• 9 months ago

    Uncommon Issue: Clicking with apparent connection to engagement of the soft palate, ear popping when swallowing

    7 months ago or so, I noticed a certain clicking noise that seemed to be coming from my nasopharynx area when I said certain words. "Favor," "cookie," and "papa" to name a few. Although this clicking is not particularly noticeable to others, it is indeed audible if they know to be listening for it or if we are in a quiet space. It is very audible to myself and, more importantly, very audible to a microphone. As an aspiring voice actor, this issue has caused me much consternation. I can't bring myself to submit auditions: the post production effort required to clean up my audio is excessive, much too excessive to expect clients to do for raw voice requests (which is the majority of what I can get from my agency). That's if the audio is even salvageable...sometimes the click falls on the very end of a word and it cant be edited out without damaging the word. I can't make the click not happen but I can control (to an extent) when it "drops" by keeping my soft palate in whatever position the the word I just spoke had it in, with the click then occurring when the palate relaxes. The click also occurs upon blowing air or upon release of puffing out my cheeks.

    A month or so after the clicking began, I developed an additional issue. My ears began to pop or crackle upon swallowing. This may have been spurred by sticking a cue tip too far in my ear, it may be unrelated. It occurs mostly in my right ear, sometimes my left, once in a while both ears. If its happening , its happening each time I swallow until it doesn't. It occurs more frequently if I've eaten dairy or something greasy. Sometimes I can stop the ear popping by hocking, flexing my soft palate, sucking back to clear my saliva from my palate or by whipping my head towards my shoulder.

    Occasionally my ears may softly ring for no more than 20 seconds.

    I saw a local ENT who performed a hearing test and measured the health of my ear drums. Tests show I have above average hearing and my eardrums seem to be in decent health with no perforations or fluid behind them. He shrugged and said he had no idea what was wrong and sent me to a neurotologist. The neurotologist inserted a long camera-type device and didn't see much out of the ordinary outside of my uvula flipping up when I swallow (this is not a noticeable sensation to me). He said my Eustachian tubes looked fine. He was able to visually correlate my theory that the clicking occurred upon relaxation of the soft palate. He did not know what the issue was but recommended I see an otolaryngologist and speech pathologist and that they consider a botox injection to my palate. This was a misguided recommendation on the line of thought I could be dealing with palatal myoclonus. My clicking is not the rhythmic, repeating clicking of PM, it is cause and effect: soft palate engagement -> relaxation-> click.

    The otolaryngologist and speech language pathologist quickly ruled out the botox idea, did the camera look, again correlated the click to the soft palate, and decided TMJ was very unlikely but still had no idea why my ears might be popping. They did notice the odd bubble forming close to my eustacian tube opening. We also found out that the click was much less likely occur if I had my head chin to my chest. They recommended I try to cut back on caffeine and try a nasal saline spray. I have had a hard time cutting back caffeine but I have tried saline nasal spray and steroid nasal spay to no effect. I have also tried Neilmed sinus rinse twice daily to no effect. I have also tried twice daily steam inhalation to no effect.

    I have searched online for other cases like mine and have found very little except the odd person crying out for help. I did find this forum thread from 9 years ago (that died about 2 years ago) with a bunch of people who were dealing with the same or similar problem.

    https://forums.webmd.com/3/cold-and-flu-exchange/forum/3781

    In all that time that thread was going, only one person said it more or less went away and even then he couldn't say why accept that he dealt with it for three years, gave up on fixing it, and it just went away one day. One of the more depressing patters I've noticed from that thread and other isolated cries for help I've come across is that we keep going to professionals and everyone either inserts their own area of expertise so they can say they came up with a diagnosis or they just flatout admit they have no idea what's wrong.


    Information about me:

    - male, 26

    - lost 47 lbs in the last 10 months and had lost around 15-20 lbs by the time the clicking began (weight loss connection?)

    - uvula flips up when I swallow

    - I did not have any recent ear, sinus or throat infections or other issues that precipitated the clicking/popping

    - Clicking from speaking feels like its coming from a right "side" for the most part. Can occur from a left feeling "side" when speaking occasionally. I've noticed that clicking from both "sides" can occur when I swallow, blow air or just engage my palate.

