Differentiating the Two Types of Tinnitus

By Dave Siever

Differentiating the Two Types of Tinnitus

May 29, 2015

There is much confusion about ringing in the ears called tinnitus. It’s my belief that this is mainly because most people are not aware that there are two very distinct types of tinnitus, which are:

  • Muscle tension resulting from malocclusion (a poor bite), stress and anxiety.
  • Neuroplastic changes from cochlear dropout (lost frequencies).

The tension type involves tight jaw-closing muscles such as the masseter and temporalis, which are easily tested under palpation. Typically, what happens is that the mandible posteriorizes from the tension and the condyle (ball on the mandible) puts pressure on the auricular and tympanic nerves and arteries, which in turn causes tinnitus. In my TMD (Temporomandibular Joint Dysfunction) days, we treated hundreds of cases of tinnitus simply by anteriorizing the mandible with a splint. The stress form of this also involves the masseter and temporalis muscles, but also may include the levator-palatini muscles. There are two of these and they are small. Their job is to vent the eustachian tubes during swallowing. Under stress, they often go into spasm and don’t provide venting during swallowing and therefore the air in the middle ear becomes stale, builds up pressure and causes ringing to occur. Any relaxation technique will help alleviate this form of tinnitus. Audio-Visual Entrainment (AVE) and Cranio-Electro Stimulation (CES) work great for this. So does adjusting one’s lifestyle, or getting a splint, or getting a poorly shaped filling or cap filed down a bit.

The cochlear dropout type involves a loss of a frequency range from cochlear damage or damage to the nerves feeding up to the pons or medial geniculate. Because the frequency range is now lost, the brain recruits more neurons to get it back and in the process causes ringing. TDCS (transcranial DC Stimulation) has shown some promise at resolving this form of tinnitus.

The tension type will typically show soreness on palpitation of the masseter, temporalis and lateral-pterygoid muscles, often accompanied with TM joint soreness and often clicking when opening and closing and the jaw.

The cochlear dropout type will show a loss of hearing at certain frequencies during and audiology exam.

by Dave Siever, C.E.T. - 

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