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De La Torre Canales G, Christidis N, Grigoriadis A, Strandberg T, Montan V, Medina Flores D, Al-Moraissi EA, Christidis M. Associations between temporomandibular disorders and tinnitus - a systematic review. Cranio 2024:1-17. [PMID: 39290041 DOI: 10.1080/08869634.2024.2404270] [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: 09/19/2024]
Abstract
OBJECTIVES Temporomandibular disorders (TMD) and tinnitus are highly prevalent conditions, that affects about 10-30% of the adult population and seem to co-exist. The primary objective of this systematic review was to investigate any associations between TMD and tinnitus. The secondary objective was to investigate if the associations differ between painful and non-painful TMDs. METHODS An electronic literature search in five databases was performed, from the inception of the databases until 26th of October 2022. This was to identify clinical trials with prevalence numbers of patients with TMD, with and without tinnitus and vice versa. From 1240 studies, a total number of 32 studies were included in the meta-analysis. A risk of bias analysis was made using the Methodological Evaluation of Observational Research (MORE). RESULTS Seventeen studies showed low risk of bias, while fifteen studies showed some risk of bias. Among patients with TMD, 57.5% also displayed tinnitus. In contrast, among patients with tinnitus, 92.9% also suffered from TMD. There was a strong association between patients with TMD that also had tinnitus, and patients with tinnitus that also had TMD (p's < 0.001). The odds ratio for TMD-patients also having tinnitus was 1.556 (p < .05), while it for tinnitus-patients also having TMD was 2.859 (p < .05). Six studies examined the psychological status, and there was a higher degree of psychosocial distress among patients with TMD and TMD/tinnitus. CONCLUSIONS There is a strong significant association between TMD and tinnitus, but further research is needed to unravel the nature of this association and its clinical implication.
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Affiliation(s)
- Giancarlo De La Torre Canales
- Division of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
- Egas Moniz Center for Interdisciplinary Research (CiiEM); Egas Moniz School of Health & Science, Caparica, Almada, Portugal
| | - Nikolaos Christidis
- Division of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Anastasios Grigoriadis
- Division of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Tilde Strandberg
- Division of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Veronica Montan
- Division of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Dyanne Medina Flores
- Division of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
- Department of Prosthodontics, Bauru School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Essam Ahmed Al-Moraissi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Thamar, Yemen
| | - Maria Christidis
- The Institute of Health Sciences, The Swedish Red Cross University, Huddinge, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
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Abstract
Objective: Interest in the symptoms pertaining to Costen's syndrome has revived in recent years. The aim of this work is to address the symptoms of Costen's syndrome from the basic science perspectiveMethods: A minireview of the literature related to Costen's syndrome symptoms was performed by retrieving relevant articles from the PubMed database from 1980 until 2021.Results: The validity of Costen's syndrome symptoms has been confirmed by a multitude of articles. Conclusion: Maladaptive plasticity in the central nervous system pathways probably accounts for the incidence and severity of Costen's syndrome symptoms.
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Affiliation(s)
- Kamal G Effat
- Department of Otolaryngology, El-Sahel Teaching Hospital, Cairo, Egypt
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Effat KG, Berty A. Otological symptoms in patients with rheumatoid arthritis of the temporomandibular joint. Cranio 2023:1-8. [PMID: 37747112 DOI: 10.1080/08869634.2023.2260281] [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: 09/26/2023]
Abstract
OBJECTIVE The aim of the current study was to describe the pattern of otological symptoms in patients with rheumatoid arthritis (RA), having clinical temporomandibular joint (TMJ) involvement. This issue had not been previously addressed. METHODS A questionnaire and examination findings protocol was applied for 141 patients with RA and 141 control subjects. RESULTS Otological symptoms (otalgia, hearing loss, tinnitus, and vertigo), all had a significantly higher incidence in RA patients, compared to control subjects (P = .001). CONCLUSION The onset and maintenance of otological symptoms in patients with TMJ involvement by RA probably result from peripheral, as well as central nervous system alterations in sensory stimuli programming.
