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Author: admin, 03.02.2014
Acupuncturist answered yes, the patient asks the illness is in middle ear how does ACU can treat? Acupuncturist examination the patient right ear at ACU point TH21 can palpate the superficial temporal artery pulsation. The practitioner following the anatomy illustration needling into the skin and connective tissues at the side of the artery vein and parotid gland released the obstructive tissue the tinnitus symptom is released. In other case for example: the illness for more then ten years the TMJ joint is compressed to the ear the patient had tinnitus one side and lost hearing on other side the ACU treatment is too late. In medicine there are a variety of treatment can be use to treat this disorder, in particular, in the field of dentistry and neurology. Structurally, the illness is involved the mandible ramus (bone) the TMJ (joint), the ligaments and the muscles in which are attached to the bone and joint, the skin and connective tissue envelop the joint. Acute or chronic inflammation of the TMJ, the joint capsule is swelling or the joint movement is restricted. Both side of the mandible ramus, is there, structurally, a history of one side is abnormal or fracture or the clavicle fracture. Age changing in childhood such as lost tooth or the tooth is growing on faulty tooth position.
Both sites of the muscles those attaching to the TMJ and bone are lost of coordinate movement cause imbalances of both side joint movements.
In the case of chronic inflammation located on the head of the temporomandibular joint, the trauma causing the articular dist thinner or disappeared: the condylar process may direct impacts to the external acoustic meatus that will affected to the ear and the cranial nerves pathway in this region, especially lesion to CNX.
In this stage, all this syndrome is initial by the chronic inflammation, additionally, the lesion is not limited in superficial of the joint deeper tissue also involved; the swollen tissues, faulty bone position that compress to the neurovascular pathway, tissues adhesion over stretch the skin muscle increasing tension surround the TMJ and scalp and also will affected to the involved cranial nerve function. The lesion muscles include: masseter, temporoparietalis, temporalis, three auricularis, sternocleidomastoid, are chronic tighten and contracted. The lesion neurovascular involved: superficial temporal vein and artery, auriculotemporal nerve (V3), facial nerve (CNVII), Vagus nerve (CNX), the artery pulsation can be palpated, local skin sensation at between the joint, especially, at the head of mandible and external acoustic meatus is over sensitive. The patient complain headache, stiffness of neck, insomnia, crunching teeth at night and sore jaw, difficulty in transportation, inanition, feel dizziness or nauseas. The young patient do known carefully avoid the difficulty occurred and when the symptom appear the patient will quickly lying in bed to release the symptom.
In adult, in many instances not have the necessity able to achieve the symptom relieved, even taken medication before or after the symptom occurred. In this state or the complicate syndrome occurred, the illness is regarded as a difficult case to manage especially, in western medicine regards unable to treat. When illness is in acute inflammation stage the treatment will improve rapidly, only need few treatments is requires. In this case, frequently, occurs in childhood the patient has some difficulty in the dentistry: in the time of changing tooth loosing or growing, or prolong mouth open in tooth extracted. When illness is in chronic state the patient had experiences many type of treatment and lost confident in all the treatments, in this case, acupuncture treatment can be difficult, frequently, the patient come for acupuncture is tried acupuncture for reduce severe headache frequency, and stress relieved. Most of the patients feel relax and the headache is reduced immediate after treatment, but pain syndrome rapidly return.
The practitioner needs to make a plan for the treatment that involved on looking at the illness whole outline, in which should be individual. The muscle involved to the TMJ and mandible (bone) movement is the muscle attached to the joint and bone.
The TMJ is the body most active and larger motion joint and both side of the TMJ need to balance and harmoniously work together.
The acupuncture management needs to concern the others’ type of treatments for TMJ, without specific reason; it is preferable focus on acupuncture treatment only.
The planning and approach of acupuncture seems more often than not is focus on the muscle, however, the treatment is focus on relieved the tension in the skin and muscles to balance the mechanical force to stabilize the joint and bone, hence, it is able to reduce the pain.


