A clicking noise in the ear, often described as popping, crackling, or tapping, is a common auditory experience. This sound is a form of somatic tinnitus, meaning the noise originates from physical activity or mechanical processes within the body rather than from an external source. While the sensation is generally harmless, understanding the different sources of this internal sound can help determine if it is a temporary issue or a sign of an underlying physical condition.
The Role of the Eustachian Tube and Pressure
The most frequent source of clicking sounds is the Eustachian tube, a narrow passageway connecting the middle ear to the back of the throat and nasal cavity. This tube’s primary function is to equalize air pressure on both sides of the eardrum and to drain fluid away from the middle ear. It typically remains closed, opening briefly when a person swallows, yawns, or chews to allow air exchange.
The clicking or popping sound is often the result of the tube opening and closing to adjust pressure between the middle ear and the outside environment. When the tube fails to open or close properly, Eustachian Tube Dysfunction (ETD) occurs, which causes the distinctive noise and a feeling of fullness. Inflammation from colds, allergies, or sinus infections are frequent causes of ETD, as the swelling can block the tube’s opening.
Rapid changes in altitude, such as during air travel or scuba diving, can also trigger clicking as the ear struggles to keep up with barometric pressure differences, known as barotrauma. Simple maneuvers can often relieve this pressure imbalance and stop the clicking. Chewing gum, swallowing repeatedly, or performing the Valsalva maneuver—gently blowing air out while pinching the nose and keeping the mouth closed—can help force the tube to open and equalize the pressure.
Structural and Muscular Sources of Clicking
Clicking noises can also arise from mechanical issues in the outer ear or involuntary movements of tiny muscles in the middle ear. The accumulation of earwax (cerumen) can become dense enough to press against the eardrum, causing a crackling sound as the wax moves or shifts with jaw motion. Using cotton swabs can push the wax deeper into the ear canal, increasing the likelihood of impaction and resulting in this noise.
Another common structural source is the Temporomandibular Joint (TMJ), which connects the jawbone to the skull and sits close to the ear canal. Disorders of this joint can cause clicking or popping sounds heard in the ear, often worsening with actions like chewing, talking, or opening the mouth wide. These sounds are the result of inflammation or misalignment within the joint structure.
Involuntary spasms of the small muscles within the middle ear, specifically the tensor tympani or stapedius muscle, can lead to middle ear myoclonus. When these muscles contract rhythmically and without control, they generate a rapid, repetitive clicking, fluttering, or thumping noise. This form of clicking requires specific medical attention, as it is a neurological or muscular issue rather than a pressure or wax problem.
When the Sound is Pulsatile or Persistent
While most clicking sounds are temporary and benign, a rhythmic sound synchronized with the heartbeat is known as pulsatile tinnitus. This type of clicking is considered objective tinnitus, meaning the sound is an actual physical noise that a doctor may be able to hear with a stethoscope. The cause is related to a change in blood flow or an increased awareness of that flow in the vessels near the ear.
Underlying vascular issues are the most common culprits for pulsatile sounds, where blood flow becomes turbulent or increased. Conditions such as high blood pressure, anemia, or the narrowing of blood vessels (arterial stenosis) can cause this turbulent flow. This flow is then perceived as a thumping or whooshing noise in time with the pulse. Chronic, persistent clicking that does not resolve after several weeks, especially if it is unilateral or pulsatile, warrants a thorough medical investigation.
Diagnosis and Management Options
Diagnosing the cause of ear clicking begins with a detailed medical history and a physical examination of the ears, head, and neck. Doctors inspect the ear canal and eardrum using otoscopy to check for obvious issues like impacted earwax or signs of infection. An audiological exam may also be performed to assess hearing levels and rule out hearing loss as a contributing factor.
Management options depend entirely on the underlying cause identified during the examination. If earwax is the issue, professional cleaning methods like microsuction are used to safely remove the blockage. Clicking due to Eustachian Tube Dysfunction is managed with treatments for the underlying cause, such as decongestants or antihistamines to reduce swelling from colds or allergies.
For clicking related to the jaw, treatment for Temporomandibular Joint disorders might involve physical therapy, stress management, or the use of a bite guard. If the sound is pulsatile, further investigation with imaging tests like CT or MRI scans may be necessary to look for vascular abnormalities. Specialized medical intervention, including medication or minimally invasive procedures, is then used to address the specific blood flow or structural problem.