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Affiliation(s)
- Kamal G Effat
- Consultant Otolaryngologist, El-Sahel Teaching Hospital, Cairo, Egypt
| | - Abeer Berty
- Consultant Rheumatologist, St. Mark Rheumatology Center, Cairo, Egypt
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Bernkopf E, Capriotti V, Bernkopf G, Cancellieri E, D'Alessandro A, Marcuzzo AV, Gentili C, De Vincentiis GC, Tirelli G. Oral splint therapy in patients with Menière's disease and temporomandibular disorder: a long-term, controlled study. Eur Arch Otorhinolaryngol 2023; 280:1169-1182. [PMID: 36018357 DOI: 10.1007/s00405-022-07604-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/08/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE To assess the effect of oral splint therapy on audio-vestibular symptoms in patients with Menière's disease (MD) and temporomandibular disorder (TMD). METHODS Retrospective case-control study. Treatment group: 37 patients with MD and TMD who received gnatological treatment. CONTROL GROUP 26 patients with MD and TMD who had never received gnatological treatment. The number of vertigo spells in 6 months (primary endpoint), pure-tone audiometry average (PTA), MD stage, functional level, Dizziness handicap Index (DHI), Tinnitus handicap Index (THI) and Aural Fullness Scale (AFS) were compared at baseline and after 24 months according to groups. Analysis of Covariance was used to determine the treatment effect. RESULTS Groups were comparable for demographic, clinical data, baseline PTAs and the number of vertigo spells. Analysis of covariance showed a significant effect of gnathological treatment on number of vertigo spells ([Formula: see text] = 0.258, p < 0.001), PTA ([Formula: see text] = 0.201, p < 0.001), MD stage ([Formula: see text] = 0.224, p < 0.001), functional level ([Formula: see text] = 0.424, p < 0.001), DHI ([Formula: see text] = 0.421, p < 0.001), THI ([Formula: see text] = 0.183, p < 0.001), but not for AFS ([Formula: see text] = 0.005, p = 0.582). The treatment group showed vertigo control of class A in 86.5% and class B in 13.5% of patients. In the control group, vertigo control was of class A in 19.2% of patients and class B in 11.5%, class C in 30.8%, class D in 11.5%, class E in 19.2% and class F in 7.7%. Classes of vertigo control differed significantly (X2 test, p < 0.001). CONCLUSIONS Oral splint therapy could represent a viable treatment in patients with TMD and uncontrolled MD disease. The effects are maintained at least after 2 years.
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Affiliation(s)
| | - Vincenzo Capriotti
- Otorhinolaryngology and Head and Neck Surgery Clinic, Azienda Sanitaria Universitaria Giuliano Isontina-ASUGI, Strada di Fiume 447, 39149, Trieste, Italy. .,Otorhinolaryngology and Head and Neck Surgery Unit, ASST Bergamo Ovest, Treviglio-Caravaggio Hospital, Piazzale Ospedale Luigi Meneguzzo 1, 20047, Treviglio, BG, Italy.
| | | | - Emilia Cancellieri
- Otorhinolaryngology and Head and Neck Surgery Clinic, Azienda Sanitaria Universitaria Giuliano Isontina-ASUGI, Strada di Fiume 447, 39149, Trieste, Italy
| | - Andrea D'Alessandro
- Otorhinolaryngology and Head and Neck Surgery Clinic, Azienda Sanitaria Universitaria Giuliano Isontina-ASUGI, Strada di Fiume 447, 39149, Trieste, Italy
| | - Alberto Vito Marcuzzo
- Otorhinolaryngology and Head and Neck Surgery Clinic, Azienda Sanitaria Universitaria Giuliano Isontina-ASUGI, Strada di Fiume 447, 39149, Trieste, Italy
| | - Caterina Gentili
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | | | - Giancarlo Tirelli
- Otorhinolaryngology and Head and Neck Surgery Clinic, Azienda Sanitaria Universitaria Giuliano Isontina-ASUGI, Strada di Fiume 447, 39149, Trieste, Italy
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Effat KG. A clinical study on the incidence of internal derangement of the temporomandibular joint following harvesting of temporalis fascia. Cranio 2022:1-8. [PMID: 35514168 DOI: 10.1080/08869634.2022.2072452] [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: 10/18/2022]
Abstract
OBJECTIVE The aim of the current clinical study was to reveal whether harvesting of a temporalis fascia graft would be associated with a higher incidence of temporomandibular joint (TMJ) internal derangement. METHODS The study group involved 104 patients who had middle-ear operations, 67 of which involved harvesting of temporalis fascia and 37 that did not. The TMJs were clinically examined in each group. RESULTS The total incidence of internal derangement of the TMJ was significantly higher in the group that had temporalis fascia harvesting (79.1%), compared to the group that did not have temporalis fascia harvesting (29.7%), (p= 0.001). CONCLUSION Harvesting of temporalis fascia probably alters mandibular kinematics and predisposes to internal derangement of the TMJs.