    Audio of Clicking: https://soundcloud.com/macelortay/clicking-test-2

Responses

  • 8 months ago

    RE: Uncommon Issue: Clicking with apparent connection to engagement of the soft palate, ear popping when swallowing

    Hello. I've had this exact same problem for about 1,5 years. I've listened to your recording on Soundcloud and my clicking sounds exactly the same. Maybe mine's even more pronounced.
    I know what you're going through. Went to an ENT who couldn't help me. Searched the entire web for solutions only to find people writing they had the same problem but no solution. Learning to live with it seemed to be the only thing to do.
    It seems such a small problem but it can be really mentally exhausting. Especially when it affects your work. You write you're an aspiring voice actor, I'm a recording artist, so I know how obstructive this seemingly small problem can be.
    On my search for 'clicking soft palate' and related searches I stumbled on pages about how to prevent snoring and apnea related stuff. First I ignored those until decided to read into it a bit. And that turned out to be a good decision.
    I've been doing palate exercises now for about a week and my clicking has reduced dramatically. I would say right now it's down to about 10% of what it used to be. I've posted about it here https://www.medhelp.org/posts/Ear--Nose--Throat/Clicking-noise-from-soft-palate/show/1916543 (it's the Sept 3 2018 post) and then I came across your post which is an even more accurate description of the problem.
    It's kind of hard to describe the exercises here but I would advise you to google for 'strenghthen soft palate'. The exercise that works for me is the one where you blow into a straw. It's a anti snoring exercise which helps to make your palate tighter. For me this works and I can talk, sing and record freely again. Hopefully it will work for you as well. Good luck and let me know it works for you.

    Edit: Forgot to mention a couple of things.
    1. For me as well it started in a period where I had lost about 15 lbs so maybe there is a weight loss connection indeed.
    2. My ears also click when I swallow. Sometimes just the right ear, sometimes just left, sometimes both.
    3. With me the soft palate clicking can occur on one or both sides of the palate.
    4. I had been flying prior to when the clicking started. And since I have very painful inner ears when on a plane, especially during landing, I believe there might be a connection to an inner ear pressure problem as well (it's all connected back there).
    5. There's no clicking when I talk while putting my chin on my chest and a lot of clicking when I talk while raising my chin.
    6. The clicking stays away a for few minutes after I ate or drank something.
    7. Strong coffee or bitter tea seems to make the clicking worse.
    8. You're right, it's not palatal myoclonus. It has to do with your soft palate being too loose.
  • 8 months ago

    RE: Uncommon Issue: Clicking with apparent connection to engagement of the soft palate, ear popping when swallowing

    Oh wow! Thank you so much for commenting. Everything you've described really does sound like my problem, even down to the ear popping! You're the first person I've seen with our issue that feels they're actually figured out a way to mitigate the issue. If you've had such process in a week's worth of work, I wonder if it's actually possible to fully stop it with soft palate exercises. I'm going to looking into this ASAP.

    I've been in communication with an SLP academic who's to taken an interest in this problem. I'm going to make sure he sees your comment as well he may be able to give us a more mechanical perspective
      • 8 months ago
        You’re welcome. I hope the exercises will help you to get rid of this.

        BTW the first exercise with a straw had an immediate effect for me. The clicking was completely gone. I gradually came back during the day but not as strong as it was, not by far.
        Now I start every day with a few exercises and if during the day I hear clicking when I talk I do a few extra exercises.
        I can do those without a straw now. You have to build up pressure in your mouth in a way that you feel it push against your palate. My adam’s apple lifts a bit when I do it, as if swallowing.
        I build up the pressure by inhaling and holding that breath. With that pressure in your mouth you can push against your palate. I’m not really sure how to describe it better.
        I combine the straw exercise with an exercise where I yawn or just open my mouth really wide, until I feel it in my jaw. I sometimes hear my palate crack a bit when I do that.
        Smiling in a really extreme way also helps to strengthen your palate. It looks a bit weird though so better do it when you’re alone... ;-)

