A Letter Regarding TMJ Syndrome and Headaches.

Dear Dr. Chartrand: I came in to see you, because I was having earaches. You examined me, and suggested that see a orthotic specialist. He examined me, and said I had a problem with my jaw as a result of an injury from 32 years ago. I was very surprised that it showed up now. He made a mouth appliance for me to wear at night, because I was clenching my teeth in my sleep. I no longer experience pain in my ears, and want to thank you for taking the time to help me. ---Miss D.L.

Dear Miss D.L.: Glad to help. For our readers who may not be aware, often an "earache" can arise from injury, swelling or pressure on the trigeminal nerve in the are of the jaw. TMJ syndrome sufferers particularly complain of pain at or near the eardrum.

One of the reasons the pain is felt at the eardrum is that an area called the tympanic plexus where a number of nerve branches come together from different areas of the head.

A branch of the trigeminal, vagus, facial, and fourth cervical are the main ones that cross each other at this junction. For that reason, sinus inflammation (facial), toothache (trigeminal), sore throat (vagus), or injury of a back quadrant of the tongue (4th cervical) can all cause what the sufferer may perceive as an "earache".

Differentiation begins by an examination of the eardrum itself, which in any of the above cases would reveal normal coloration, compliance, and physical landmarks. If all appears normal, and hearing test results are normal, another cause is suspected.

In your case, a combination of past untreated injury and cartilaginous and osseous changes over time culminated to expose the need for appropriate treatment. I'm happy to hear that your problem was found and resolved, and wish you continued good health.

For educational purposes only; not to be construed as medical advice or opinion.