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Affiliation(s)
- Kamal G Effat
- Department of Otolaryngology, El- Sahel Teaching Hospital, Cairo, Egypt
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Risbud A, Muhonen EG, Tsutsumi K, Martin EC, Abouzari M, Djalilian HR. Migraine Features in Patients With Isolated Aural Fullness and Proposal for a New Diagnosis. Otol Neurotol 2021; 42:1580-1584. [PMID: 34420023 PMCID: PMC8595802 DOI: 10.1097/mao.0000000000003324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare the presence of migraine features between patients with isolated aural fullness (AF) who meet the diagnostic criteria for migraine headache and those who do not, and to propose diagnostic criteria for migraine-related AF based on our results. METHODS We performed a retrospective study of patients presenting to a tertiary-care neurotology clinic between 2014 and 2020 with migraine-related AF. This was defined as isolated, prolonged aural fullness concurrent with migraine features once other etiologies were ruled out via examination, audiometry, and imaging. Migraine features were compared between patients meeting the diagnostic criteria for migraine headache and those not meeting the criteria. RESULTS Seventy-seven patients with migraine-related AF were included. The mean age was 56 ± 15 years and 55 (71%) patients were female. Eleven (14%) patients fulfilled the criteria for migraine headache (migraine group). Of the 66 patients who did not meet the criteria (nonmigraine group), 17 (26%) met 4/5 criteria, and 32 (48%) met 3/5 criteria, for a total of 49 (74%) patients. The migraine and nonmigraine groups were only different in 5 of 20 features, including family history of migraine (p = 0.007), sound sensitivity (p < 0.001), mental fogginess (p = 0.008), visual motion sensitivity (p = 0.008), and light sensitivity (p < 0.001). CONCLUSION There are minimal differences in the overall prevalence of migraine features between patients with migraine-related AF who meet and do not meet the diagnostic criteria for migraine. Our findings suggest that the criteria may be too stringent and exclude many patients from potentially benefitting from treatment with migraine prophylaxis.
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Affiliation(s)
- Adwight Risbud
- Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, California
| | - Ethan G. Muhonen
- Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, California
| | - Kotaro Tsutsumi
- Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, California
| | - Elaine C. Martin
- Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, California
| | - Mehdi Abouzari
- Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, California
| | - Hamid R. Djalilian
- Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, California
- Department of Biomedical Engineering, University of California, Irvine, California
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Mejersjö C, Pauli N. Ear symptoms in patients with orofacial pain and dysfunction - An explorative study on different TMD symptoms, occlusion and habits. Clin Exp Dent Res 2021; 7:1167-1174. [PMID: 34060246 PMCID: PMC8638311 DOI: 10.1002/cre2.457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/22/2021] [Accepted: 05/05/2021] [Indexed: 11/08/2022] Open
Abstract
Objectives Ear symptoms coincident with TMD symptoms have been noticed for a long time. The aim was to investigate the relationship between reported ear symptoms in TMD patients and different TMD symptoms, dental occlusion, oral parafunction and habits. Material and methods Consecutive patients, ≥18 years of age and referred to a specialist clinic for orofacial pain and dysfunction during a three‐month period, were considered for the study. Patients with poor general or psychiatric health were excluded. One hundred thirty‐two patients were included and studied with regard to reported ear symptoms in relation to clinical dysfunction, occlusion, habits and subjective rating of their symptoms. A clinical examination was performed according to RDC/TMD and extended with occlusal factors, parafunctions and habits. Results Ear symptoms were reported by 72% of the TMD patients, with ear fullness in 49% as the most frequent symptom. The patients with ear symptoms were significantly older and proportionally more often females. Ear symptoms were significantly correlated to the subjective index, to myalgia (p = 0.003), decreased opening capacity (p = 0.01), TMJ pain (p = 0.02), parafunctions (p = 0.007), and some occlusal factor (p = 0.018–0.003). Muscle pain on palpation was significantly associated with ear fullness, and changed hearing and sensitivity to sound, on the same side (p < 0.005). Conclusions Ear symptoms are frequently reported by TMD patients. Concomitant ear symptoms are associated with oral parafunction and muscle pain on palpation on the same side as the ear symptoms.
