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  • Is there any definitive way to diagnose TMJ as opposed to Eustachian Tube Dysfunction

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    Old 04-24-2002, 07:07 AM   #1
    Lizzie51427
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    Is there any definitive way to diagnose TMJ as opposed to Eustachian Tube Dysfunction

    Hi All:
    Went to a new ENT last week, who diagnosed me with Eustachian Tube Dysfunction with conductive hearing loss and ear pain(otalgia). He prescribed prednisone for me, and when it didn't work (well, it's a little better, I guess, but not much...), he said, "I think you may have TMJ, because you don't have hearing loss (even though he wrote that I did on my receipt)." He said that if the prednisone didn't work then I have TMJ, and I should try some mouth guard thing. My question is, How can you differentiate between the two? I have NO pain in my jaw, or clicking or popping or difficulty opening my mouth...It just makes me wonder if people are being misdiagnosed because the ENT can't "see" into the inner ear and the CTs, etc. don't show much. I've heard that inner ear disorders can take a long time to resolve, and I'm wondering if these doctors are diagnosing TMJ in inner ear cases, just to get you off their backs...I mean, I can see if you've got some jaw symptoms, but if all you've got is inner ear ones, I don't see how they can just automatically diagnose TMJ (esp. 5 days after a different diagnosis). I even bit down on this tongue depressor to prove I have no pain or problems in this area, but I guess that doesn't matter? I'm so confused! Lizzie

     
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    Old 04-24-2002, 09:24 AM   #2
    Nicole23
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    Re: Is there any definitive way to diagnose TMJ as opposed to Eustachian Tube Dysfunc

    Hi Lizzie. Well the main symptom I have had with TMJ is that my ear plugs up even over the smallest hills. It took me several ENT's, until finally one diagnosed me with TMJ. He is a Doctor at one of the top Ear Clinics in the country. Anyway, my Ortho didn't even revognize the symptoms. <IMG SRC="http://www.healthboards.com/ubb/frown.gif"> So I would sugest you find an excellent ENT-the best one u can find and then get an MRI.

     
    Old 04-24-2002, 10:33 AM   #3
    Lizzie51427
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    Re: Is there any definitive way to diagnose TMJ as opposed to Eustachian Tube Dysfunc

    Dear Nicole,
    Thanks for the reply! I was HOPING to avoid another MRI! I'd had one for my neck and that was bad enough, but when I went to go have another one for my inner ear last November, I hadn't taken my Antivert that day, and it felt like my head was "falling" pressure-wise, I guess.
    After you were diagnosed, what did they do for you? I was reading on this board, and it seems like there's nothing they can do for you...
    By the way, were you ever diagnosed with an inner ear problem? I was...And, do you have any dizziness/lightheadedness/imbalance problems?
    This is the most confusing thing I've ever heard of! Thanks so much for all your help!
    Sincerely,
    Lizzie

     
    Old 04-24-2002, 10:44 AM   #4
    Lizzie51427
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    Re: Is there any definitive way to diagnose TMJ as opposed to Eustachian Tube Dysfunc

    Dear Nicole,
    I almost forgot! Did you have any sinus problems before this? I'd had sinus infections every 3 months for at least the last 8 or 9 years, and I finally had surgery last Feb. 2001. But, I had a CT sinus scan back in November also, trying to find the answer to my inner ear problem,and it showed polyps and retention cyst/band of scar tissue. So, I'm still thinking it may have something to do with swelling inside, as my right side sinus always feels congested too. Unfortunately, the first ENT I went to was the one who did my surgery and he said "Your sinuses look GREAT!" (Of course he WOULD say that, right?) And, the second one I went to practices at the same hospital as the first one and may not want to say anything, he didn't even look at my CT sinus scans I'd brought. But, the day of my sinus surgery the first ENT asked me in the prep room, "Did you bring your films?" and, I hadn't, so who knows if that's why he forgot to remove polyps. And, I don't know if this has anything to do with anything, anyway...
    Just a thought...
    Thanks again!
    Lizzie

     
    Old 04-24-2002, 07:10 PM   #5
    Mike30
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    Re: Is there any definitive way to diagnose TMJ as opposed to Eustachian Tube Dysfunc

    Hey Lizzie,

    Me too exactly! I am a 30 year old male who has suffered from acute sinusitis several times in the past 5 years. Six months ago I developed symptoms that I had not previously experienced with sinusitis, but were upper respitory in nature. Namely, my Eustachian tubes seemingly filled with fluid followed an associated "clicking" or "popping" sound in my ears. I can make this sound when Iopen or clsoe my jaw and sometimes it is so loud people can hear it across the room. Even the ENT said he had never heard it bfeore. Furthermore, I have been experiencing on and off dizziness throughout the last six months. I do not have post nasal drip and I am pretty much headache and sinus pressure free, although very rarely I do experience both.

