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    Second post - Clicking sound in nose/ear while/after speaking
    tmkain posted:

    I am a 27-year old male. This is my second posting on this topic, but after several trips to ENT doctors and no luck, I've decided to repost with more details of my symptoms.

    For the last 2 months or so I have been experiencing an odd problem in my left cheek area. When I speak, especially at the ends of sentences that finish with hard sounds ("k," "p," etc. - "like" is a good example, whereas a word like "nine" produces no sound), I hear a strange "click" sound in the area; basically, when I lower my jaw after a word to take a breath or start the next word, the sound is audible, like something is happening with the eustachian tube or jaw bone/cheek bone. There is no pain, although being conscious of the sound itself makes the area more sensitive. The clicking sound only happens when I speak. I also notice a clicking sound near the base of my head in the back of my neck when I turn my head from left to right. I think the two clicking phenomena might be related.

    Other info:
    The symptoms subside completely when I am laying down on my back or stomach - in other words, when I'm horizontal.
    I yawn and burp more frequently than before - it sometimes seems like my body is trying to correct the problem with yawns and burps.
    My throat gets sore easily, and it always feels like I've been talking too much.
    I am a terrible nail-biter; my dentist thought my habit may have misaligned my jaw, which could cause sounds, but I hear no sounds when I'm eating.
    My ENT here in Japan stuck some kind of hose in my ear and blew air through the passage between the ear and nose - an odd sensation, but it didn't get any results.

    Do you have any idea what this might be about? Really, any ideas would be appreciated. It's starting to drive me crazy, and I don't want to keep going to ENT offices and have the hose blow air through the Eustachian tube, only to experience the sounds minutes later.
    Rod Moser, PA, PhD responded:
    As you may know, the Interent poses some significant barriers when it comes to making or even narrowing down diagnoses. Since I do not know the medical details of your case, your complete medical history, or have any way of examining you first-hand, it is next to impossible to ascertain any patient-specific "ideas" as to what may be going on.

    Yes, you have considered TMJ - this can cause clicking. Eustachian tube dysfunction and even chronic sinusitis can cause odd, difficult-to-locate symptoms. Just because one Japanese ENT has not been able to find the answer, does not mean an answer cannot be found. Of course, not all things in medicine can be diagnosed at all. Unfortunately, this is not something that I can blindly determine over the Internet.

    What treatments have you tried?
    tmkain replied to Rod Moser, PA, PhD's response:
    Dear Dr. Moser,

    Thank you again for providing your input.

    I have actually tried several different ENT doctors in Japan, but all of them attempt to correct the problem by shooting air through the Eustachian tube, which, as I said, does nothing to alleviate the symptoms. Do you have any advice for me about things I could maybe propose to them? Would an X-ray be something worth trying? Anything else you can think of?

    I haven't tried any other treatments because I don't know what kind of treatments are appropriate or available, and my doctors have not been much help. Do you think I should see an oral surgeon about TMJ? I was under the impression, though, that TMJ would be persistent - not only when I talk, but when I eat or otherwise move my jaw - and painful, too, which my condition isn't.

    If I were to continue seeing the ENT about this problem, is there anything else that they can do to "look inside" and see what's going on in the area? Just knowing the root or precise location of the sound would be an immense help.

    Finally, does the fact that I don't experience any clicking when I'm laying down indicate anything to you?

    Thanks for your help.
    Rod Moser, PA, PhD replied to tmkain's response:
    Your unusual symptoms really have me stumped. Basically, it is going to take a persistent clinician to keep searching for a source; a task that can be unbelievably difficult, I might add. Any chance that you can go to a large, university-based clinic in Japan? The large institutions may offer you collaborative efforts of several clinicians of different medical disciplines. I wish that I could be more helpful to you, but your case is one that I would refer to others, since it is well beyond my primary care expertise.

    I don't know if a CT or MRI would be diagnostically helpful, but imaging studies may be in your future. This is really the only way to look inside, as you mentioned. As you know, you can't "see" clicks.
    yes_please responded:
    Hi tmkain,

    I know that you posted this three years ago.

