Avaliação do efeito do tratamento de distúrbios temporomandibulares sobre o zumbido

Abstract

RESUMOIntrodução: A interação entre o zumbido e os distúrbios temporomandibulares é um tema que possui abordagem antiga e complexa, pois os fatores etiológicos, bem como a patogênese desta inter-relação ainda não são bem definidos. Ademais, sabe-se que o zumbido possui maior prevalência nos portadores de distúrbios temporomandibulares quando comparados com a população geral, o que sugere haver esta correlação. Objetivo: Avaliar o efeito do tratamento dos distúrbios temporomandibulares na percepção do zumbido. Método: Trata-se de um estudo de coorte, prospectivo, em que se estudaram pacientes portadores de distúrbios temporomandibulares (DTM) que apresentavam zumbido antes e após o tratamento odontológico do DTM. Os pacientes foram avaliados quanto à idade, sexo, caracterização do zumbido -local do sintoma e tempo de duração e avaliação auditiva através de audiometria. A intensidade do zumbido foi avaliada através de escala analógico-digital antes e após o tratamento dos DTM. Resultados: Avaliamos 15 pacientes com DTM e zumbido, com idade média de 37,7±17,1 anos, sendo 86,7% do sexo feminino. Em 60% dos casos o zumbido era unilateral e a mediana do tempo de duração foi de 24 meses. Em 5 (33,3%) pacientes identificou-se perda auditiva neurossensorial a audiometria. Comparando-se os escores da escala analógico-visual antes e após o tratamento odontológico, verificou-se que houve redução significativa (p<0,001) da intensidade do zumbido. Em 4 (26,6%) pacientes houve desaparecimento do zumbido. Conclusão: Houve redução significativa na percepção do zumbido nos pacientes submetidos a tratamento das desordens temporomandibulares. Palavras-chave: transtornos da audição, zumbido, transtornos da articulação temporomandibular, transtornos craniomandibulares. SUMMARYIntroduction: The interaction between tinnitus and temporomandibular disorders is a very complex issue that has been long approached, because neither the etiologic factors nor the pathogenesis of such a two-way association has been clearly defined yet. Additionally, tinnitus is known to be more prevalent in temporomandibular dysfunction individuals in comparison with the general population, hence, suggesting the existence of this two-way association. Objective: Evaluate the effect of the temporomandibular disorder treatment when tinnitus is noticed. Methods: It is about a prospective cohort study, in which temporomandibular dysfunction (TMD) individuals showing a tinnitus before and after the dental TMD treatment were studied. Patients' age, sex, and tinnitus features -place of symptom and time length were examined, and an audiometric evaluation was performed. Intensity of tinnitus was evaluated by a digital analogue scale before and after the TMD treatment. Results: We evaluated 15 TMD and tinnitus patients aged between 37.7±17.1, 86.7% of whom were female. In 60% of the cases, tinnitus was unilateral and the average time length was 24 months. In 5 (33.3%) patients, a neurosensorial hearing loss was seen at audiometry. When comparing the visual analogue scale sc...

Relationship between Otological Symptoms and TMD

“…Tullberg and Ernberg found that, immediately after treatment, 73% of patients reported improvement in tinnitus, especially in patients with oscillating tinnitus, and that this characteristic may be associated with a better prognosis 24 . Webster et al have obtained positive results in the reduction of tinnitus with conservative treatment for TMD, explaining that this may be due to the fact that the average age of the sample was lower, having patients with minimal exposure to noise and chronic diseases, as well as the presence of only a few individuals with audiometric alterations 26 . Nevertheless, TMD should be considered as a likely isolated or concomitant etiology for tinnitus symptoms.…”

Terapia manual na qualidade de vida e no sintoma do zumbido

“…A síndrome da dor miofascial pode ser aliviada com a técnica digito pressão para a desativação dos pontos de gatilho miofascial e para o alívio parcial ou até total do zumbido inespecífico. Após evidências clínicas, constataram que pessoas que tem o sintoma do zumbido inespecífico, tem três vezes maior probabilidade de se queixarem de dor miofascial [15][16][17].…”

Masseter muscle surface electromyography in college students with a high degree of anxiety and temporomandibular disorder

“…It is characterized by a set of signs and symptoms with great variation between subjects, and by negative repercussions on quality of life. In general, the clinical condition consists of pain or discomfort in the masticatory muscle or TMJ, muscle spasm, inadequate occlusion, headache, deviations and joint noises (such as cracking and crackling) during mastication and opening of the oral cavity, restrictions on the performance of mandibular movements and masticatory, vocal and auditory difficulties [1][2][3][4][5] .…”

“…The American Academy of Orofacial Pain estimates that 40-75% of the US population has some type of TMD signs and that 33% have some symptoms 1 . However, it is estimated that only 3.6% to 7% require or seek some type of intervention 2 .…”