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Affiliation(s)
- Christina Mejersjö
- Clinic of Orofacial Pain, Sahlgrenska Academy at the University of Gothenburg and the Public Dental Health Service, Gothenburg, Sweden
| | - Nina Pauli
- Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
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Boedts MJO. Tympanic Resonance Hypothesis. Front Neurol 2020; 11:14. [PMID: 32117001 PMCID: PMC7008469 DOI: 10.3389/fneur.2020.00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 01/07/2020] [Indexed: 11/13/2022] Open
Abstract
Seemingly unrelated symptoms in the head and neck region are eliminated when a patch is applied on specific locations on the Tympanic Membrane. Clinically, two distinct patient populations can be distinguished; cervical and masticatory muscle tensions are involved, and mental moods of anxiety or need. Clinical observations lead to the hypothesis of a “Tympanic Resonance Regulating System.” Its controller, the Trigeminocervical complex, integrates external auditory, somatosensory, and central impulses. It modulates auditory attention, and directs it toward unpredictable external or expected domestic and internal sounds: peripherally by shifting the resonance frequencies of the Tympanic Membrane; centrally by influencing the throughput of auditory information to the neural attention networks that toggle between scanning and focusing; and thus altering the perception of auditory information. The hypothesis leads to the assumption that the Trigeminocervical complex is composed of a dorsal component, and a ventral one which may overlap with the concept of “Trigeminovagal complex.” “Tympanic Dissonance” results in a host of local and distant symptoms, most of which can be attributed to activation of the Trigeminocervical complex. Diagnostic and therapeutic measures for this “Tympanic Dissonance Syndrome” are suggested.
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Affiliation(s)
- Michael J O Boedts
- Brai3n, Ghent, Belgium.,ENT Department, AZ Maria Middelares, Ghent, Belgium
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Higgins TS, Cappello ZJ, Wu AW, Ting JY, Sindwani R. Predictors of eustachian tube dysfunction improvement and normalization after endoscopic sinus surgery. Laryngoscope 2019; 130:E721-E726. [PMID: 31747061 DOI: 10.1002/lary.28416] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 10/11/2019] [Accepted: 10/23/2019] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Studies have demonstrated improvement in Eustachian tube dysfunction (ETD) symptomatology after functional endoscopic sinus surgery (FESS); however, factors associated with ETD symptom alteration have not been elucidated. This study evaluated factors associated with improvement and normalization of ETD symptoms after FESS. METHODS A case-control study was performed of FESS patients who had clinically significant ETD symptoms based on the Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7 ≥ 2.1) without middle ear effusion (MEE) preoperatively. Study patients were identified as those with a normalized ETDQ-7 at 2 months postoperatively. Controls were patients whose ETDQ-7 did not normalize at 2 months. Demographics, surgery characteristics, chronic rhinosinusitis phenotype, Lund-Mackay score, temporomandibular joint dysfunction (TMJD), preoperative ETDQ-7 and SNOT-22 scores, and tympanograms were analyzed. Univariate and multivariate analyses were performed comparing study cases and controls. RESULTS Data were collected on 165 patients, with 46% patients having clinically significant preoperative ETD and 60 patients meeting final study inclusion/exclusion criteria. FESS was associated with both SNOT-22 and ETDQ-7 improvement (P < 0.001). Nasal polyposis was associated with a higher probability of ETDQ-7 normalization (OR 4.429, P = 0.035). Factors associated with failure of ETDQ-7 normalization included TMJD (OR 0.086, P < 0.001, 95% CI 0.019-0.391) and high preoperative ETDQ-7 (OR 0.140, P = 0.006, 95% CI 0.032-0.613). CONCLUSION In patients with clinically significant ETD symptoms without MEE, FESS was associated with ETDQ-7 improvement. Nasal polyposis was associated with an increased probability of normalization of ETD symptoms postoperatively, whereas TMJD had a negative association. LEVEL OF EVIDENCE 3b Laryngoscope, 2019.
