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60 year old female with chief complaint of right ear “feeling plugged” for over 6 months. Was referred to me from a current patient. Visual inspection revealed that when she spoke something didn’t seem right with her jaw. Let me explain why this was clinically important to me:There is a muscle in the inner ear called the tensor tympani. It attaches to the neck of the malleus. The malleus articulates with the incus and the stapes bones so together they dampen noise by helping the tympanic membrane absorb the sound inside the inner ear canal. If the tensor tympani muscle doesn’t work correctly, the malleus does not move and this creates more tension in the tympanic membrane which actually increases the volume and sharpness of sounds – and research also suggests it can cause a “feeling of ear fullness.” Anatomically there is more compelling evidence. The tensor tympani muscle is innervated by a branch of the trigeminal nerve – the same nerve that supplies the masseter, temporalis, medial and lateral pterygoid muscles. These muscles open and close the jaw (TMJ). In addition the lateral pterygoid attaches to the tensor tympani muscle via the posterior elements of the temporomandibular disc. And lastly, researchers have found that inflammatory chemicals which cause motor inhibition (Substance P, CGRP) can be found in the tensor tympani. If this is all true then we can postulate that any dysfunction in the lateral pterygoid can inhibit the tensor tympani muscle.
• Cervical spine ROM: 45 deg L, 60 deg R
• Inspection of her bilateral TMJ revealed IDD (inter-dental distance) of 12 deg. (average IDD is accepted as 26 deg)
•Intra-oral palpation revealed very taut and tender right sided temporalis and lateral pterygoid muscles.
Treatment: 3 visits in total over 5 days.
•Intra-oral release of the temporalis and lateral pterygoid muscles.
•Electro-acupuncture to the lateral pterygoid motor point and trigeminal nerve trunk at low freq for 10 mins.
Follow up visit 10 days later:
•Patient reported that the morning following her last treatment the “feeling of fullness” was gone. It has been gone ever since.
NourishDoc doesn’t provide medical advice, diagnosis, treatment, or prescriptions. Read our terms of use, privacy & medical disclaimer for more info
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