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Ferrillo M, Marotta N, Viola P, Chiarella G, Fortunato L, Ammendolia A, Giudice A, de Sire A. Efficacy of rehabilitative therapies on otologic symptoms in patients with temporomandibular disorders: A systematic review of randomised controlled trials. J Oral Rehabil 2024; 51:1621-1631. [PMID: 38685701 DOI: 10.1111/joor.13716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 02/28/2024] [Accepted: 04/18/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND The term temporomandibular disorder (TMD) indicates a set of musculoskeletal conditions involving temporomandibular joint (TMJ), masticatory musculature, and related anatomical structures. Pain is the most common clinical manifestation of TMD, and the auditory system might be involved and affected, through tinnitus, dizziness, otalgia and ear fullness sensation. OBJECTIVES The aim of this systematic review of randomised controlled trails (RCTs) was to evaluate the efficacy of rehabilitative approaches on otologic symptoms in patients with TMD. METHODS PubMed, Scopus and Web of Science were systematically searched from the inception until 8th October 2023 to identify RCTs presenting participants with a diagnosis of TMD associated with otologic signs and symptoms, rehabilitative approaches as interventions, and modification of the otological symptoms as outcome. RESULTS Out of 931 papers suitable for title/abstract screening, 627 articles were assessed for eligibility. Five studies were included reporting the efficacy of occlusal splint therapy, low-level laser therapies, and physical therapy in patients diagnosed whit secondary otalgia or tinnitus associated with TMD. No RCTs evaluating other otologic symptoms, ear fullness, dizziness or vertigo were found. CONCLUSIONS Results of this systematic review suggested that rehabilitative approaches might be effective in improving secondary otalgia and tinnitus in TMD patients. Thus, further RCTs with a higher level of evidence and more representative samples should be conducted to better understand the effects of TMD therapy on otologic complains.
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Affiliation(s)
- Martina Ferrillo
- Dentistry Unit, Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Nicola Marotta
- Physical Medicine and Rehabilitation Unit, Department of Experimental and Clinical Medicine, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Pasquale Viola
- Audiology Unit, Regional Centre of Cochlear Implants and ENT Diseases, Department of Experimental and Clinical Medicine, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Giuseppe Chiarella
- Audiology Unit, Regional Centre of Cochlear Implants and ENT Diseases, Department of Experimental and Clinical Medicine, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Leonzio Fortunato
- Dentistry Unit, Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Antonio Ammendolia
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Amerigo Giudice
- Dentistry Unit, Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Alessandro de Sire
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
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Monzani D, Baraldi C, Apa E, Alicandri-Ciufelli M, Bertoldi C, Röggla E, Guerzoni S, Marchioni D, Pani L. Occlusal splint therapy in patients with Ménière's disease and temporomandibular joint disorder. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2022; 42:89-96. [PMID: 35129540 PMCID: PMC9058932 DOI: 10.14639/0392-100x-n1641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 09/19/2021] [Indexed: 01/04/2023]
Abstract
Objective This retrospective study aimed to verify the outcomes of stabilising occlusal splint therapy prescribed to 22 patients with unilateral definite Ménière’s disease and comorbid temporomandibular joint disorder. Methods The results of a battery of audiometric and vestibular tests were recorded before and after 6 months of treatment, as well as the scores of disease-specific questionnaires. Results The average hearing threshold in the affected ear and the acoustic immittance were unchanged. No spontaneous and positional nystagmus were recorded. Caloric hypo-responsiveness and vestibular myogenic evoked responses did not vary. No changes of stabilometric body sway parameters in eyes opened condition and with optokinetic stimulation delivered to the unaffected labyrinth were observed. A significant reduction was recorded in eyes closed condition and with the optokinetic stimulation toward the affected ear. The Tinnitus Handicap Inventory, the Situational Vertigo Questionnaire and the Numeric Pain Rating Scale scores improved. The number of vertigo attacks was reduced. Conclusions Occlusal splint therapy is a favourable option to reduce aural symptoms of Ménière’s disease and comorbid temporomandibular joint disorder, even if its pathophysiological mechanism remains elusive.