    I am also a 27 year old male. Last year I woke up in the morning with this: clicking and noise when I talk. Since then it has gotten so bad I can barely talk anymore without debilitating discomfort and pain as well. This is affecting me badly as well as my relationship with my family and friends since I find it so hard to communicate with them.

    I have seen many experts in the TMJ, ENT, Dental, Orthodontia, and even Homeopathic and Kinesiology fields. None has been able to help me. They all seem to try to wedge their profession into my problem without listening and understanding the issue.

    After an exhaustive search on the internet I have only found your post describing the exact same symptoms I experience. I literally feel your pain because this is the most debilitating thing I have ever experienced. Like you described, it only happens when I'm vertical and after 'hard' consonants, not nasal words like 'Mommy'.

    I know it has nothing to do with my Eustachian tubes as they were tested and found to be totally clear and I'm pretty sure it's not my TM joint because it doesn't happen when I say nasal words or when I chew or move my mouth.

    Please tell me that after four years you have found a solution to this problem. I am going absolutely bonkers.

    Thank you
    tmkain replied to yes_please's response:

    First of all, I'm just glad to know that that three-year-old post I made helped somebody out. When I first realized the clicking was happening, not being able to find ANYTHING on the Internet remotely close to what I was experiencing was really depressing.

    I'm happy to report that my clicking is no longer constant - it flares up every once in a while (seasonally, maybe (?)), but only for maybe two weeks at a time. Like you, I saw pretty much every "specialist" imaginable but couldn't get anyone to do anything but throw their hands up and point in another direction.

    After a few months of that, I pretty much threw in the towel. As my symptoms started to fade in and out, though, I did a little self-diagnosis: what could be making the symptoms go away? What might be behind the relapse when they start again? I came up with two theories. First, I thought the clicking might be caused by some sort of seasonal or environmental trigger. You know how some people can "feel" rain coming in their knees/other joints due to changes in air pressure? Maybe, I thought, something in the air or the temperature was just shifting something around in my facial bone/cartilage arrangement that made two parts snap against each other when I said hard consonants. To me, it's as feasible a conclusion as I can come to - the only problem is that I could never figure out exactly what the triggers were.

    The other hypothesis I came up with was pretty simple: stress and stress-related habits that involve my jaw. Maybe the continuous pain and frustration was all the product of a vicious stress cycle: something stressful set off the clicking; thinking about the problem created more stress, which led to more stress-induced clicking, and so on. I noticed that if I just gave up trying to fix it, it would eventually go away - but that's easier said than done. You have to have reached a certain level of exasperation first (but I think you might be there). If you assume that no doctor is going to be able to figure it out and you're not going to be able to fix it yourself, you actually have less to stress about. Compounding the problem by devoting every waking moment to thinking about it (like I did) does more damage than good, I think.

    For good measure, I also said goodbye to my years and years of nail biting, which I just assumed had a negative impact on my jaw placement. If you're a nail biter, it's probably time to give it up - even if it's not tied to the clicking problem.

    The only difference between my case and yours is that you say your pain is "debilitating," whereas mine was just annoying. My main problem was the mental anguish - that dreadful feeling of a click coming on, that lack of any control over the situation.

    Sorry I couldn't be of more practical help. If you can live with the pain, I'd recommend just accepting it as a fact of life and trying to focus on something else. Keep talking with your family even if the clicking continues - they'll likely be a source of relief in a sea of stress.

    Good luck!
    yes_please replied to tmkain's response:

    Thank you so much for replying. I did not have too much hope that after all these years you would reply to my post.

    Im really happy for you that the clicking is mostly gone. How long did it take before it was no longer constant? I have had it for about seven months with no break although some days it is worse than others.

    On bad days it feels debilitating because every sentence I say is accompanied by multiple loud clicks which are very distracting. I think though that you are correct that when I forget about it, it bothers me less.

    I have been combing the Internet all this time and you are the only person to have described the exact same symptoms as me. Can you elaborate on the things that you do which helps the problem? Which climate do you live in? Have you moved since it started? Do you have/had any other illness that may have started it? TMJ for example?

    Any information would be really appreciated. Perhaps here is a way I can send you a personal message to communicate about this?

