandible-Moving Muscles. (Try using your mandible to say that 3 times, fast!) These include the medial pterygoid and lateral pterygoid muscles, which help open your mouth, and the masseter and temporalis muscles, which help close it.

(The lateral pterygoid muscle also assists with moving your mandible from side to side.)

Now that you’re gotten to know your remarkable mandible, let’s look at what can happen to it that may lead to TMJ hearing loss.

What Causes TMJ?

TMJ is a group of musculoskeletal disorders that, as you've seen, can cause a wide variety of symptoms including hearing loss.

No specific cause of TMJ has been identified. However, researchers generally believe TMJ is related to a variety of factors including age, gender, stress, and personality.

Possibly the biggest problem with TMJ hearing loss is getting the proper diagnosis. Since many things can cause hearing loss, and people tend to think of ear problems first, it can take time for TMJ to be recognized and treated.

What Happens in TMJ Hearing Loss?

Just as the cause of TMJ remains unidentified, so does the mechanism of TMJ hearing loss. However, there is a direct connection between your temporomandibular joint and your middle ear. Based on this, there are four main theories concerning why TMJ and hearing loss may be related:

  • The TMJ disc may move out of alignment, increasing pressure on the TMJ nerves and, in particular, in your Eustachian tube, which connects your mouth and nasal passages with your esophagus (food tube). This may lead to blocking of the Eustachian tube, which can cause hearing loss.
  • Displacement of the TMJ disc may also cause inflammation along the route from the temporomandibular joint to your ear, blocking the Eustachian tube and leading to hearing loss and, possibly, earache, tinnitus, and vertigo.
  • A third theory suggests that malfunction between the muscles and nerves of your chewing and hearing processes may lead to problems keeping your Eustachian tube open – and to hearing loss.
  • The fourth theory is more straightforward, offering the possibility that psychosocial disorders may be the cause of at least some TMJ problems, hearing loss among them.

Fortunately, TMJ hearing loss is usually reversible with treatment, mainly treatment to relieve the type of TMJ disorder you have. 
 

Sources:

Kitsoulis P, Marini A, Iliou K, et al. “Signs and symptoms of temporomandibular joint disorders related to the degree of mouth opening and hearing loss.” BMC Ear Nose Throat Disord. 2011;11:5.

Dalla-Bona D, Shackleton T, Clark G, Ram S. “Unilateral ear fullness and temporary hearing loss diagnosed and successfully managed as a temporomandibular disorder: a case report. J Am Dent Assoc. 2015;146(3):192-194.

Pekkan G, Aksoy S, Hekimoglu C, Ohghan F. “Comparative audiometric evaluation of temporomandibular disorder patients with otological symptoms.” J Craniomaxillofac Surg. 2010;38(3):231-234.

Axelsson R, Tullberg M, Ernberg M, Hedenberg-Magnusson B. “Symptoms and signs of temporomandibular disorders in patients with sudden sensorineural hearing loss. Swed Dent J. 2009;33(3):115-123.

Tuz HH, Onder EM, Kisnisci RS. “Prevalence of otologic complaints in patients with temporomandibular disorder.” Am J Orthod Dentofac Orthop. 2003;123(6):620-623.

Riga M, Xenellis J, Peraki E, et al. “Aural symptoms in patients with temporomandibular joint disorders: multiple frequency tympanometry provides objective evidence of changes in middle ear impedance.” Otol Neurotol. 2010;31(9):1359-1364.

“TMJ disorders.” National Institute of Dental and Craniofacial Research, National Institutes of Health (2013). 

“Jaw injuries and disorders.” U.S. National Library of Medicine-MedlinePlus (2016).   

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