Info. on right ear pain on descent - now right ear TMJ issues....experiences etc

[Wazza78]

Hi All,

I am chasing some information as to whether the following is possible.

i am a commercial diver and therefore am trying to prove my current injury is dive related. All doctors I have spoken to dont seem to agree my injury could be caused from the following - but I believe it has,

Anyway - about 5 years ago I descended but had trouble equalising in right ear, there was a large pressure build up and pain, so I ascended equalised and continued to dive. Ever since the ear has been a bit squeaky, crackles when I swallow, but generally okay - apart from whenever I first equalise there is a pain in the right ear - a short sharp pain.

In the last year there has been continual pain and crackling in that ear, which I believe is around the Tembro mandibular Joint (TMJ). This comes and goes but whenever I go to an area of different pressure (up a hill, duck dive) - there is incredible pressure build up in that right ear.

So i beieve that during that dive 5 years ago, the ear was pushed in so far that it has injured the TMJ, which will ovbiously affect the eustachian tube etc.

I do get fatigue in my face from holding the regulator which I know can cause TMJ but I believe the damage was done from this dive years ago.

My ear has been checked and is fine, but the TMJ problem has been suggested. The dentist suggests it is "dental" but I really believe it isfrom that single dive.

Can anyone suggest anything to support my idea?
Many thanks

Wazza

 

[sprange]

If you examine the structures involved you'd realize that it would be nearly impossible for the tympanic membrane or any other component of your ear to cause damage to the TMJ without -extensive- tissue damage being noted. The TMJ is just that--a joint like others in your body and it tolerates a lot of abuse both conscious (gum chewing) or otherwise (bruxing aka 'grinding'). While a popping sound is associated with some TMJ disorders, the type that you describe seems to be associated with eustachian function and I have hard time believing another dentist would suggest that this is due to any kind of barotrauma-induced TMJ damage.

 

[Wazza78]

Hi Sprange

Thanks for your opinion. I am due a TMJ scan next week,

I have noticed the clicking seems to be around the Tragus of the ear (the loby bit close to the TMJ), When I move this it feels very lose and makes a clicking noise. If I put pressure on it and slide my finger downwards over it, I feel something move, like a tissue or ligament is torn away.

Anyway - just my observations. Id be appreciative of any feedback,

Wazza

 

[Duke Dive Medicine]

Concur with sprange in that it's nearly impossible that the barotrauma is related to the TMJ issue. Do you still have trouble equalizing your right ear, or do you notice any popping or discomfort with changes in ambient pressure (flying, etc)? Also, what kind of equipment do you use for commercial diving? If you use a SCUBA regulator all the time, you may be able to make a case that the TMJ problem is related to that instead of the barotrauma.

 

[Wazza78]

Concur with sprange in that it's nearly impossibleb e barotrauma is related to the TMJ issue. Do you still have trouble equalizing your right ear, or do you notice any popping or discomfort with changes in ambient pressure (flying, etc)? Also, what kind of equipment do you use for commercial diving? If you use a SCUBA regulator all the time, you may be able to make a case that the TMJ problem is related to that instead of the barotrauma.

Thanks guys. I can equalise fine in my right ear. However I notice immense pressure build up when driving up hills or free diving in my right ear. I use normal scuba regulators. I get very sore jaw muscles from clenching when scuba diving though. I recently had a tympanic audiogram and I was type ad in right ear. Left ear type a. Does this sound like it might be tmj from scuba? Sorry for the very long delay in replying!

 

[Duke Dive Medicine]

Hi Wazza,

Thanks much for the update. Hopefully in the intervening 1 1/2 years you've been evaluated in person by a medical professional... what was his/her opinion?

Re your tympanogram: that's a bit above my pay grade, but to the best of my knowledge the static compliance of your tympanic membrane and middle ear apparatus has nothing to do with temporal-mandibular joint dysfunction. Try sending a private message to DoctorMike, he's an ENT physician. Or, Mike, if you're reading this, it would be great to have you weigh in.

If your jaw muscles are sore from clenching the regulator too hard, try a different mouthpiece. I know there are companies out there who can custom-make them, maybe another SB member can recommend one. Also, though it sounds simple, try being mindful of how tight your jaw muscles are while diving.

Best regards,
DDM