    Strangely enough it also started in my left ear but also occasionally pops up in my right ear as well. It gets worse the longer I talk, so a long conversation really is hard on me.

    yes_please replied to yes_please's response:
    Also, after going to several doctors, and realizing that they were having a hard time hearing the noise, I actually recorded the sound by pressing my phone to my cheek and recording as I blew air out of my mouth. (clicking happens when I blow too) I then listened to the recording with the volume cranked up. It's very audible and sounds like someone clicking a Snapple cap. That's my doctors words not mine..
    yes_please replied to tmkain's response:
    Another thing- how is your posture? I slouch a lot and when I straighten up the clicking gets a bit better. Do you have a similar experience? Any info like this is very very helpful.

    Thanks in advance!
    tmkain replied to yes_please's response:
    Dear Yes_Please,

    Don't you think it would be better to keep our discussion on this board just so other sufferers will have a better chance of finding help? If you'd really rather make our conversation private, let me know.

    I can't really say how long it took for the symptoms to subside - considering that my first post here was three years ago and I probably turned to the website after several months of problems, I'd say it's now been four years or so since I actually started experiencing the clicking/snapping/sensations. By my best estimation, my symptoms probably went away "for good" (knock on wood) about 3.5 years after initial onset, with periods of good and bad in between.

    What alleviates the problem?
    1. Accepting that it will happen most of the time
    2. Thinking about something else/not trying to determine the source/cause of the problem when the clicking is bad
    3. Eliminating unnecessary sources of stress
    4. Making yourself horizontal when the problem is unbearable
    5. Relaxing your shoulders
    6. Not putting any unnecessary pressure on your jaw (nail-biting, grinding, etc.)
    7. Trying different environments (dry/moist, hot/cool, etc.)
    8. Getting a lot of sleep
    That's all I can think of right now, but I'll let you know if I remember anything else.

    I live in Japan, actually, where the weather is pretty humid in the spring, summer, and fall and quite dry in the winter. The temperature rarely gets below freezing. For me, the clicking seemed to be most pronounced in the winter, but it's not like the humidity ever seemed to make it go away. I've lived in the same place since the symptoms started, so location doesn't seem to have that much of an effect.

    What you say about posture is intriguing. I have pretty bad posture, too - people tell me my head is always kind of jutting forward. As I said, my symptoms kind of disappeared without me doing anything specific (like adjusting my posture), but if going horizontal makes the symptoms go away, you could easily say that making your neck and back as straight as possible might produce similar results. Makes sense to me. If good posture makes a considerable difference, I would recommend making a conscious effort to correct your posture and invest in chairs that force you to sit up (if there is such a thing).

    My medical history is pretty boring: no broken bones, no TMJ, no sleep disorders, no depression... nothing except for type I (juvenile) diabetes, which I got when I was 21. I doubt that triggered the problem, though. The only thing with a potentially direct influence on the area is my nail-biting habit.

    I'm 100% positive that I had the same condition that's currently driving you crazy. Honestly, it drove me crazy too. There were times when I got so mad at it, so reluctant to talk for fear of making the click happen, and so frustrated that no one could understand what the heck I was going through that I just had to cry. That aggravation went on until I just gave in and said, "OK. If this isn't going away, I'm going to learn to live with it." Then it just evaporated one day.

    I wish I could tell you that there's something you can do to make it go away, but I just can't. Maybe the posture thing is the key. But for me, it was more about acceptance than an actual remedy. That sure made life easier to live.

    Best of luck!
    yes_please replied to tmkain's response:
    Dear tmkain,

    Thanks for your detailed reply. I agree that keeping our conversation here is a good idea. I was supposed to receive and email when you posted a new message but that didn't happen so I only saw your post very recently.

    Thanks for the list of things that helped you. I'll try to bear it in mind when this *thing* is bad. I definitely have better and worse days, although it almost always is worse in the morning and better during meals.

    It is very encouraging to know hear that it disappeared one day and I fervently pray for it to remain that way.

