Imagine how creepy it would be to notice your ear was leaking fluid.
We had a woman come in saying that she normally had “wet” ears, but was now having a lot of fluid dripping out of her ear for the past few days. It was associated with eating, rather, moving the jaw in chewing motions. My initial thought was some sort of head trauma and ruptured ear drum, but I moved to her temporal mandible joint (TMJ) popping out right away. Strangely, I don’t recall learning about the TMJ at all in medical school, it was sort of an off-chance conversation I had with my dentist.
No recent head injury, no fever, neuro exam was completely normal.
Only contributory element from the history and physical was the complain about pain and clicking on the affected side from eating, and palpation revealed an outward movement of the mandible while opening and closing the jaw.
Honestly, I don’t understand how there could be CSF leaking out if the ear drum is intact (which it was). The closest explanation I can find is that it’s a spontaneous cranial CSF leak, which is made worse by increased intracranial pressure.
But then the question becomes, why didn’t she have any of the usual symptoms like headache?
I want to see her again. We told her to go to a dentist and hopefully get a brace to help strengthen the muscles to keep the bones in place, but it seems like a difficult thing to do for a person without insurance.