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Headaches, pain and fullness in ears, crackling sound while swallowing. Impacted wisdom tooth removed. Am I having TMJ?

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ENT Specialist
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hi, please can you help. i have been suffering with headaches since september a constant headache which i wake up with and go to sleep with. i also have pain, fullness in my ears and around them and they constantly crackle when i swallow. my gp has been useless, instead of tying to find the cause they just give me pain medication to take. i have two children and it seems because of this the doctors are very quick to say its tension headaches and tell you to have time out! nothing stops the pain ever. i told my denist who suggested my wisdom teeth could be causing the pain in my ears and head, so i had my impacted wisdom teeth removed (this was not very nice) and nothing has changed at all.

i have been told its tension headaches, allergies, sinus, something up my nose!, wisdom teeth.

i went to an osteopath who thought i was on the verge of being depressed, this is really really getting me down and i feel like i am a bad mother because im just in pain all day and cant cope with shouting children, i am losing the will to live.

i had acupuncture which helped with the pain but didnt stop either but i cant afford this every week so have had to stop.

could it be a problem with my ears or tmj thats keeps popping up when i research crackling ears, please please help me.

kind regards
Posted Mon, 25 Jun 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 2 hours later

Thank you for your query.

1. The Eustachian tube connects the middle ear to the nose. It is normally in a collapsed state. It can be voluntarily opened by yawning, swallowing, chewing gum, blowing your nose or performing the Valsalva maneuver. A crackling sound in the ears or behind the eyes and nose is commonly felt when this happens. This is normal. Assuming that your underlying condition is allergy, do you have sneezing and watery discharge (rhinorrhea) and nasal obstruction?

2. Get a Tympanogram done to check middle ear pressures and Eustachian Tube function. Also get a PTA (Pure Tone Audiogram) to check your hearing.

3. It is difficult to see the sinuses on anterior nasal examination as they are surrounded by bone and their openings are very small and usually hidden. The gold standard investigation is a plain CT PNS (Para Nasal Sinuses) and an HRCT Temporal Bones on a multi slice machine. This will reveal or rule out any sinusitis immediately.

4. There are many causes of headache which can be ruled out on detailed history and examination. Try and describe these in detail. Ideally an MRI or MRA is done for headache that does not respond to medication. Do you ever take medication for your headache or doe it subside on it's own? Besides sinus headache, tension headache, cluster headaches, neuralgias and migraine should be ruled out. Get a Neurologist's opinion as your headaches may not be always related to ENT disease. An MRI Scan is usually advised in a patient of headache so as not to miss any major cause. I must emphasize that almost 99% of MRIs are normal.

5. Rule out:
a. Anemia (as you are iron deficient).
b. Thyroid problems. Get your Thyroid Function Tests (TFT's) and USG Neck done.
c. Cervical spondylosis and cervical spine problems.
d. Venous thrombosis in the cerebral veins if you are on oral contraceptive pills.
e. High or Low Blood Pressure. Monitor your blood pressure for changes around the headache episodes.
f. Low CSF (Cerebro Spinal Fluid) pressure headaches usually subside on lying down. Does your headache increase on standing or sitting, or with exercise and decrease on lying down?

If you can share these investigation reports, I will be able to suggest treatment options.

Awaiting your reply,

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