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

Ralli, Massimo; Altissimi, G; Turchetta, Rosaria; Mazzei, Filippo; Salviati, Massimo; Cianfrone, Francesca; Orlando, Maria Patrizia; Testugini, Valeria; Cianfrone, Giancarlo

doi:10.1159/000452472

Cited by 41 publications

(53 citation statements)

References 62 publications

(106 reference statements)

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“…This case demonstrates that tinnitus modulation can be found even when no somatic disorder is present; in fact, somatic modulation of tinnitus is a widespread condition that can be present with or without underlying somatic disorders 31,40 . Furthermore, as previously discussed, several authors reported a large capability of somatic tinnitus modulation in multiple patient series ranging between 65.3% and 83.3% 32,35,[41][42][43]45,47,61,65 . In this patient, the negative history for self-reported somatic disorder suggests caution while taking into account a somatic origin for his tinnitus.…”

Section: Comments On This Casesupporting

confidence: 53%

“…Application of head and neck maneuvers revealed that 41% of patients could only increase their tinnitus loudness, 17% could only decrease their tinnitus loudness, and 10% could either increase or decrease their tinnitus loudness depending upon the maneuver. In a recent study from our group, maneuvers on craniocervical region induced tinnitus loudness increase in 59,1% and decrease in 40,9% 65 .…”

Section: Considerations On Somatic Modulation Of Tinnitusmentioning

confidence: 59%

“…Furthermore, once selected, a correct diagnosis and treatment of the somatic disorders underlying tinnitus is mandatory However, the identification of somatic tinnitus may be complex in some cases. In a previous paper from our group on 310 patients with somatic tinnitus 65 , we found a significant association between positive history and positive tinnitus modulation for the same region, thus hypothesizing that such connection could help identify, among tinnitus patients, those with underlying head and neck dysfunctions that could play a role in their tinnitus, and who could benefit from further multidisciplinary investigation and physical therapy. In these cases, it is important to seek for cooperation of other specialists, such as dentists, gnathologists, osteopaths, orthopedics, physiotherapists for a second-level evaluation of a possible disorder affecting non-auditory regions.…”

Section: Considerations On Somatic Modulation Of Tinnitusmentioning

confidence: 76%

“…Somatic modulation has been reported in approximately two-thirds of tinnitus patients 35,43 ; other studies revealed tinnitus modulation in 85% 45 TMJ is the most common affected region in patients with somatic tinnitus. Rubinstein studied 102 individuals with tinnitus reporting that about one-third of the patients had influence on tinnitus by mandibular movements and/ or pressure applied to the temporomandibular joint [63][64][65] and found that subjects with tinnitus had a significantly higher prevalence of cranio-mandibular disorders. Chole 58 found tinnitus to be significantly more prevalent among a group of 338 patients with TMJ disorders compared to 694 controls.…”

Section: Considerations On Somatic Modulation Of Tinnitusmentioning

confidence: 99%

“…In all cases, we evaluated audiological history, tinnitus characteristics, self-administered questionnaire scores, somatic dysfunction history and tinnitus modulation following a set of maneuvers as previously published 65 . A detailed description of the maneuvers used for somatic modulation examination is listed in Table 2.…”

Section: Personal Experiencementioning

confidence: 99%

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Somatic Tinnitus

Ralli¹,

Greco²,

Cialente³

et al. 2017

The International Tinnitus Journal

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Modulation of tinnitus characteristics such as pitch and loudness has been extensively described following movements of the head, neck and limbs, vertical or horizontal eye gaze, pressure on myofascial trigger points, cutaneous stimulation of the hands, electrical stimulation of the median nerve, and transcranial direct current stimulation. Modulation of tinnitus follows complex interactions between auditory and somatosensory afferents and can be favored by underlying somatic disorders. When tinnitus appears to be preceded or strictly linked to a somatic disorder, and therefore related to problems of the musculoskeletal system rather than of the ear, it is defined somatic tinnitus. A correct diagnosis and treatment of somatic disorders underlying tinnitus play a central role for a correct management of somatic tinnitus. However, the identification of somatic tinnitus may be complex in some cases. In this paper, after a general review of the current evidences for somatic tinnitus available in the literature, we present and discuss some cases of patients in which somatic modulation of tinnitus played a role-although different from case to case-in their tinnitus, describing the diagnostic and therapeutic approaches followed in each individual case and the results obtained, also highlighting unexpected findings and pitfalls that may be encountered when approaching somatic tinnitus patients.

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Section: Comments On This Casesupporting

confidence: 53%

Section: Considerations On Somatic Modulation Of Tinnitusmentioning

confidence: 59%

Section: Considerations On Somatic Modulation Of Tinnitusmentioning

confidence: 76%

Section: Considerations On Somatic Modulation Of Tinnitusmentioning

confidence: 99%

Section: Personal Experiencementioning

confidence: 99%

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Somatic Tinnitus

Ralli¹,

Greco²,

Cialente³

et al. 2017

The International Tinnitus Journal

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Striatal networks for tinnitus treatment targeting

Larson

Sabes

Mizuiri

et al. 2021

Human Brain Mapping

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Neuromodulation treatment effect size for bothersome tinnitus may be larger and more predictable by adopting a target selection approach guided by personalized striatal networks or functional connectivity maps. Several corticostriatal mechanisms are likely to play a role in tinnitus, including the dorsal/ventral striatum and the putamen. We examined whether significant tinnitus treatment response by deep brain stimulation (DBS) of the caudate nucleus may be related to striatal network increased functional connectivity with tinnitus networks that involve the auditory cortex or ventral cerebellum. The first study was a cross‐sectional 2‐by‐2 factorial design (tinnitus, no tinnitus; hearing loss, normal hearing, n = 68) to define cohort level abnormal functional connectivity maps using high‐field 7.0 T resting‐state fMRI. The second study was a pilot case–control series (n = 2) to examine whether tinnitus modulation response to caudate tail subdivision stimulation would be contingent on individual level striatal connectivity map relationships with tinnitus networks. Resting‐state fMRI identified five caudate subdivisions with abnormal cohort level functional connectivity maps. Of those, two connectivity maps exhibited increased connectivity with tinnitus networks—dorsal caudate head with Heschl's gyrus and caudate tail with the ventral cerebellum. DBS of the caudate tail in the case‐series responder resulted in dramatic reductions in tinnitus severity and loudness, in contrast to the nonresponder who showed no tinnitus modulation. The individual level connectivity map of the responder was in alignment with the cohort expectation connectivity map, where the caudate tail exhibited increased connectivity with tinnitus networks, whereas the nonresponder individual level connectivity map did not.

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