Ear Congestion feelings or clogged ears can be related to mal alignment of the lower jaw – the bite. Patients suffering from craniomandibular disorders often complain of hearing loss, fullness in the ears, and hyperacusis (hypersensitivity to sounds). Eustachian tube dysfunction is often involved.
There is causal relationships that has been absent in dental and medical literature, yet correction of a craniomandibular disorder often eliminates the aforementioned ear complaints. Naturally some folks in the medical and dental community do not always agree. Although controversial, most anatomic and physiologic evidence supports the belief that the tensor veli palatini muscles is solely responsible for active tubal dilation on swallowing.
Eustachian Tube Dysfunction
Three functions of the eustachian tube are:
- Protection of the middle ear
Normally the eustachian tube is closed, open only when there is positive pressure in the nasopharynx or by muscle action of the tensor veli palatini, levator palatini, or salpingopharyngeous.
The tensor veli palatini muscle is innervated by a segment of the trigeminal nerve. When this small muscle is stimulated the effect of such excitation can be muscular contraction. When deep somatic pains occur from temporalis, masseter and medial pterygoid muscles contract, the effects can also spread causing the lumen of the eustachien tube to remain patent at rest and pressure from the nasopharynx to be transmitted to the middle ear. Patients complain of fullness or pressure feelings (autophony) and their voices sound hallow (like talking in a drum or echo chamber). Hearing, however, is unaltered.
Chronic contracture of the medial pterygoid can impair normal funciton of the tensor veli palitini muscles as it descends vertically between the medial pterygoid plate and pterygoid muscle and can be entrapped when the medial pterygoid is in dysfunction, preventing normal dilation of the eustachien tube lumen.
This results in an inability to equalize the middle and outer ear pressure. Patients may complain of pain in rapidly descending airplanes and when scuba diving. This explains why many TMD patients who complain of ear pain, fullness, and /or pressure are relieved of symptoms following successful treatment and use of a well designed mandibular orthotic.