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Ear clicks caused by eustachian tube and/or tensor palatine disfunction
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mushi posted:
I have been having ear clicks for at least two years in both years. It occurs only when I am speaking. I have tried Sudafed, anti inflammatory and even anti-anxiety medication to no avail. Previously I went to an ear clinic, where the doctor shot Botox in my soft palate. It helped for 2 weeks in 1 ear, and not at all in the other. The side effects of having a full/plugged ear for those 2 weeks followed by my eustachian tube remaining open and hearing an echo as I spoke were unbearable.

I have just seen a highly respected maxillofacial doctor in Los Angeles. The new doctor ruled out sounds from my jaw, and agreed that the clicks were caused by the tensor and eustachian tube. He also took a CT scan and saw nothing conclusive. He said he couldn't help me, and that he is not aware of any treatment or doctors who would know about this, and agrees that though the Botox may offer little relief, it is not an acceptable solution to my problem.

I am looking for referrals or information about my condition.
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Rod Moser, PA, PhD responded:
Based on your posting, you may have a condition called myoclonus, even though your ENT did not call it by that name. Although there can be many different causes, one possibility for clicking in the ears.

Those three tiny ear bones in your middle ear (the area on the other side of your eardrum) have muscles (the stapedial and tensor tympani muscle) that are attached to them. Like any muscle, they can go into spasm and rapidly twitch (myoclonus). Then this happens in the ear, it will cause the eardrum to vibrate like a drum, resulting in a clicking or even a machine-like sound. The muscles in the throat and palate (the tensor veli palatini muscle) can also be contributory.

If you, indeed, are diagnosed with myoclonus, this may not an easy problem to fix. Surgery is sometimes performed to cut those muscles, or the muscle-paralyzing botulism toxin (Botox) is injected into them in an effort to correct more serious cases. This is one of the treatments that are tried.

An ENT sub-specialist (a neurotologist) is the best person to evaluate and manage this difficult-to-treat disorder. Unfortunately, WebMD does not permit referrals to specific doctors or clinics, but in Los Angeles, you should not have any problem finding a neurotologist.
 
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mushi replied to Rod Moser, PA, PhD's response:
Thanks for your swift reply, Dr. Moser. The first doctor was a neurotologist, but as I stated above, the Botox treatment was unsuccessful on many levels. He indeed said it was myoclonus. However, he said that surgery is not used anymore for this, and only Botox treatments. Do you find this to be true? Would it be best for me to call a lot of neurotologists until I find one that does the surgery?
 
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Rod Moser, PA, PhD replied to mushi's response:
That is a difficult question for me to answer, since I do not do this type of procedure.Treating myoclonus is far beyond my primary care perspective, so I defer to the experts. So, if surgery is not a viable option for myoclonus anymore, did your neurotologist offer you anything? I would not suggest that you doctor-shop, but rather try and find one specialist that is treating myoclonus on a regular basis. I wish that I could help you, but I am at a loss to know what your options might be.
 
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eurovoice responded:
Hi mushi:
I'm in a very similar situation to the one you were in when you posted this message. I am wondering whether over the last year you have had any success in either figuring out exactly what's going on, and/or how to fix it or at least find some relief. Any thoughts would be highly appreciated.
Best of luck,
Peter
 
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mushi replied to eurovoice's response:
I found a doctor that might be able to help. He is located in Boston, and if you do a search for palatal myoclonus Boston doctor his name will come up. I transferred my records but it has taken a while for them to get back to me. Also not sure how feasible it is for me to have surgery and follow ups since I am on the opposite coast. Good luck and please share any leads.


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