Scientific Online Resource System

International Bulletin of Otorhinolaryngology

Is There a Relationship Between Otological Symptoms and Temporomandibular Joint Disorders A Retrospective Study

M. Bencheva, M. Stoilov

Abstract

Introduction: Otological symptoms are often associated with temporomandibular joint disorders (TMD). The exact correlation between these two phenomena is being controversially discussed in the literature for many years. This retrospective study aims to investigate the possible association of otological symptoms with specific TMD findings, as well as stress and chronic pain.
Method: We analyzed the anonymized medical records of 56 patients. This included the assessment of the clinical functional status and Manual Structural Analysis (MSA) in accordance to the German Society for Functional Diagnostics and Therapy (DGFDT) and the Graded Chronic Pain Status (GCPS).
Results: From all 56 patients with TMD 32 had otological symptoms. The most common TMD symptoms in patients with aural complains were pain by palpation of the m. masseter (81,82- 83,33%) and m. digastrics venter posterior (81,82% – 100%). Articular sounds were a prevalent finding especially in tinnitus patients (63,64%). An insufficient posterior static occlusion was present in 27,27% – 50% of the cases. Approximately half of the patients with aural complaints mentioned, that they feel stressed. Most of the patients suffered from a functional chronic pain (56,25%). A dysfunctional chronic pain was prevalent in 18,75% of the cases.
Conclusion: The results indicate, that TMD patients with aural
complaints have most often pain in the areas of m. digasticus
venter posterior and m. masseter, so there might be an association
of ear symptoms with a pathology of these muscles. However, no
causal relationship could be proven. Arthropathology, malocclusion,
psychological condition and stress levels are other factors, that
seem to have influence. The etiology is multifactorial and remains
unclear.

Keywords

TMD, otological symptoms, tinnitus, otalgia

Full Text


References

Salvetti G, Manfredini D, Barsotti S, Bosco M. Otologic symptoms in temporomandibular disorders patients: is there evidence of an association-relationship? Minerva Stomatol. 2006 Nov-Dec; 55(11-12):627–37.

Gelb, H. & Arnold, G. E. Syndromes of the head and neck of dental origin. I. Pain caused by mandibular dysfunction. Arch. Otolaryngol. 1959, 70:681–91.

Kuttila, S. J.; Kuttila, M. H.; Niemi, P. M.; Le Bell, Y. B.; Alanen, P. J. & Suonpaa, J. T. Secundary otalgy in adult population. Archives Otolaryngologic Head Neck Surgery 127(4):401–5, 2001.

Kuttila, S. J.; Kuttila, M. H.; Le Bell, Y.; Alanen, P. & Jouko, S. Aural Symptoms and Signs of temporomandibular Disorder in Association with Treatment Need and Visits to Physician. Laryngoscope, 109(10):1669–73, 1999.

Bernhardt O, Gesch D, Schwahn C, Bitter K, Mundt T, Mack F, Kocher T, Meyer G, Hensel E, John U. Signs of temporomandibular disorders in tinnitus patients and in a population-based group of volunteers: results of the Study of Health in Pomerania. J Oral Rehabil. 2004 Apr; 31(4):311–9.

Durham J. Temporomandibular disorders (TMD): an overview. Oral Surgery 2008; 1:60.

Vickers ER. Temporamandibular disorder. in: Orofacial pain: problem based learning. Sydney University Press 2006; 141-144.

Hugger A, Lange M, Schindler HJ, Turp, JC. Funktionsstorung, Dysfunktion, craniomandibulare Dysfunktion (CMD), Myoarthropathie des Kausystems (MAP). DGFDT Begriffsbestimmungen 01/2016.

Poveda Roda R, Bagan JV, Diaz Fernandez JM, Hernandez Bazan S, Jimenez Soriano Y. Review of temporomandibular joint pathology. Part I: classification, epidemiology and risk factors. Med Oral Patol Oral Cir Bucal. 2007 Aug 1; 12(4):E292–8.

List T, Jensen RH. Temporomandibular disorders: Old ideas and new concepts. Cephalalgia. 2017 Jun; 37(7):692–704.

Dworkin SF, Massoth DL. Temporomandibular disorders and chronic pain: disease or illness? J Prosthet Dent. 1994 Jul; 72(1):29–38.

Furquim BD, Flamengui LM, Conti PC. TMD and chronic pain: a current view. Dental Press J Orthod. 2015 Jan-Feb; 20(1):127–33.