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Affiliation(s)
- Daniele Monzani
- Otolaryngology Unit, Department of Medical, Surgical and Pediatric Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Carlo Baraldi
- School in Neurosciences, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Medical Toxicology-headache and Drug Abuse Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Enrico Apa
- Otolaryngology Unit, Department of Medical, Surgical and Pediatric Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Matteo Alicandri-Ciufelli
- Otolaryngology Unit, Department of Medical, Surgical and Pediatric Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Carlo Bertoldi
- Dentistry and Oro-maxillofacial Surgery Unit, Department of Surgery, Medicine, Dentistry, Transplantation Morphology, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Simona Guerzoni
- Medical Toxicology-headache and Drug Abuse Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Daniele Marchioni
- Otolaryngology Unit, Department of Surgical, Odontostomatologic and Pediatric Sciences, University of Verona, Verona, Italy
| | - Luca Pani
- Medical Toxicology-headache and Drug Abuse Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Pharmacology Unit, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Department of Psychiatry and Behavioral Sciences, University of Miami, Miami, USA.,VeraSci, Durham, NC, USA
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Campagna CA, Anauate J, Vasconœlos LGE, Oiticica J. Effectiveness of Dry Needling in Bothersome Chronic Tinnitus in Patients with Myofascial Trigger Points. Int Arch Otorhinolaryngol 2021; 26:e233-e242. [PMID: 35602278 PMCID: PMC9122774 DOI: 10.1055/s-0041-1730429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/03/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction
Therapeutic dry needling (DN) is effective in reducing the discomfort of chronic somatosensory tinnitus in patients with myofascial trigger points (MTP)s.
Objective
To evaluate the efficacy of DN in chronic somatosensory tinnitus discomfort in patients with MTP.
Methods
Placebo-controlled paired trial that included 16 patients with a diagnosis of somatosensory chronic tinnitus and with the presence of at least one active or latent MTP. Treatment was performed in two phases: (1) four sessions (one session per week for four consecutive weeks) of placebo DN and (2) four sessions of therapeutic DN with a gap (washout) of 15 days between these phases.
Results
The Tinnitus Handicap Inventory (THI) variable and its emotional domain had a statistically significant reduction in therapeutic DN when compared with placebo DN (
p
= 0.024 and p = 0.011, respectively).
The tinnitus visual analogic scale (VAS) signaled a reduction in tinnitus discomfort when compared with moments before and after therapeutic DN (
p
< 0.05).
Conclusion
The therapeutic DN technique for MTP in patients with chronic tinnitus of somatosensory origin proved effective in reducing symptom discomfort, as measured by the THI (total score) and its emotional domain when compared with placebo DN.
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Affiliation(s)
- Carla Alexandra Campagna
- Otolaryngology Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Juliana Anauate
- Otolaryngology Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Jeanne Oiticica
- Otolaryngology Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
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Jin IK, Choi SJ, Yoo J, Jeong S, Heo S, Oh H. Effects of Tinnitus Sound Therapy Determined Using Subjective Measurements. J Am Acad Audiol 2021; 32:212-218. [PMID: 34034341 DOI: 10.1055/s-0041-1722984] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Sound therapy is generally considered as an effective method for relieving tinnitus. There have been various reports on the effects of tinnitus interventions involving sound therapy as a component; however, there have been only a small number of reports on the effects of sound therapy itself on tinnitus. PURPOSE The aim of the study is to elucidate whether sound therapy significantly improves tinnitus as determined by subjective measurements. RESEARCH DESIGN Prospective study involves within-subject (baseline, 3-month, 6-month) measurements. STUDY SAMPLE This includes 16 adults with subjective and sensorineural tinnitus. INTERVENTION Participants undertook sound therapy for 3 hours a day for 6 months. The level of stimulus for sound therapy was set to the mixing point of each participant. No counseling was provided. DATA COLLECTION AND ANALYSIS Participants rated the visual analog scale for loudness and annoyance using a numeric 0 to 100 point scale and completed the Korean version of the Tinnitus Primary Function Questionnaire at the baseline, 3-month, and 6-month time points. RESULTS Sound therapy led to significant improvements of tinnitus in participants in all subjective measurements. Significant effects were found not only between the baseline and 3-month but also between the 3-month and 6-month follow-ups. CONCLUSION Results of the present study showed that the sound therapy alone led to significant improvements of tinnitus in participants as assessed by subjective measurements. To improve the effects of sound therapy, consistent sound therapy may be required for a certain period of time such as 3 hours a day over a 6-month period.
