Diagnosis of Somatosensory Tinnitus

Sánchez, Tanit Ganz; Rocha, Carina Bezerra

doi:10.1007/978-1-60761-145-5_52

Cited by 7 publications

(17 citation statements)

References 6 publications

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“…Thirty-one participants presenting with tinnitus that was suspected to have a somatosensory component were recruited from the CIUSSS de la Capitale-Nationale (facility IRDPQ) Auditory Disability Program waiting list and from a local association for individuals with tinnitus. To be included, participants needed to be aged 18 years or older and present with a somatic component to their tinnitus, as described in the criteria established by Sanchez and Rocha (2011b): manifestation of tinnitus following cervical trauma or manipulations, or simultaneous occurrence with symptoms such as pain and tension in the neck, head, or jaw; concurrent increase of tinnitus intensity and cranial/ cervical/thoracic pain; inadequate posture at rest, when sleeping, and at work; and bruxism or temporomandibular joint problems.…”

Section: Participantsmentioning

confidence: 99%

Long-Term Effects of a Multimodal Physiotherapy Program on the Severity of Somatosensory Tinnitus and Identification of Clinical Indicators Predicting Favorable Outcomes of the Program

et al. 2019

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Tinnitus, the perception of sound in the absence of external auditory stimuli, is commonly associated with problems of the auditory system. Head and neck disorders can also be involved in tinnitus emergence. In such cases, the term somatosensory tinnitus is used. Physiotherapy treatments have been identified as a promising avenue in the treatment of somatosensory tinnitus.The aim of the study was to explore the effect of a physiotherapy program on the intensity and severity of somatosensory tinnitus and to identify the clinical characteristics of the patients who respond well to this treatment.Quasi-experimental pre–post single-group design.Thirty-one adults with presumed somatosensory tinnitus.All participants received on average ten physiotherapy treatments over six weeks. Treatments included cervical and thoracic mobilizations, as well as muscular strengthening, stretching, postural instruction, and cervical stabilization.Outcomes were measured at baseline, at the end of the physiotherapy program, and three months later. The primary outcomes were the Tinnitus Handicap Inventory and visual analog scales for loudness and annoyance caused by tinnitus.After the last evaluation, participants were divided into two groups: improved and unimproved participants. Participants were considered improved if they (1) showed significant improvement in at least two of the three primary outcome measures and (2) indicated subjective improvement. Thereafter, the baseline characteristics that correctly identify participants susceptible to improve significantly following treatment were determined (Cohen’s effect size d > 0.8).A significant improvement in tinnitus intensity was observed at the end of the program. Of the 31 participants, 14 experienced persistent improvement in the intensity of their tinnitus and were classified as improved. Baseline characteristics strongly associated with tinnitus improvement were no increase in tinnitus when exposed to noise (d = −1.57), no family history of tinnitus (d = −1.16), somatosensory modulation in response to the contraction used to resist pressure applied to the forehead (d = 1.20), and recent onset of tinnitus (d = 1.03).This exploratory study showed that a multimodal physiotherapy program is effective in decreasing the severity of tinnitus, principally in individuals presenting with somatosensory tinnitus in combination with specific clinical characteristics.

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Section: Participantsmentioning

confidence: 99%

Long-Term Effects of a Multimodal Physiotherapy Program on the Severity of Somatosensory Tinnitus and Identification of Clinical Indicators Predicting Favorable Outcomes of the Program

et al. 2019

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“…Patients were investigated for a positive history of TMJ and/or NECK dysfunction; a history was considered positive when at least one of the following events was present before the onset of tinnitus: head or neck trauma, intensive manipulation of teeth, jaw or cervical spine, recurrent pain episodes in the head, neck, or shoulders, increase in both pain and tinnitus at the same time, inadequate postures during rest, walking, working, or sleeping, or intense periods of bruxism during the day or night [Sanchez and Bezerra Rocha, 2011].…”

Section: Methodsmentioning

confidence: 99%

Somatosensory Tinnitus: Correlation between Cranio-Cervico-Mandibular Disorder History and Somatic Modulation