    One question I have for you is: Did it always occur by your left ear, and was it always a single click? I occasionally have it in my right ear as well and often occurs as two or three simultaneous clicks. This is when it is bad and it makes me want to crawl into a hole and not speak to anyone. Inevitably this is also when my boss will decide to have a long discussion about some project with me.

    Another thing: I also hear a lot of noise when I swallow. Did you get that as well?

    I actually made a recording of the noise by placing my recorder near my ear against my skin. I can make the click happen by blowing air out of my mouth; it happens right after. On the recording it is very audible; it sounds like someone 'popping' the top of a Snapple cap. The sound is nothing like that from inside my ear. From inside it sounds like a sharp snap.

    Look for my next post, I am going to see if I can upload the recording to the web and then I'll post a link to it.

    I am very grateful for your responses, they are like a link to future life without this and when you said: "There were times when I got so mad at it, so reluctant to talk for fear of making the click happen, and so frustrated that no one could understand what the heck I was going through that I just had to cry."- I understand exactly how you felt because I could have used the same exact words to describe how I feel quite often.

    By the way, interestingly, I also have a 'forward head'
    Also, if think of anything else that may help please post it.

    Gratefully yours,

    yes_please replied to yes_please's response:
    Here is the promised link :

    I hope this helps someone who may need it.
    LincolnH replied to yes_please's response:
    I have the same clicking sound!
    I am a 42 year old male.

    In order to make the click happen, all I need to do is say a 'k' sound, and then "snap"
    Sometimes it's soft, sometimes it's loud, and sometimes it doesn't happen at all.
    It doesn't cause any pain, the problem for me is that I am professional actor and Voice Over actor, so this is literally preventing me from doing my job when it happens.

    Here's what I've noticed:
    If I make the 'k' sound and relax, snap.
    If I make the k sound while opening my mouth wide, and keep my soft pallete up, without relaxing it, it doesn't click until I relax my soft pallette. Then as soon as my soft pallete drops, click!
    I've tried doing it with absolutely no movement from my jaw, and it clicks just the same.

    My ENT said it was a large strand of mucous that was snapping when my mouth moved a certain way .
    I was BAFFLED that he had absolutely no suggestions on how to get rid of it (as I had already tried Mucinex and it did nothing).
    He also said I had reflux and prescribed a reflux medication.

    Again, this sound prevents me from doing my job in many circumstances.

    He said it may be allergy related

    I've tried nasal rinses, several allergy medicines, mucinex, and blowing my nose a lot. Nothing seems to work.

    Is this the same thing you other guys are having, or is it different?

    Need help!
    yes_please replied to LincolnH's response:
    Hi Lincoln H,

    I just saw your post.

    This is really interesting because I've been doing some self evaluation recently and I can tell you with utter confidence that I have the 100% EXACT thing you have.

    I discovered that the common denominator that caused the sound was that my soft palate was lifting up. K, T, S sounds, blowing out, burping, all lift the soft palate and when it releases it snaps something near the ear.

    I deeply commiserate with your frustration and pain. I'm happy though, that you found this forum. The value of several people collaborating is that it may be much easier to find a solution based on comparing situations to see what common characteristic we share.

    For example, many of the specialists I saw, claimed that this is a result of my (mild) tmj, or possible breakdown of the cartilage in the joint or maybe osteoarthritis. Others said it could be a swollen Eustachian tube. One specialist did a test that tmkain referenced, using a tympanometer to suck air through my ears to test my Eustachian tubes (they were fine).

    So, do you have any TMJ problems? I have pretty minor ones. Do you grind or clench your teeth at night? I do a bit.

    How long have you had this?

    I wonder if there is any meaning behind the fact that I got it soon after starting voice lessons for singing. I couldn't continue them.

    One thing that really helps me is when it's very noisy, I tend to not hear the clicking and thus not get distracted by them or pay attention. Lying on my back also helps.

    Please let us know if you discover any solution! I certainly will.

    Good luck!
    yes_please replied to yes_please's response:
    Oh and by the way, the large strand of mucous idea sounds really strange. I've had this for almost a year. How long does a strand of mucous stick around for? Has it fossilized in my nose?

    Did the ENT actually see this mucous?

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