Cracking in the ear, ear pits

Cracking noises in the ear often have harmless reasons

Cracking in the ear is a relatively nonspecific symptom, which can occur as a normal concomitant of pressure equalization in the ear, but also as a result of more serious ear diseases. The latter usually show other symptoms such as tinnitus, earache or fever, and they urgently require a medical check-up. Mostly, however, the ear biting is a rather harmless, albeit for those affected extremely annoying symptoms.

contents

• Cracking noises in the ear often have harmless reasons
• Symptomatology and causes
• Diseases of the middle and inner ear
• Craniomandibular dysfunction (CMD)
• diagnosis
• Treatment with cracking in the ear
• Help with ear bumps by CMD

Symptomatology and causes

The ear biting is usually perceived by those affected when swallowing or moving the jaw, but may also be independent of such movements. The ear noise during swallowing is often due to the simultaneous pressure equalization, in which the eustachian tube (connection between nasopharynx and middle ear, Eustachian tube) briefly opens, so that the air pressure in the ear can be adjusted to the external pressure.

Ear pains can have many causes. (Image: Bilderzwerg, Fotolia)

The short opening of the Eustachian tube is accompanied by a movement of the eardrum, which is perceived as a more or less urgent cracking. For example, pressure equalization may be required during flight or other sudden changes in altitude or changes in air pressure (for example, driving uphill or downhill by car). Even when diving or the subsequent emergence of pressure equalization is clearly noticeable.

Diseases of the middle and inner ear

Cracking and other noises are sometimes seen as a concomitant in diseases of the middle ear, such as a middle ear infection or a so-called tympanic effusion. Both diseases are usually associated with earache and a reduction in hearing.

In middle ear infection, fever is another key symptom, in the case of tympanic effusion, those affected often suffer concomitantly from severe dizziness. The cause of otitis media is often a bacterial infection.

A tympanic effusion is usually due to a so-called Tubenkatarrhs, so a closure of the Eustachian tube, as it occurs more frequently, for example, when running cold. The pressure balance can only be limited or not at all done and the permanent negative pressure in the tympanic cavity leads to the development of the tympanic duct in the worst case.

Even in the tubal catarrh, a cracking in the ear is sometimes perceived, for example, when the obstruction of the eustachian tube with secretion briefly dissolves or moves. As a disease of the inner ear, which can lead to an occasional cracking in the ear in addition to a persistent tinnitus, the so-called Hydrops cochleae (edema in the inner ear) is also known.

In a dysfunction of the causal system, sufferers often perceive an unpleasant cracking in the ears. (Image: andriano_cz / fotolia.com)

Craniomandibular dysfunction (CMD)

Impairments and dysfunctions of the temporomandibular joint and the masticatory muscles are often brought by the affected persons in connection with a cracking in the ear. Actually, this is more of a jaw crack that is passed over the bone to the ear. This arises because the condyle can no longer slide smoothly in the acetabulum, such as in cartilage layer damage or osteoarthritis of the temporomandibular joint.

Cranio-mandibular dysfunction (CMD) is associated with symptoms such as movement limitations of the jaw and discomfort during chewing, but also tension-related headaches, neck pain, shoulder pain and back pain.

Some sufferers suffer from persistent tinnitus. Furthermore, swallowing problems are often part of the complaint. Dizziness and blurred vision may be due to craniomandibular dysfunction.

diagnosis

If the cracking in the ear can be observed without further concomitant symptoms, the specialists also often find it very difficult to make a definite diagnosis. The classical approach to the diagnosis of ear complaints provides for an initial examination of the patients to their complaints, a visual examination of the ear canal using an otoscope. If illnesses of the ear are the basis of the complaints, otoscopy usually already provides clear indications for this.

An examination of the nasopharynx can provide clues to the diagnosis. Furthermore, the sound conduction can be determined on the basis of a hearing test, which, for example, makes it possible to draw conclusions about a present tympanic effusion. A measurement of the tympanic membrane mobility (tympanometry) also provides evidence of a possibly existing tympanic duct, since in a corresponding examination not only the pressure conditions, but also possibly existing fluid in the ear become recognizable.

If the causes of cracking in the ear in the area of ​​the jaw are suspected, a visit to an oral surgeon offers a closer look at the position of the teeth, jaw movement, masticatory muscles and the temporomandibular joint. Here X-rays of the jaw can contribute to the diagnosis.

Treatment with cracking in the ear

The treatment of the complaints should always be oriented to the respective causes. Thus, for example, against a middle ear infection often proceeded first with a combination of analgesic ear drops, decongestant nasal sprays and the oral intake of anti-inflammatory preparations.

With the help of a hearing test, the ear specialist can detect if there is a conductive problem. (Image: Kzenon / fotolia.com)

For more serious bacterial otitis media, there is no way around taking antibiotics. In the worst case surgery may be necessary if the inflammation has passed from the middle ear to the so-called mastoid of the temporal bone (mastoiditis). Another possibility for the treatment of recurrent inflammation of the middle ear is the use of a so-called tympanic tube (also tympanic drainage or middle ear drainage). This tube is used in the course of a relatively uncomplicated operation in the eardrum and serves to improve the ventilation and the secretion drainage.

Also in a tympanic effusion is sometimes resorted to this treatment method. In most cases, however, an opening of the eustachian tube can already be achieved with the use of decongesting nose drops and the ventilation of the tympanic cavity can be restored. If a bacterial infection is suspected as the cause of the tympanic effusion, antibiotics can be used. An operative opening of the eardrum with subsequent removal of accumulated secretions is required only in severe cases. This applies in a similar way to the use of a tympanostomy tube, which should only be used in case of recurrent symptoms.

Help with ear bumps by CMD

If no causes of the ear noises in the ears can be established, functional impairments of the temporomandibular joint and the masticatory muscles should be taken into consideration as a possible cause, especially if the affected persons perceive cracking in the ear mainly during chewing or other jaw movements. Here a physiotherapeutic treatment can certainly be helpful. This is primarily aimed at correcting muscle tension, correcting movement and stabilizing the temporomandibular joint.

Naturopathy also offers a good option with manual procedures such as osteopathy, in particular to combat the craniomandibular dysfunctions. The patients tend to nocturnal teeth grinding, is sometimes resorting to a so-called bite splint, which should help to avoid excessive stress on the temporomandibular joint and the muscles.

If no physical causes of the ear bump can be determined and / or the therapeutic measures show no success, it is possible to proceed psychotherapeutically against cracking in the ear. For example, with the help of cognitive behavioral therapy, attempts are made to influence the perception of the ear bones, so that those affected no longer find this disturbing and stressful. (fp, last updated on 1.3.2018)