A clicking sound in the ear, often called non-pulsatile or mechanical clicking, is a frequent complaint. This internal noise can manifest as a pop, crackle, or distinct clicking sensation. It is categorized as objective tinnitus if a doctor can hear the sound, or subjective if only the patient perceives it. Understanding the cause is the first step toward relief, as origins range from simple pressure changes to involuntary muscle activity.
Understanding Eustachian Tube Dysfunction
The Eustachian tube is a narrow passage connecting the middle ear cavity to the back of the throat, serving to equalize pressure across the eardrum. Normally, this tube remains closed, opening briefly when a person swallows, yawns, or chews to allow air exchange. Clicking often occurs when the tube opens or closes improperly, leading to a noticeable sound as the eardrum shifts position.
Dysfunction can be triggered by common conditions, such as fluid buildup from a cold, seasonal allergies, or rapid changes in atmospheric pressure. This pressure imbalance, known as barotrauma, is often experienced during airplane travel or scuba diving. Performing actions like the Valsalva maneuver—gently blowing air against a closed nose—or simply swallowing can temporarily force the tube open, resulting in popping or clicking.
Clicking Caused by Muscle Spasms
Another internal cause of ear clicking involves the involuntary movement of tiny muscles located within the middle ear space, a condition known as middle ear myoclonus (MEM). The middle ear houses two muscles, the tensor tympani and the stapedius, which dampen loud sounds and protect the inner ear. When these muscles spasm, they create a repetitive, rapid clicking or fluttering sound.
This clicking is neurological or muscular in origin, differing from simple pressure-related popping. Patients often describe the noise as machine-like, a rapid tapping, or a rhythmic thumping not synchronized with the heartbeat. The involuntary contractions of the tensor tympani muscle, which attaches to the malleus, are frequently responsible for this quick, repetitive clicking. The exact cause of the spasms is often unknown but relates to abnormal neural activity.
External Factors and Referred Sounds
Not all clicking sounds originate from the middle ear; some are due to physical obstruction in the ear canal. Excess earwax, known as cerumen, is a common culprit that can lead to crackling or clicking sensations. When a buildup of wax shifts within the ear canal, or when air bubbles pass through it, the resulting friction or movement is perceived as an internal clicking sound. Foreign bodies or small hairs resting against the eardrum can also create a rustling or clicking noise with head movement.
A separate source of clicking is the Temporomandibular Joint (TMJ), which connects the lower jaw to the skull near the ear. Because of the joint’s close proximity to the ear canal and middle ear structures, sounds produced by the TMJ are easily transmitted and perceived as originating in the ear. Clicking, popping, or grinding noises that occur when chewing, speaking, or widely opening the mouth often originate from inflammation or misalignment within the TMJ. This referred sound is a mechanical joint noise rather than an auditory system issue.
Knowing When to Consult a Doctor
While many causes of ear clicking are temporary, certain accompanying symptoms warrant a medical evaluation. If the clicking persists for more than a few weeks or significantly interferes with sleep or concentration, consult a professional. A doctor can help determine if the cause is Eustachian tube-related, muscular, or due to another underlying condition.
Specific red flags requiring prompt medical attention include clicking accompanied by intense pain, vertigo, or sudden hearing loss. Pulsatile clicking, a rhythmic sound that beats in time with the heart, should also be evaluated quickly, as it can indicate a vascular issue. Any discharge from the ear combined with clicking suggests a possible infection requiring immediate diagnosis and treatment.