Harper DE, Schrepf A, Clauw DJ. Pain Mechanisms and Centralized Pain in Temporomandibular Disorders. J Dent Res. 2016 Sep; 95(10):1102–8.

Monaco A, Cattaneo R, Marci MC, Pietropaoli D, Ortu E. Central Sensitization-Based Classification for Temporomandibular Disorders: A Pathogenetic Hypothesis. Pain Res Manag. 2017:5957076. doi: 10.1155/2017/5957076. Epub 2017 Aug 28.

Latremoliere A, Woolf CJ. Central Sensitization: A Generator of Pain Hypersensitivity by Central Neural Plasticity. J Pain. 2009 Sep; 10(9): 895–926.

National Institute of Dental and Craniofacial Research. Prevalence of TMJD and its Signs and Symptoms. July 2018. https://www.nidcr.nih.gov/research/data-statistics/ facial-pain/prevalence

Gauer RL, Semidey MJ. Diagnosis and treatment of temporomandibular disorders. Am Fam Physician. 2015 Mar 15; 91(6):378–86.

Chisnoiu AM, Picos AM, Popa S, Chisnoiu PD, Lascu L, Picos A, Chisnoiu R. Factors involved in the etiology of temporomandibular disorders – a literature review. Clujul Med. 2015; 88(4): 473–478.

Manfredini D, Lombardo L, Siciliani G. Temporomandibular disorders and dental occlusion. A systematic review of association studies: end of an era? J Oral Rehabil. 2017 Nov; 44(11):908–923.

Turp JC. Correlation between myoarthropathies of the masticatory system and ear symptoms (otalgia, tinnitus). HNO. 1998 Apr; 46(4):303–10.

Ramirez Aristeguieta LM, Sandoval Ortiz GP, Ballesteros LE. Theories on otic symptoms in temporomandibular disorders: past and present. Int J Morphol 2005; 23(2):141–56.

Kusdra PM, Stechman-Neto J, Leao BLC, Martins PFA, Lacerda ABM, Zeigelboim BS. Relationship between Otological Symptoms and TMD. Int Tinnitus J. 2018 Jun 1; 22(1): 30–34.

Mottaghi A, Menendez-Diaz I, Cobo JL, Gonzalez-Serrano J, Cobo T. Is there a higher prevalence of tinnitus in patients with temporomandibular disorders? A systematic review and meta-analysis. J Oral Rehabil. 2018 Aug 20. doi: 10.1111/joor.12706. [Epub ahead of print]

Brookes GB, Maw AR, Coleman MJ. “Costen’s syndrome” – correlation or coincidence: a review of 45 patients with temporomandibular joint dysfunction, otalgia and other aural symptoms. Clin Otolaryngol Allied Sci. 1980; 5(1):23–36.

Seedorf H, Leuwer R, Fenske C, Jude HD. The “Costen Syndrome” – Which Symptoms Suggest that the Patient may Bene.t from Dental Therapy? Laryngorhinootologie. 2002 Apr; 81(4):268–75.

Tuz HH, Onder EM, Kisnisci RS. Prevalence of otologic complaints in patients with temporomandibular disorder. Am J Orthod Dentofacial Orthop. 2003 Jun; 123(6):620–3.

Porto De Toledo I, Stefani FM, Porporatti AL, Mezzomo LA, Peres MA, Flores-Mir C, De Luca Canto G. Prevalence of otologic signs and symptoms in adult patients with 19 Bencheva temporomandibular disorders: a systematic review and meta-analysis. Clin Oral Investig. 2017 Mar; 21(2):597–605.

Costen J. A symdrome of ear and sinus symptoms dependent upon dis- turbed function of the temporomandibular joint. 1924. Ann Otol Rhinol Laryngol. 1934; 106(10 Pt 1):805–19.

Eschler J. Costen’s syndrome in the light of mandibulomotoric incoordination. Dtsch Med Wochenschr. 1967 Apr 14; 92(15):711–4.

Myrhaug H. Objective proof of parafunctions of the inner ear muscle. Quintessenz. 1970 Dec; 21(12):107–12.

Ghada MWF. Ear Embryology. Glob J Oto 2017; 4(1): 555–627.

Whyte JR, Gonzalez L, Cisneros AI, Yus C, Torres A, Sarrat R. Fetal devel-opment of the human tympanic ossicular chain articulations. Cells Tissues Organs. 2002; 171(4): 241–9.

