What is the cause of a 77-year-old female's left ear clicking sound when biting and chewing, without associated pain, dizziness, or history of trauma, for 2 weeks?

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Differential Diagnosis for 77 Year Old Female with Clicking Sound in Left Ear

  • Single most likely diagnosis
    • Temporomandibular Joint (TMJ) Disorder: The clicking sound when biting and chewing is a classic symptom of TMJ disorder, which is a common condition that affects the joint that connects the jawbone to the skull. The absence of pain, dizziness, and trauma history also supports this diagnosis.
  • Other Likely diagnoses
    • Middle Ear Myoclonus: This is a condition characterized by involuntary contractions of the muscles in the middle ear, which can cause a clicking sound. It is often associated with other symptoms such as tinnitus or hearing loss, but can also occur in isolation.
    • Palatal Myoclonus: This is a rare condition that affects the muscles of the palate, causing involuntary contractions that can lead to a clicking sound. It is often associated with other symptoms such as ear fullness or tinnitus.
    • Eustachian Tube Dysfunction: This condition affects the tube that connects the middle ear to the back of the throat, and can cause a clicking or popping sound when swallowing or chewing.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Temporal Bone Fracture: Although the patient denies a history of trauma, it is possible that a fracture could have occurred without her knowledge or memory of the event. A temporal bone fracture can cause a clicking sound, and is a medical emergency that requires prompt attention.
    • Vascular Malformation or Aneurysm: A vascular malformation or aneurysm in the temporal bone or middle ear can cause a clicking sound, and is a potentially life-threatening condition that requires prompt diagnosis and treatment.
  • Rare diagnoses
    • Patulous Eustachian Tube: This is a rare condition where the Eustachian tube remains open, causing a clicking or popping sound when breathing, chewing, or speaking.
    • Stapedial Myoclonus: This is a rare condition that affects the stapedius muscle in the middle ear, causing involuntary contractions that can lead to a clicking sound.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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