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Affiliation(s)
- In-Ki Jin
- Division of Speech Pathology and Audiology, Research Institute of Audiology and Speech Pathology, College of Natural Sciences, Hallym University, Chuncheon, South Korea
| | - Soon-Je Choi
- Department of Speech Pathology and Audiology, Graduate School, Hallym University, Chuncheon, South Korea
| | - Jeeun Yoo
- Department of Speech Pathology and Audiology, Graduate School, Hallym University, Chuncheon, South Korea
| | - Seungyeop Jeong
- Department of Speech Pathology and Audiology, Graduate School, Hallym University, Chuncheon, South Korea
| | - Sohee Heo
- Department of Speech Pathology and Audiology, Graduate School, Hallym University, Chuncheon, South Korea
| | - Hongyeop Oh
- Department of Speech Pathology and Audiology, Graduate School, Hallym University, Chuncheon, South Korea
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Cimino R, Bucci R, Ambrosio A, Carrabba L, Corrado B, Simeon V, Michelotti A. Temporomandibular disorders, neck disability, and oral parafunctions in tinnitus patients: A cross-sectional epidemiological study from Southern Italy. Cranio 2020; 40:485-493. [PMID: 32559128 DOI: 10.1080/08869634.2020.1781499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To assess the prevalence of temporomandibular disorders (TMD) in a sample of tinnitus patients and to determine the association between tinnitus, TMD, neck disability, and oral parafunctions. METHODS Seventy-nine tinnitus patients were enrolled and underwent standardized clinical examination for TMD. The tinnitus severity was measured with the Tinnitus Handicap Inventory (THI). The oral parafunctions were self-reported with the Oral Behavior Checklist (OBC). The neck disability was recorded with the Neck Disability Index (NDI). RESULTS More than half of the sample presented TMD, and the most frequent diagnosis was TMD pain. Higher THI was observed in TMD-pain individuals, compared to TMD-free (β 18.4; 95%CI 6.7, 30.1; p = 0.002). The OBC showed a significant low-to-moderate positive correlation with the THI (rho= 0.368, p = 0.001), while the NDI did not. DISCUSSION Standardized assessment of TMD and oral behaviors should be integrated into the routine diagnostic evaluations of tinnitus patients.
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Affiliation(s)
- Roberta Cimino
- Department of Neurosciences, Reproductive Sciences and Oral Science, School of Orthodontics and Temporomandibular Disorders, University of Naples Federico II, Naples, Italy
| | - Rosaria Bucci
- Department of Neurosciences, Reproductive Sciences and Oral Science, School of Orthodontics and Temporomandibular Disorders, University of Naples Federico II, Naples, Italy.,Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Andrea Ambrosio
- Department of Neurosciences, Reproductive Sciences and Oral Science, School of Orthodontics and Temporomandibular Disorders, University of Naples Federico II, Naples, Italy
| | - Laura Carrabba
- Department of Neurosciences, Reproductive Sciences and Oral Science, Audiology Unit, University of Naples Federico II, Naples, Italy
| | - Bruno Corrado
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Vittorio Simeon
- Department of Public, Clinical and Preventive Medicine, Medical Statistics Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Ambrosina Michelotti
- Department of Neurosciences, Reproductive Sciences and Oral Science, School of Orthodontics and Temporomandibular Disorders, University of Naples Federico II, Naples, Italy
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