After pain reduced the needle insertion method is focus on the treatment on correlation of the muscles joint and bone. When the TMJ is restricted the needle is inserted into the skin and into the joint capsules and the ligament attached to the joint to remove the adhesion.
The point is located at the medial side of the condylar process of mandible TMJ; slightly open the mouth there is a hole of the mandibular notch.
Medial pterygoid: origin—medial and lateral pterygoid plates, insertion—angle of the mandible.
The needle is obliquely inserted into the skin and the side of the muscle from ST5 toward ST6. ST7 is located at the condylar process is that TMJ capsules, ligament, and pterygoid lateralis attached.
There are some points that located at skull, most of which is involved the scalp and muscle. Acupuncture able to relieve the tension or the lesion in the temporalis and is obliging in the treatment of TMJ. There are three points in which is located at the sternocleidomastoid muscle attached to the mastoid process.
The point SI 17 is located posterior to the angle of the mandible at the lateral side of the sternocleidomastoid muscle and the posterior belly of the digestive muscle. The point TH 16 is located at the medial side of the sternocleidomastoideus posterior inferior to the mastoid process. Initial SI17 make a line connected to BL10, several points are made at 0.5cm interval, and the needle is inserted perpendicularly into the skin and the muscle fascia.
After needle insertion tension headaches, the skin and neck muscles are relaxes, the patient able to open the jaw largely. To cure the illness require balance both side temporo- mandipular joint and sternomastoid muscles movement. Headache associated with TMJ syndrome is common in adults and children, frequently, go with TMJ acute inflammation and chronic inflammation, chronic pain, tinnitus aurium, and others impairment.
At the head of the joint and the external acoustic meatus where is the neurovascular pass through. When the joint is in unstable position the participant in eating, especially, biting a hard food such as a nut can increase trauma to the joint causing acute inflammation. Frequency headache, the patient is stressful, tinnitus, hearing difficulty in one side of the ear, insomnia, stiffness of neck, difficulty in air flight more often after air flight increasing the syndrome such as the poor hearing, headache frequency and dizziness. The TMJ trauma is not have the necessity too severe, acupuncture needle is inserted at the acute inflammation pain point can rapidly relieves the pain and improve the healing.
The pain syndrome return is because the illness other factors still remain that need more treatment to remove the others’ factors.
In this case, the illness had a long period of history, and the illness is severed, and the body damaging tissue is complicated, in which is need times for treatment to assist the body healing process. If that is possible the practitioner should confidently tell the patient how many treatments is required.
That will avoid confusing the patient; in which is the different treatment provided different approach and different conception. The needle is inserted into the skin and muscle receptors that are the way to get the first relieve, the relaxation treatment.
An acute inflammation of TMJ for example: located the swelling point, needle is inserted precisely into the inflammation lump, three needles are inserted into the lump can immediately relieved the swollen and pain. A single needle not good enough to remove the obstruction, in which is need three points in one side of the joint and need others needle insertion to the other side of the joint. The TMJ joint capsules and ligament attach to condylar process, superficially, is the masseter, and deep internal is pterygoid muscles.


For relieve the tension of the masseter, the needle insertion method is the same as above; the needle is obliquely inserted into the skin and the muscle from ST7 toward SI18, and from SI18 toward ST7. The needle is along the side of the condylar process perpendicularly inserted into the skin, masseter, joint capsules, ligament, and pterygoid lateralis, can relieved all these tissues tension. The point SI18 is inserted needle into the skin masseter deep interior is temporalis tendon and pterygoid muscles.   When needle is inserted into this point need to slightly open the mouth and get in to different layer tissues.
Such as TH22 and GB3, these two points are located at superior border of the zygomatic arch can feel superficial temporal artery pulsation, deep interior is the temporalis tendon or muscle.
In the case of epilepsy when the temporalis muscle contraction, frequently, may severely damage the teeth and the jaw.
Two needles are inserted into the side of the muscle and one needle is inserted into the center of the muscle that can rapidly relieve the tension of the skin and the muscle. In the case of an early stage, such as in acute inflammation state require few treatments can relieve the symptom.
The patient should aware in eating, should eating soup instead of chewing food, just need few days the pain is gone.
Acupuncture point such as facial points BL2, TaiYang, ST5, ST6, ST7, TH21, TH22, TH17, SI19, and extremities points such as LI4, Liv3, are selected and gentle needle insertion method is used and the needle is retentions in the points for 15minutes. Some patients are not have the necessity listen to the treatment explanation or to known the illnesses recovery processes and withdrawn the treatment. Without good communication between the patient and practitioner and knowing the treatment plan and illness recovery need times, the treatment is difficult proceeding. The needle may go through the skin, the side of the muscle, the joint, and deep into periosteum, which included the correlative of the skin muscle joint and bone. The needle is inserted into the side of the condylar process and deep into the pterygoid muscle.
Needle insertion remain mouth close and the needle is obliquely along the edge of the zygomatic arch.
Needle insertion depth is 0.7 cm limited to the tendon only, deep interior the blood vessel plexus is near to the point. The anterior auricula arteries, superficial temporalis artery and vein are run through the point, auriculotemporal nerve (CN V), temporal branches of facial nerve also distributed in this point. In a chronic and complicate case, acupuncture able to achieve the result that largely dependent upon the experiences of the practitioner, and what the patient want to achieve. However, the cause of the disorder is remains and repeat over used may lesion to the joint, chronic inflammation and joint restriction is result. When TMJ severe syndrome is occurred in which is the faulty position of the jaw compressing to the neurovascular tissues will affected to the cranial nerves, the senses organs and affected to CNS and ANS as well. If the needle insertion is concerned or target to the temporalis, these three points should be selected and go with GB8 SHUAI-GU that located at the scalp and temporalis muscle.
In general, acupuncture can reduce the headaches; relieve the stress, improving the tinnitus at the early stage. In this stage, the pain is occurs when the patient largely open the jaw or biting the hard food, when it is sever even open the mouth singing or talking become difficult, frequency headache go after all that activities. When the hearing is lost and containing severe tinnitus aurium that nerve tissue is damaged difficult to achieve the result.



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