        I’m curious what the SLP academic has to say about it.
        Keep me posted, okay? It’s been a big issue for me the past 1,5 years.
      • 8 months ago
        I certainly will, in fact, send me an e-mail. It's a g(oogle) mail account and the unique component is macelortay ( don't wanna just type the whole thing out and give it to every text trawler on the web).
      • 1 month ago
        Hi there! Finally some other people who have encountered the same issue. Have the excercises worked for you? I am going to try them out then!
      • 1 month ago
        Hi! Yes, for me the exercises work very well. I start everyday doing them and my clicking has reduced dramatically. Most importantly, it's not on my mind every second of the day. So especially mentally it's a big relief.
        I’d say the clicking is down to less than 10 % of what it used to be.
        It’s all about strengthening your soft palate. I do three exercises each morning that work really well for me.
        Here’s the drill:
        1. Yawn as wide as you can. Or just open your mouth as wide as you can. Try focussing on your palate and try raising it. It’s a matter of feeling what happens. After a while you’ll get the hang of it.
        2. Blow through a straw: Inhale, keep the air in your mouth and puff your cheeks. Then put your chin on your chest and slowly exhale through a straw. Or just blow on a finger if you don’t have a straw.
        3. Smile! Try to make the smile as wide as you can. At the same time try to build up pressure in your mouth and head (kind of hard to describe this) up to the point your head starts shaking and starts going red. If that makes sense… If you think, this must look creepy, you’re doing it right.

        Edit: About the ‘building up pressure’ part in step 3; I found this article about jet pilots who have a technique to fight g-forces. They force blood to their head to keep from passing out. It’s called the Hook maneuver.

        This is the part that describes it:
        'Breathe in, and begin to say the word “Hook.” You should feel your glottis, the opening between your vocal cords, at the back of your throat. About three-quarters of the way through the word, before hitting the “K” sound, close your glottis and hold for 2.5 to 3 seconds.'

        Here’s the full article:
        https://gearpatrol.com/2017/10/04/hook-maneuver-agsm-tutorial/

        If you do this right you can really build up the pressure and focus it on your palate.

        Good luck!
      • 16 days ago
        Hi there! Thank you for replying! Do you use instagram, whatsapp or facebook? I would like to ask you more questions about them . Thank you :) I have been doing the excercises. The clicking intensity really changes a lot during the day, sometimes it is so THERE and sometimes I don't notice it or its very soft. There has been two times when I got a cold and the clicking vanished for that period of time. When I healed, it returned, such an odd thing, I think it is better to laugh haha. It is so ridiculous.
      • Hi! I've got the same problem and it has been 3 years since the first time I noticed it. At first I noticed the clicking is associated with some specific sound of consonants like "k", "t", "g", later I found out it happens every time when the part behind nose is involved in some kind of "stretch and release" activity. So the clicking doesn't really require speaking. I can literally sit here and make it click all day at any frequency I want. Pure breathing in or out doesn't lead to clicking because no "stretch and release" is involved.

        I went to see a doctor and then a specialist. They did a CT scan of my sinus, also had a look inside my nose with a camera. All tests came out fine, except that they saw a small amount of mucus inside my nose and they thought this might be the cause. So I took their advise to take nose spray for allergy, and also saline spray and sinus irrigation every day. It has been almost 6 months now since I started the medicine, but I haven't seen much effect.

        The clicking is mainly on my right side although sometimes it happens to both sides. The clicking is from deep inside and behind nose. Whatever is there cant be blown out. I even tried to reach the spot carefully with a cotton bud but it can't reach. I guess there's a turn at the back of nose, the clicking spot is above there and can't be reached from the nostril. But I'm sure my clicking comes from the nose, not the ear, not the throat or the palate.

        There are a few situations that the click went away:
        1. When I had a bad cold and nose blocked with mucus;
        2. Temporarily goes away after I use sinus rinse (I guess the reason is similar to 1: nose filled with fluid);
        3. Temporarily goes away after I eat hot food or spicy food (maybe because more mucus are produced when eating hot and spicy food);
        4. "Standing on head" position. (I think the gravity makes the mucus or whatever the cause is go to the opposite direction so it can't click)

        I am so annoyed by this problem. I feel like I can't enjoy my life anymore. Every day is pain for me although the clicking itself is not painful. I tried the exercise jk_nl introduced but it didn't work for me. Maybe because my clicking comes from nose, not soft palate?