Symptoms

Cracking in the ear, ear cracking

Cracking in the ear, ear cracking



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Cracking noises in the ear often have harmless reasons

Cracking in the ear is a relatively unspecific symptom, which can occur as a normal side effect of pressure equalization in the ear, but also as a result of more serious ear diseases. The latter usually show other symptoms such as buzzing in the ears, ear pain or fever, and they urgently require a medical examination. Most often, however, the cracking of the ears is a rather harmless symptom, even if it is extremely annoying for those affected.

Symptoms and causes

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

The short opening of the ear trumpet is accompanied by a movement of the eardrum, which is perceived as a more or less insistent cracking. The pressure compensation may be necessary, for example, when flying or for other sudden changes in altitude or changes in air pressure (for example driving uphill or downhill by car). The pressure equalization is also clearly perceptible when diving or subsequent surfacing.

Diseases of the middle and inner ear

Cracking and other ear noises can sometimes be observed as an accompanying symptom in diseases of the middle ear, such as an inflammation of the middle ear or a so-called tympanic effusion. Both diseases are usually accompanied by ear pain and a hearing impairment.

With otitis media, fever is another key symptom, and those with tympanic effusion often suffer from severe dizziness. Bacterial infection is often the cause of otitis media.

A tympanic effusion can usually be observed as a result of a so-called tube catarrh, i.e. a closure of the ear trumpet, as is more common, for example, in the case of a cold. The pressure equalization can only take place to a limited extent or not at all and the permanent negative pressure in the tympanic cavity leads in the worst case to the development of the tympanic effusion.

Cracking in the ear is also sometimes noticed in the tube catarrh, for example when the clogging of the ear trumpet with secretion loosens or moves briefly. The so-called hydrops cochleae (edema in the inner ear) is also known as a disease of the inner ear, which in addition to persistent tinnitus can also lead to occasional cracking in the ear.

Craniomandibular Dysfunction (CMD)

Impairments and functional disorders of the temporomandibular joint and the chewing muscles are often also associated with a crack in the ear by those affected. Actually, however, this is more of a jaw crack that is passed over the bone to the ear. This occurs because the joint head can no longer slide smoothly back and forth in the socket, such as in the case of damage to the cartilage layer or arthrosis of the TMJ.

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

Some sufferers have persistent tinnitus. Furthermore, swallowing problems are often part of the symptoms. Dizziness and blurred vision can result from craniomandibular dysfunction.

Diagnosis

If the crackling in the ear can be observed without additional accompanying symptoms, it is often extremely difficult for specialists to make a clear diagnosis. The classic approach to diagnosing ear complaints involves an initial examination of the patient's complaints by visual examination of the ear canal using an otoscope. If the complaints are the cause of the ear, otoscopy can usually already provide clear indications of this.

An examination of the nasopharynx can provide clues to make a diagnosis. Furthermore, the sound conduction can be determined on the basis of a hearing test, which, for example, enables conclusions to be drawn about an existing timpani effusion. A measurement of the eardrum mobility (tympanometry) also provides an indication of a possible tympanic effusion, since a corresponding examination not only reveals the pressure conditions, but also any fluid in the ear.

If the causes of the cracking in the ear in the area of ​​the jaw are suspected, a visit to a maxillofacial surgeon is advisable, who takes 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 for crackling in the ear

The treatment of the complaints should always be based on the respective causes. For example, a middle ear infection is often first treated with a combination of pain-relieving ear drops, decongestant nasal sprays and oral ingestion of anti-inflammatory preparations.

With more serious bacterial otitis media, there is no way around taking antibiotics. In the worst case, surgery may be required if the inflammation has passed from the middle ear to the so-called mastoid process of the temporal bone (mastoiditis). Another option for treating repeated inflammation of the middle ear is the use of a so-called tympanic tube (also tympanic drainage or middle ear drainage). This tube is inserted into the eardrum in the course of a relatively uncomplicated operation and serves to improve ventilation and the discharge of secretions.

This treatment method is also sometimes used for timpani. In most cases, however, the use of decongestant nasal drops can open the ear trumpet and restore the ventilation of the tympanic cavity. If bacterial infection is suspected to be the cause of the tympanic effusion, antibiotics can be used. An operative opening of the eardrum with subsequent removal of the accumulated secretion is only necessary in serious cases. This applies in a similar way to the use of a tympanic tube, which should only be used if the symptoms appear repeatedly.

Help with ear cracking through CMD

If no causes of ear noises can be found in the ears, impairment of the function of the temporomandibular joint and the chewing muscles should be considered as a possible cause, especially if those affected perceive the cracking in the ear mainly when chewing or other jaw movements. Physiotherapy treatment can be very helpful here. The primary aim of this is to relieve tension in the muscles, correct the movement sequences and stabilize the temporomandibular joint.

Naturopathy also offers a good option with manual procedures such as osteopathy, in particular to combat craniomandibular dysfunction. If the patient tends to grind his teeth at night, a so-called bite splint is sometimes used, which should help to avoid excessive stress on the temporomandibular joint and the muscles.

If it is not possible to determine the physical causes of ear cracking and / or if the therapeutic measures are unsuccessful, there is the possibility of psychotherapeutic measures against cracking the ears. With the help of cognitive behavioral therapy, for example, attempts are made to influence the perception of the ear crack, so that those affected no longer perceive this as disturbing and stressful. (fp)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters

Swell:

  • Hans-Michael Mühlenfeld et al .: Earache, S2k guidelines, German Society for General Medicine and Family Medicine (DEGAM), (accessed 28.08.2019), AWMF
  • Debara L. Tucci: Earache (Otalgia), MSD Manual, (accessed August 28, 2019), MSD
  • Thomas Lenarz, Hans-Georg Boenninghaus: ENT, Springer-Verlag, 14th edition 2012


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