Below is an attempt at the (my own personal) complex system dysfunctional hypothesis for communication with other clinicians. Just a draft and far from ready!
1- TMJ dysfunction (temporomandibular joint). The dysfunctions can be some form of mechanical problem, inflammation in terms of arthritis, such as Psoriatic arthritis, or RA… and then with the TMJ – where the disks playing a central role – involved…
Below PDF-picture showing TMJ/D and relations to ear (more pictures coming soon) here some texts in Swedish
The temporomandibular joint is ”wall to wall with the outer ear canal.
Can TMJ Cause Tinnitus?
The short answer to this question is, yes! TMJ can cause tinnitus. The TMJ is located just in front of the ear and share some nerve supply with ear. Inflammation and pain in the TMJ may alter the ear structure and the hearing perception causing abnormal sound hearing that does not exist. TMJ disc dysfunction may also cause clicking or crunchy sound that you and other people around you can hear.
An interesting fact is that ear ringing may be the only TMJ symptom you have. The good news is that TMJ tinnitus is treatable and will go away following proper TMJ treatment. However, studies found that patients with TMJ disorders are 3 times more likely to have ear ringing. On the other hand, people with TMJ headache are 6 times more likely to experience tinnitus.
** Can breathe in a little through the eardrum.
Before very Hard Tinnitus Syndrome (vHTS) started, ENT doctors had problems with earwax that had stuck to my left eardrum. After much deliberation, the wax was simply ”pulled” off the eardrum. A few hours later, I started using a hearing aid. So I was at the hospital not to fix earwax but to try out hearing aids. I was only able to use the hearing aid for 2 hours under very severe symptoms in the form of knife cutting rapid variations in sound form. Extremely uncomfortable. I then made 2 more attempts with a hearing aid because I thought I might be oversensitive. But with the same result and since then I haven’t used a hearing aid that I probably didn’t really need.
3- During the night, the symptoms become more severe during sleep. Last sleep awakening is the strongest possible symptom. At the same time, dryness and tightness in the nose increases gradually, mostly in the left osteomeatal complex. This may also have an impact on pressure changes, possibly explaining the increased vHTS symptoms. Another reason is that reactivation of sympathetic systems (including Locus Coeruleus/NE) can be overactivated when I have pronounced elevated NE and low GABA (which evolutionarily should ”control” NE, but also that Glutamate (precusor of GABA) is low***.
The fact that I have had surgery before the nose for basal cell carcinoma type III Glass, may not have anything to do with the functionality of the nose, but maybe it can have? At the same time, at the time of the operation, it was extremely uncertain whether to put enough implants or let it spontaneously heal, which can lead to e.g. the septum being affected. Apparently, they use a new surgical instrument that they had not used before on any patients, so the operation itself took a surprisingly long time in relation to how little surgery was done. A lot of time was spent on the two clinics discussing what to do.
”External auditory canal (EAC) exostoses are multiple, benign bony growths within the external auditory canal in response to repeated exposure to cold water. They can cause conductive hearing loss and recurrent otitis externa” Bilateral External Auditory Exostoses Causing Conductive Hearing Loss: A Case Report and Literature Review of the Surfer’s Ear https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5749938/#:~:text=External%20auditory%20canal%20(EAC)%20exostoses,recurrent%20otitis%20externa%20%5B1%5D.
“Otosclerosis is a disease of the ear that results in abnormal bone growth. These growths affect function of the middle ear bones, leading to issues with hearing – including tinnitus” Otosclerosis: A Surprising Cause of Tinnitus (That Can Be Cured) https://treblehealth.com/otosclerosis-and-tinnitus/#:~:text=Otosclerosis%20is%20a%20disease%20of,issues%20with%20hearing%20%E2%80%93%20including%20tinnitus.
*** 2023-01-27 Bo vS Neurotransmittorer
Adrenalin* 5.75 µg/g Crea 2,0 – 5,5
Noradrenalin* 45.42 µg/g Crea 15 – 36
Dopamin 207.94 µg/g Crea 130 – 240
GABA(*) 1.83 µmol/g Krea 1,5 – 5,0
Glutamat* 6.86 µmol/g Krea 8 – 25
Serotonin(*) 80.69 µg/g Crea 80 – 190
AND about my relationship to pharmaceuticals (without general criticism of more traditional use, of course, in this context):
Exceptionally, after careful consideration, uses newer, relevant references drug suggestions from clinicians. Have tried (become wise regular) use a Benzodiazepine (Diazepam) that acts via GABA A and because my GABA system (the main inhibitor to balance excitatory neurotransmitters that NE) is crucial for is low (and its procusor Glutamate) while the Locus Coeruleus/NE and adrenaline are elevated – something that can have a complicating negative effect on existing dysfunctions in general as well. I get too (in my opinion) easy side effects from ”ordinary” drugs and try more with lactic acid bacteria etc.
-> Why about RA in the title?
Will on other pages use arthritis/(auto)inflammations/… as a starting point for how TMJ’s discs can play a central role in many different dysfunctions/diseases/…
For example, to my surprise, I see e.g. the title: ”Evaluation of the TMJ (Temporomandibular joint) means of Clinical TMD Examination and MRI Diagnostics in Patients with Rheumatoid Arthritis: ”… However, the majority of studies showed that approximately 50% of RA patients develop a clinical involvement of the TMJ [5–9].” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4160621/#:~:text=However%2C%20the%20majority%20of%20studies,TMJ%20%5B5%E2%80%939%5D.