Frumker SC, Kyle MA : The dentist`s contribution to rehabilitation of cervical posture and function:orthopedic and neurological considerations in the treatment of craniomandibular disorders. Basal Facts 1987; 9, 105–109.

Rubinstein B. Tinnitus and craniomandibular disorders – is there a link? Swed Dent J 1993; 95: 1–46.

Pinto, O. F. A new structure related to the temporomandibular joint and middle ear. J. Prosthet. Dent. 1962; 12(1):95–103.

Komori, E.; Sugisaki, M.; Tanabe, H. & Katoh, S. Discomalleolar ligament in the adult human. Cranio1986; 4:300–5.

Von Kor. M, Dworkin SF, Le Resche L. Graded chronic pain status: an epidemiologic evaluation. Pain. 1990 Mar; 40(3):279–91.

Turp JC, Nilges P. Diagnostik von Patienten mit orofazialen Schmerzen-Die deutsche Version des “Graded Chronic Pain Status”. Quintessenz 2000; 51:721–27.

Klasen BW, Hallner D, Schaub C, Willburger R, Hasenbring M. Validation and reliability of the German version of the Chronic Pain Grade questionnaire in primary care back pain patients. Psychosoc Med. 2004 Oct 14; 1:Doc07

Peroz I. Otalgia and tinnitus in patients with craniomandibular dysfunctions. HNO. 2001 Sep; 49(9):713–8.

Linsen S, Schmidt-Beer U, Koeck B. Tinnitus-Verbesserung durch Kiefergelenk-Distraktions-Therapie. Dtsch. Zahnaerztl. Z. 2006; 61 (1): 27–31.

Kuttila M, Le Bell Y, Savolainen-Niemi E, Kuttila S, Alanen P. E.ciency of occlusal appliance therapy in secondary otalgia and temporomandibular disorders. Acta Odontol Scand. 2002 Aug; 60(4):248–54.

de Felicio CM, Melchior Mde O, Ferreira CL, Da Silva MA. Otologic symptoms of temporomandibular disorder and effect of orofacial myofunctional therapy. Cranio. 2008 Apr; 26(2):118-25.

Unell L, Strom D, Ekman K, Johansson A, Arnrup K, Carlsson GE. A 3-year study of patients with tinnitus and jaw muscle tenderness. Cranio 2018, epub: 02 Feb 2018 doi: 10.1080/08869634.2018.1430097

Ramirez LM, Ballesteros LE, Sandoval GP. Otological symptoms among patients with temporomandibular joint disorders. Med Chil. 2007 Dec; 135(12):1582-90. doi: / S0034-98872007001200013. Epub 2008 Feb 13.

Peroz I. Dysfunctions of the stomatognathic system in tinnitus patients compared to controls. HNO. 2003 Jul; 51(7):544-9. Epub 2003 Apr 9.

Ravuri SP. Tinnitus and Temporomandibular joint disorder subtypes. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124 (3), 194–195.

De La Torre Canales G, Camara-Souza MB, Munoz Lora VRM, Guarda-Nardini L, Conti PCR, Rodrigues Garcia RM, Del Bel Cury AA, Manfredini D. Prevalence of psychosocial impairment in temporomandibular disorder patients: A systematic review. J Oral Rehabil. 2018 Nov; 45(11):881–889.

Bigelow RT, Semenov YR, du Lac S, Hoffman HJ, Agrawal Y. Vestibular vertigo and comorbid cognitive and psychiatric impairment: the 2008 National Health Interview Survey. J Neurol Neurosurg Psychiatry. 2016 Apr; 87(4):367–72.

Bhatt JM, Bhattacharyya N, Lin HW. Relationships between tinnitus and the prevalence of anxiety and depression. Laryngoscope. 2017 Feb; 127(2):466–469.

Hilgenberg PB, Saldanha AD, Cunha CO, Rubo JH, Conti PC. Temporomandibular disorders, otologic symptoms and depression levels in tinnitus patients. J Oral Rehabil. 2012 Apr; 39(4):239–44.

McCormack A, Edmondson-Jones M, Fortnum H, Dawes PD, Middleton H, Munro KJ, Moore DR. Investigating the association between tinnitus severity and symptoms of depression and anxiety, while controlling for neuroticism, in a large middle-aged UK population. Int J Audiol 2015, 54:9, 599–604.




DOI: http://dx.doi.org/10.14748/orl.v14i4.6756

Refbacks

Font Size


|