Signs of temporomandibular disorders in tinnitus patients and in a population‐based group of volunteers: results of the Study of Health in Pomerania

Abstract

The literature has documented a controversial discussion on the possible relationship of otogenous symptoms and craniomandibular dysfunction since the 1920s. Therefore, an investigation was conducted which consisted of two parts: a case study with population-based controls and a cross-sectional study. The aim of the first study was to screen a group of patients suffering from acute or chronic tinnitus for temporomandibular disorders (TMD) in comparison with a population-based group of volunteers without tinnitus. To this end, 30 patients (13 females and 17 males, age 18-71 years) suffering from acute hearing loss associated with tinnitus, isolated acute tinnitus, and chronically transient tinnitus were examined for symptoms of craniomandibular dysfunction. The results were compared with those of clinical functional analysis from 1907 subjects selected representatively and according to age distribution from the epidemiological 'Study of Health in Pomerania' (SHIP); the occurrence of tinnitus was ruled out in these control subjects. Statistical analysis was performed with Chi-square and Mann-Whitney U-tests. Sixty per cent of the tinnitus patients and 36.5% of the control subjects exhibited more than two symptoms of TMD (P = 0.004). Tinnitus patients had significantly more muscle palpation pain (P < 0.001), temporomandibular joint (TMJ) palpation pain (P < 0.001), and pain upon mouth opening (P < 0.001) than the general population group. No statistical differences were found in TMJ sounds, limitation of mandibular movement, or hypermobility of the TMJ. Furthermore, 4228 subjects of the population group examined in the epidemiological study were screened for co-factors of tinnitus with the help of a multivariate logistic regression model which was adjusted for gender, age, and a variety of anamnestic and examined data. Increased odds ratios (OR) were found for tenderness of the masticatory muscles (OR = 1.6 for one to three painful muscles and OR = 2.53 for four or more painful muscles), TMJ tenderness to dorsal cranial compression (OR = 2.99), listlessness (OR = 2.0) and frequent headache (OR = 1.84) A relationship between tinnitus and TMD was established in both examinations. Tinnitus patients seem to suffer especially from myofascial and TMJ pain. A screening for TMD should be included in the diagnostic survey for tinnitus patients.

The impact of tinnitus on the quality of life in patients with temporomandibular dysfunction

“…It is known that the pathophysiology of tinnitus remains unknown 35 and its relationship to TMD also is not clear. However, high frequency, moderate, oscillating, and sporadic intensities are usually is associated with TMD 12,36 .…”

Zumbido em indivíduos sem perda auditiva e sua relação com a disfunção temporomandibular

“…Nonetheless, it is a fact that such symptom is more frequent among individuals with TMD than those in the general population [3][4][5][6][7][8][9] . Notwithstanding, in some studies which showed a greater prevalence of TMD signs and symptoms in tinnitus patients, they did not do any audiological evaluation or did not exclude those individuals with hearing loss from the sample and, therefore, did not rule out the otological etiology of the tinnitus 10,11 . Thus, the present study aimed at characterizing tinnitus in normal-hearing individuals and search for a possible relationship with Temporomandibular Dysfunction (TMD).…”

A Digital Panoramic Radiograph Study of Length of Styloid Process in Nepalese Population

“…When more than 3 cm it is called an elongated styloid process causing dull pain in the ears, throat or mastoid region, difficulty in swallowing, foreign body sensation, symptoms of temperomandibular dysfunction like limited or asymmetric jaw movements or even carotid artery compression syndrome with rare cases of strokes [3][4][5][6][7][8]. Long styloid process was first described in 1652 by…”