water in the ear

[luca m]

I have a patient who reports a feeling of water in the ear. She presented with persistent neck pain following MVA. No reported vertigo, tinnitus, hearing loss, or ear pain (or voices in her head). She has ruled out otits media/externa and ear pathologies through her MD.

This sensation is more pronounced when the neck pain increases.

Anyone have a similar complaint? Ideas?



Luca

[ginger]

Luca, it is common in the throes of restoring normal movement to upper spinal facet joints, to discover various referred pain and altered sensation issues resolve. When dealing with C1 and 2, these will include the so called "migraine' phenomena, tinnitis, face pain and so on. It could be that these reports of altered sensations to the ear relate to these same common causes. Continuous mobilisation applied to the upper spinal facet joints will very likely resolve this also. Definitely worth a try.
Cheers

[BB]

My only experience with this was with a pt. who had an Arnold-Chiari malformation (brain stem, and even cerebellum in severe cases, has come through the foramen magnum). When I researched it I discovered that such a sound in the ear is a typical presentation of the problem.

I don't know what this would possibly mean for your patient. If there is a connection it would not be a good one. It would mean that her brain stem had come through the foramen magnum.

[emad]

Hello Luca :

How old is your patient ? What is her profession ? To what do you refer by MVA . I think it worth to begin to address the Cervical pain if there is current complaint using neurodynamics and explain pain . Personally , I have not met a complaint like that , however I do receive patients referred from An ENT specialists whom think complaints such as tinnutus ,drowsiness are blamed for cervical .I think a good idea for your patient to visit another ENT specialist .

cheers
Emad

[luca m]

Emad,

The patient is a 37 year old female, interior designer. MVA refers to motor vehicle accident, 9 months ago. She has benefited from neurodynamics with respect to her pain intensity. She seems to fall back each time she attempts to work at her drafting table, even for 10 minutes. Each time right upper trap and right SCM becomes hypertonic. Also very sensitive to cold. She is a hockey mom and each visit to the arena sets her back (ie muscles tighten, ear sensation and neck pain, stiffness).

Ginger,

Thanks for your input. I had been mobilizing C1 and C2 (probably not as long per session as I suspect you normally would though). She does not have any headaches or symptoms associated with migraines. She seems to benefit more from lower cervical, cervicothoracic mobs though.

I had originally suspected some sort of convergence between CN XI and CN's IX and X because of the SCM involvement. This may still be so, but even when SCM seems "quiet" she still has pain and "water in the ear" sensations.

BB,

Good suggestion. I found this about Arnold Chiari Malformations:

A recent review of the otologic manifestations of Chiari in 16 patients indicated that 81% reported episodic aural fullness, 81% tinnitus, 69% vertigo, and 56% flutuating hearing. Headache was also common (about 80%). Sterling et al. 2001.

Her descriptor may be this aural fullness. She has no weakness, ataxia or numbness, or headaches, and MRI and did not pick up on this. I don't know how well that particular Dx was investigated though.
I'll speak to her doctor about it.
Thanks