    I have had three CT scans which all show sinus infections of my frontal and ephemiod sinuses. However, after trying months of anti-biotics and steroid treatment, the nasal sinus disease specialist now believes that the CT scans are most likely "false positives" and that my problems are more symptomatic of allergies or perhaps TMJ

    So joy joy, now it get to go see the Dizziness specialist. Keep me updated if you hear anythign and I'll do the same!
    Best in Health,

    Mike
    Please do not post e-mail addresses or personal details. Thanks - mod3]
    <p>[This message has been edited by moderator3 (edited 04-25-2002).]

     
    Old 04-24-2002, 10:02 PM   #6
    MikeV
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    Re: Is there any definitive way to diagnose TMJ as opposed to Eustachian Tube Dysfunc

    It is just a symptomatic paperchse isn't it?!

    The loud clicking in your ears must be your tmj I would have thought? Did this not occur to the ENT even? I am so often staggered by the lack of knowledge of tmjd symptoms - my dentist who treats tmj was not aware of the dizziness associated with it. My brother in law who is a GP was not aware of it etc etc. ENTs look in your ears and say they look fine and someone else will tell you they are not etc.

    Years ago I went to a neurosurgeon for dizziness - I told him I thought it was my neck - injury history, dizziness often caused by extension of the nexk etc, relief from dizziness if I squeezed my nexk hard etc.
    "No, its not your neck only old people get that" was his reply. He thought he detected a nystagmus (his colleague with him did not see it) and that I had an infection in my vestibular. CT scans, ENGs etc etc. Nothing. Went to see a cranial osteopath and he said it was my neck.

    This mish mash of knowledge and opinion would appear to be represented in virtually all of the cases I read about on here.

    I sometiems wonder if it would not be better to simpy decide for yourself what you have and deal with it! Maybe the psychological certainty would bring some relief!

     
    Old 04-25-2002, 06:53 AM   #7
    Lizzie51427
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    Re: Is there any definitive way to diagnose TMJ as opposed to Eustachian Tube Dysfunc

    Dear Mike V,
    I smiled reading that last part...I had decided it was my ears, because as bad as THAT is with difficulty diagnosing and treating,after reading this board, it sounded like with TMJ, the cure (surgery) was almost worse than the disease. (And, did you read that "TMJ Reality" post? Heartbreaking!)
    In my case I also have the neck thing to consider...
    But, all 4 neurosurgeons I'd gone to before I had my surgery said they didn't think my problem was from THAT...(one of the few things they agreed on...)
    Also, after my GP and ENT said my ears looked fine, I'd gone to the Emergency Room, and was diagnosed with "Otitis Media". So, all those months before when they were telling me they looked fine...it makes me think, you know?
    As to the clicking in the ears, the Eustachian Tubes can make that noise also. (But, I think that's the opposite problem of what I have...I think the clicking is the opening of those tubes...and mine WON'T open...)
    If ONLY this TMJ could be more easiy diagnosed, with a ONE clear differential...You know, like you HAVE to have jaw pain, or jaw "clicking", "popping", difficulty opening your mouth...
    Well, that's that...Not too much help I realize. Just as confused as ever!
    Oh, almost forgot...my husband's good friend was just diagnosed with TMJ, but he has played hockey all his life, and got into one or two fights (ahem...) also. He has all the jaw/headache symptoms...
    I have all the other ones, NO jaw ones...SO, it makes it hard to think we have the same disease, you know?
    Well, let me know what the cranio-osteopath says, okay?
    This is a big mystery, isn't it?
    Take care and good luck today at your appt.
    Lizzie

     
    Old 04-25-2002, 07:04 AM   #8
    Lizzie51427
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    Re: Is there any definitive way to diagnose TMJ as opposed to Eustachian Tube Dysfunc

    Dear Mike 30,
    I have never heard of a false positive on a CT sinus scan...When I had mine last fall, it showed no infection, but it showed polyps and a retention cyst or a band of scar tissue...But, when I brought it in to the ENT who had done the surgery last Feb. 2001, he said my sinuses looked "GREAT!" Then I remembered that right before I went in for my surgery, he had come into the prep room and asked me if I'd brought my last CT scan with me...and I hadn't, but he said he wouldn't need it...So, now maybe I'm thinking maybe he forgot about the polyps, etc...? And, I'm wondering if THAT could cause inner ear problems?
    And, I went to a new ENT who read the report on the last CT, but didn't even look at the films. And, I'm thinking, they both practice at the same hospital, and could know each other, and he doesn't want to say this could be causing the inner ear problem...
    All I know is last Thursday he told me "Eustachian Tube Dysfunction", "Hearing Loss---Conductive", and "Otalgia". He gave me prednisone which helped somewhat with the pain, but my ears are still not "clear", and I still have the dizziness/lightheadedness...So, when I called him back, he said, "I think you have TMJ, because you have no hearing loss..."
    I've read on here that if you try the antibiotics, decongestants, steroids, etc. then maybe you can consider ear tubes, but when I asked about this, he said, "You don't need tubes, you have no fluid in your ear..." But, I thought the point was to let in AIR?
    I'm confused...STILL...
    Lizzie

     
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