From the Guidelines
Aural fullness during mastication is most commonly caused by Eustachian tube dysfunction, which can be exacerbated by factors such as allergies, sinus infections, or temporomandibular joint (TMJ) disorders. This is because the Eustachian tube, which connects the middle ear to the back of the nose, plays a crucial role in equalizing pressure between the ear and the environment, and its dysfunction can lead to aural fullness, especially during activities like chewing that affect the surrounding muscles and joints 1. The Eustachian tube's normal function is to open briefly during swallowing or yawning to replace air absorbed in the middle ear and even out pressures, but if it fails to do so, it can lead to negative pressure and aural fullness.
Some key points to consider in the context of aural fullness during mastication include:
- The Eustachian tube's anatomy and function, including its role in protecting the middle ear from germs and mucus in the back of the nose 1
- The potential causes of Eustachian tube dysfunction, such as allergies, sinus infections, or upper respiratory infections that cause swelling around the tube
- The possible contribution of TMJ disorders to aural fullness, given the joint's proximity to the ear canal and potential to create pressure changes when moving
- The importance of relieving symptoms through techniques like yawning, swallowing, or the Valsalva maneuver, and considering medical interventions like nasal decongestants or steroid sprays if symptoms persist.
In terms of management, it is essential to address any underlying causes of Eustachian tube dysfunction, such as allergies or sinus infections, and to consider simple techniques to equalize pressure and relieve aural fullness. If symptoms persist or are accompanied by other concerning signs, consultation with a healthcare provider is necessary to rule out more serious conditions 1.
From the Research
Aural Fullness During Mastication
- Aural fullness is a common symptom of middle ear diseases, most importantly Eustachian tube dysfunction (ETD) 2, 3.
- Eustachian tube dysfunctions, such as stenotic or patulous tube, can cause aural fullness sensation 3.
- Inner ear disorders, such as endolymphatic hydrops (EH), can also cause aural fullness 2.
- The Toynbee phenomenon, which occurs when swallowing against occluded nostrils, can create positive middle ear pressure and contribute to middle ear disease 4.
- Middle ear pressure regulation is actively controlled by both the Eustachian tube and the mastoid air cell system, with the mastoid playing a crucial role in continuous regulation of smaller pressures 5.
Eustachian Tube Dysfunction
- Eustachian tube dysfunction can be caused by various factors, including anatomical abnormalities, such as a narrow orifice of the tubal ostium, or functional disturbances, such as impaired tubal opening 6.
- Laser ablation of the posterior half of the epipharyngeal tubal ostium can improve middle ear ventilation in patients with Eustachian tube dysfunction 6.
- Tubal function testing, such as the Valsalva maneuver and tympanometry, can be used to diagnose Eustachian tube dysfunction 3, 6.