TMD has been called the “great impostor” for a good reason. This condition manifests itself in so many different ways; the treating doctor can be easily chasing a phantom. If the ear symptom you experience has not been resolved after a visit to the Ear Nose and Throat physician, the problem could very well be TMD.
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Link to a Scientific Article
Tensor tympani muscle: strange chewing muscle
Tinnitus arises from the traction on the malleus by Pinto's ligament (disco-malleolar ligament) and/or associated musculature to the ear and Eustachian tube (tensor tympani and tensor veli palatini from throat) as well as other triggers particularly medial Pterygoid muscle. These triggers must be released.
Tensor tympani is a tiny middle ear muscle that is attached to the malleus. When contracted, the tension is increased on the tympanic membrane. Its nerve supply is from the Mandibular nerve, a branch of the Trigeminal Nerve (fifth Cranial Nerve).
Pinto’s ligament connects the articular disc of the TM Joint to the malleus bone of the ear.
Link to a Scientific Article
A study of the discomalleolar ligament in the adult human

(Middle ear)
While the Eighth cranial nerve enables hearing, one of the sensory branches of the Fifth cranial nerve – Trigeminal innervates the middle ear leading to the referred pain.
Another way TMD gives rise to ear pain is due to the remnants of Pinto’s ligaments that connected the posterior portion of the glenoid fossa (the socket of the TM Joint) to the middle ear. In TMD, the condylar head is often posteriorized – pushed backwards - leading to increased pressure in this area causing ear pain.
Normally, the Eustachian tube is closed which helps prevent the inadvertent contamination of the middle ear by the normal secretions found in the back of the nose. A tube that is always open is called a patulous Eustachian tube. Patients with this rare condition are plagued by chronic ear infections. A much more common problem is a failure of the Eustachian tube to regulate pressure effectively. Partial or complete blockage of the Eustachian tube can cause popping, clicking, and ear fullness.
As Eustachian tube function worsens, air pressure in the middle ear falls, and the ear feels full and sounds are muffled. Eventually, a vacuum is created which can then cause fluid to be drawn into the middle ear space (termed serous otitis media) If the fluid becomes infected, the common ear infection (supperative otitis media) develops.
Ears can feel stuffy and congested when the Eustachian tube is blocked. This can happen with swelling and inflammation as when there is an infection. It can also happen when the tiny muscle that controls the opening – called Tensor veli palatini is in spasm. When the jaw alignment is poor, the muscles of mastication and associated posture muscles have to compensate. This constant compensation can lead to muscles spasms and trigger points. By Neuro muscularly correcting the jaw relation often leads to the resolution of the various symptoms…including ear symptoms from this cause.
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