Everyone knows that the temporal tap procedure can interrupt the gag reflex or diminish nausea. The procedure is quite simple. Merely tap in the mid-anterior temporalis area bilaterally in a firm but not hard manner until the desired effect is achieved.
Today we'll look at a publication by GM Halmagyi, RA Yavor, and JG Colebatch. This article appears under the following citation: GM Halmagyi, RA Yavor, and JG Colebatch. Tapping the head activates the vestibular system: A new use for the clinical reflex hammer. Neurology, 1995;45:1927-1929.
Is There a Connection?
On a side note, this article starts off with the report that loud clicking sounds can activate vestibular receptors in normal subjects. This may explain why some of my TMD patients describe flashes of nausea with their clicking sounds. However, this is a subject for another time.
Meanwhile authors pondered the question whether or not vestibular activation might be produced by tapping the skull, thus circumventing the normal middle-ear conductive mechanism.
Their study is rather elaborate and needs not be described in detail for our purposes. Essentially they tapped on the middle of the forehead with a reflex hammer and recorded data via numerous electrical leads designed to record vestibular myogenic potentials.
Among the authors conclusions is the statement that the "taps activated the vestibular apparatus directly by a bone-conduction vibration wave." Certainly, then, it can be reasoned that the temporal tap procedure creates bone-conduction vibration waves as well. If so, this helps explain the effect of the temporal tap.
Next Time
In my next issue I am going to address a nagging problem for many chiropractors: namely, the negation of your professional opinion by another doctor.
Here, we have a letter from an obviously qualified chiropractor whose wise professional recommendations are dismissed by an orthodontist. This is a very interesting situation and I am quite sure you won't want to miss this one!
With each article I encourage you to write the questions you may have, commentaries on patient care, or thoughts to share with your colleagues, to me at the following address. Please include your return address.
Darryl Curl, DC, DDS
2330 Golden West Lane
Norco, CA 91760
E-mail: doccurl@ix.netcom.com