et al. 2016

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In a subpopulation of patients, tinnitus can be modulated by movements of the jaw or head and neck due to complex somatosensory-auditory interactions. In some of these subjects, tinnitus could be related to an underlying temporomandibular (TMJ) or craniocervical (NECK) dysfunction that, if correctly identified, could streamline treatment and increase chances of tinnitus improvement. However, it is still unclear whether somatic modulation of tinnitus could be used as a screening tool for identifying such patients. In this study, we included 310 tinnitus patients with normal hearing, no psychiatric comorbidities, and a positive history of TMJ and/or NECK dysfunction and/or a positive modulation of tinnitus to evaluate the characteristics of somatic modulation, investigate the relationship between positive history and positive modulation, and identify factors most strongly associated with somatic modulation. Tinnitus modulation was present in 79.67% of the patients. We found a significant association within the same subjects between a positive history and a positive tinnitus modulation for the same region, mainly for TMJ in unilateral tinnitus patients and for TMJ + NECK in bilateral tinnitus patients. A strong correlation between history and modulation in the same somatic region within the same subgroups of subjects was also identified. Most TMJ maneuvers resulted in an increased loudness, while NECK maneuvers showed an increase in tinnitus loudness in about 59% of cases. High-pitched tinnitus and male gender were associated with a higher prevalence of modulation; no differences were found for tinnitus onset, Tinnitus Handicap Inventory score, and age. In this paper, we report a strong association between history and modulation for the same regions within the same patients; such an association should always be investigated to improve chances of a correct diagnosis of somatosensory tinnitus.

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“…Signs of somatosensory tinnitus include head or neck problems (i.e., temporomandibular joint syndrome, osteophits, arthorosis, spondylosis, myofascial trigger points, etc. ), dental or jaw diseases, frequent pain in head, neck, or shoulder girdle, aggravation of events of simultaneous pain and tinnitus, incorrect body postures, and severe bruxism (Sanchez and Rocha, 2011b , c ). Such complexity demands a multidisciplinary team (i.e., dentist, physiotherapist) to diagnose.…”

Section: Resultsmentioning

confidence: 99%

“…Somatosensory tinnitus is strongly evidenced when the patient can modulate the loudness or intensity of their tinnitus (Abel and Levine, 2004 ; Latifpour et al, 2009 ; Sanchez and Rocha, 2011b , c ; Oostendorp et al, 2016 ). Hence somatic testing may identify patients who could be treated with somatosensory system-related therapies.…”

Section: Resultsmentioning

confidence: 99%

“…In the most comprehensive literature review to date on somatosensory tinnitus, Sanchez and Rocha ( 2011a , b ) spoke of the need to establish evaluation protocols and specific treatments for somatosensory tinnitus that focus on both the auditory pathway and the musculoskeletal system. Yet there has never been a scoping review or systematic review on the topic.…”

Section: Introductionmentioning

confidence: 99%

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Pathophysiology, Diagnosis and Treatment of Somatosensory Tinnitus: A Scoping Review

Haider¹,

Hoare

Costa

et al. 2017

Front. Neurosci.

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Somatosensory tinnitus is a generally agreed subtype of tinnitus that is associated with activation of the somatosensory, somatomotor, and visual-motor systems. A key characteristic of somatosensory tinnitus is that is modulated by physical contact or movement. Although it seems common, its pathophysiology, assessment and treatment are not well defined. We present a scoping review on the pathophysiology, diagnosis, and treatment of somatosensory tinnitus, and identify priority directions for further research.Methods: Literature searches were conducted in Google Scholar, PubMed, and EMBASE databases. Additional broad hand searches were conducted with the additional terms etiology, diagnose, treatment.Results: Most evidence on the pathophysiology of somatosensory tinnitus suggests that somatic modulations are the result of altered or cross-modal synaptic activity within the dorsal cochlear nucleus or between the auditory nervous system and other sensory subsystems of central nervous system (e.g., visual or tactile). Presentations of somatosensory tinnitus are varied and evidence for the various approaches to treatment promising but limited.Discussion and Conclusions: Despite the apparent prevalence of somatosensory tinnitus its underlying neural processes are still not well understood. Necessary involvement of multidisciplinary teams in its diagnosis and treatment has led to a large heterogeneity of approaches whereby tinnitus improvement is often only a secondary effect. Hence there are no evidence-based clinical guidelines, and patient care is empirical rather than research-evidence-based. Somatic testing should receive further attention considering the breath of evidence on the ability of patients to modulate their tinnitus through manouvers. Specific questions for further research and review are indicated.

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Diagnosis of Somatosensory Tinnitus

Cited by 7 publications

References 6 publications

Long-Term Effects of a Multimodal Physiotherapy Program on the Severity of Somatosensory Tinnitus and Identification of Clinical Indicators Predicting Favorable Outcomes of the Program

Long-Term Effects of a Multimodal Physiotherapy Program on the Severity of Somatosensory Tinnitus and Identification of Clinical Indicators Predicting Favorable Outcomes of the Program

Somatosensory Tinnitus: Correlation between Cranio-Cervico-Mandibular Disorder History and Somatic Modulation

Pathophysiology, Diagnosis and Treatment of Somatosensory Tinnitus: A Scoping Review

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