The perception of a clicking, popping, or crackling sound heard internally is a common symptom that can be unsettling. This sound originates not from an external source but from mechanical actions within or near the ear structure. The causes range from temporary blockages to muscle activity and joint issues, with most instances proving to be temporary or benign. Understanding the source of the noise is the first step toward finding relief.
Physical Causes Related to Pressure and Blockage
Eustachian Tube Dysfunction
One of the most frequent causes of internal ear noise is a malfunction of the Eustachian tube, a narrow passageway connecting the middle ear to the back of the throat. This tube opens briefly when a person swallows or yawns to equalize air pressure between the middle ear cavity and the outside environment. When this mechanism, known as Eustachian tube dysfunction (ETD), is impaired, the tube may not open or close correctly, often due to inflammation from colds, allergies, or sinus infections. The resulting pressure imbalance or movement of fluid trapped inside the middle ear can produce the characteristic clicking or popping sensation.
Blockages and Foreign Objects
Another mechanical cause originates in the outer ear canal due to a buildup of cerumen, commonly known as earwax. While earwax naturally works its way out, using cotton swabs or wearing hearing aids can inadvertently push it deeper, leading to impaction. A large mass of impacted wax close to the eardrum can create a crackling sound as the material moves or shifts against the delicate membrane during jaw movements. Foreign objects or tiny hairs resting on the eardrum can also generate a perceived clicking sound with movement.
Clicking Sounds Caused by Muscle Spasms
Middle Ear Myoclonus (MEM)
Rhythmic or irregular clicking can result from involuntary contractions (myoclonus) of small muscles within the head. Middle Ear Myoclonus (MEM) involves the tiny muscles inside the middle ear: the stapedius and the tensor tympani. The tensor tympani muscle protects the inner ear by dampening loud sounds; when it spasms, it pulls on the malleus bone, causing a distinct, rapid clicking or thumping sound. An involuntary twitch of the stapedius muscle can also produce a clicking, buzzing, or crackling noise by moving the chain of middle ear bones.
Palatal Myoclonus
Palatal myoclonus involves rhythmic spasms in the soft palate muscles at the back of the mouth. The tensor veli palatini muscle attaches near the Eustachian tube opening. Rapid, involuntary movement of this muscle causes the Eustachian tube walls to slap open and shut, transmitting an audible clicking sound. This sound can sometimes be heard by an examiner using a stethoscope, classifying it as objective tinnitus.
Referred Sounds Originating from the Jaw
The temporomandibular joint (TMJ) connects the lower jawbone to the skull and sits immediately in front of the ear canal, allowing joint sounds to be easily perceived. Temporomandibular Disorders (TMD) frequently cause clicking or popping noises when the cushioning disc slips out of position during jaw movement, such as chewing or opening the mouth widely.
This mechanical noise is often accompanied by other TMD symptoms, including pain around the jaw, temple, and ear, or a limited range of motion. Grinding or clenching the teeth (bruxism) strains the TMJ, contributing to the disc displacement. TMD-related ear sounds are distinct because they are synchronized with jaw movement.
Indicators That Require Medical Attention
While many instances of ear clicking are temporary, a persistent sound lasting longer than a few days warrants professional medical evaluation. Immediate attention is needed if clicking occurs alongside signs of infection, such as severe ear pain, fever, or fluid discharge from the ear canal.
Other associated symptoms that warrant a medical visit include sudden hearing loss, a feeling of spinning or unsteadiness (vertigo or dizziness), or a sensation of extreme pressure or fullness in the ear.
Diagnosis and Management
The diagnostic process begins with an otoscopic examination to inspect the ear canal and eardrum for blockages or infection. Further testing may include an audiogram to assess hearing function or specialized procedures to evaluate the movement of the middle ear bones. For temporary pressure issues, initial management involves over-the-counter decongestants or simply refraining from inserting objects into the ear canal.