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Affiliation(s)
- Thomas S Higgins
- Rhinology, Sinus & Skull Base, Kentuckiana Ear, Nose & Throat, Louisville, Kentucky, U.S.A.,Department of Otolaryngology-Head and Neck Surgery, University of Louisville, Louisville, Kentucky, U.S.A
| | - Zachary J Cappello
- Department of Otolaryngology-Head and Neck Surgery, University of Louisville, Louisville, Kentucky, U.S.A.,Section of Rhinology, Sinus and Skull Base Surgery, Head & Neck Institute, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A
| | - Arthur W Wu
- Department of Otolaryngology-Head & Neck Surgery, Cedars Sinai Medical Center, Los Angeles, California, U.S.A
| | - Jonathan Y Ting
- Department of Otolaryngology-Head & Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A
| | - Raj Sindwani
- Section of Rhinology, Sinus and Skull Base Surgery, Head & Neck Institute, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A
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Effat KG, Berty A. A comparative clinical study of temporomandibular disorder patients in the otolaryngology clinic versus a rheumatology clinic. Cranio 2019; 37:329-334. [DOI: 10.1080/08869634.2017.1422846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Kamal G. Effat
- Department of Otolaryngology, El-Sahel Teaching Hospital, Cairo, Egypt
| | - Abeer Berty
- Department of Rheumatology, St. Mark Center, Cairo, Egypt
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Effat KG. A comparative clinical study of arthrogenous versus myogenous temporomandibular disorder in patients presenting with Costen's syndrome. Cranio 2019; 39:433-439. [PMID: 31402781 DOI: 10.1080/08869634.2019.1651479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Costen's syndrome involves otoneurological and sinonasal symptoms associated with temporomandibular disorder (TMD). The current study compared the symptoms related to Costen's syndrome in patients with arthrogenous versus myogenous TMD.Methods: The study involved 294 consecutive patients with TMD, prospectively examined over a period of 6 months. These were stratified into 180 patients with arthrogenous TMD and 114 patients with myogenous TMD. A questionnaire and examination protocol was applied for each patient.Results: Sinonasal symptoms were more common in the arthrogenous group (p = .001), whereas, hearing loss and vertigo were more common in the myogenous group (p = .001).Conclusion: The current study provides support for central nervous system neuroplastic changes in the genesis of Costen's syndrome symptoms.
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Affiliation(s)
- Kamal G Effat
- The Department of Otolaryngology, El-Sahel Teaching Hospital, Cairo, Egypt
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Noreña AJ, Fournier P, Londero A, Ponsot D, Charpentier N. An Integrative Model Accounting for the Symptom Cluster Triggered After an Acoustic Shock. Trends Hear 2019; 22:2331216518801725. [PMID: 30249168 PMCID: PMC6156190 DOI: 10.1177/2331216518801725] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Acoustic shocks and traumas sometimes result in a cluster of debilitating symptoms, including tinnitus, hyperacusis, ear fullness and tension, dizziness, and pain in and outside the ear. The mechanisms underlying this large variety of symptoms remain elusive. In this article, we elaborate on the hypothesis that the tensor tympani muscle (TTM), the trigeminal nerve (TGN), and the trigeminal cervical complex (TCC) play a central role in generating these symptoms. We argue that TTM overuse (due to the acoustic shock), TTM overload (due to muscle tension), and ultimately, TTM injury (due to hypoxia and "energy crisis") lead to inflammation, thereby activating the TGN, TCC, and cortex. The TCC is a crossroad structure integrating sensory inputs coming from the head-neck complex (including the middle ear) and projecting back to it. The multimodal integration of the TCC may then account for referred pain outside the ear when the middle ear is inflamed and activates the TGN. We believe that our model proposes a synthetic and explanatory framework to explain the phenomena occurring postacoustic shock and potentially also after other nonauditory causes. Indeed, due to the bidirectional properties of the TCC, musculoskeletal disorders in the region of the head-neck complex, including neck injury due to whiplash or temporomandibular disorders, may impact the middle ear, thereby leading to otic symptoms. This previously unavailable model type is experimentally testable and must be taken as a starting point for identifying the mechanisms responsible for this particular subtype of tinnitus and its associated symptoms.
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Affiliation(s)
- Arnaud J Noreña
- 1 Aix-Marseille Université, UMR CNRS 7260, Laboratoire Neurosciences Intégratives et Adaptatives-Centre Saint-Charles, Marseille, France
| | - Philippe Fournier
- 1 Aix-Marseille Université, UMR CNRS 7260, Laboratoire Neurosciences Intégratives et Adaptatives-Centre Saint-Charles, Marseille, France
| | - Alain Londero
- 2 Service ORL et CCF, Hôpital Européen G. Pompidou, Paris, France
| | - Damien Ponsot
- 3 Académie de Lyon-Lycée Germaine Tillion, Sain-Bel, France
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Song HS, Shin JS, Lee J, Lee YJ, Kim MR, Cho JH, Kim KW, Park Y, Song HJ, Park SY, Kim S, Kim M, Ha IH. Association between temporomandibular disorders, chronic diseases, and ophthalmologic and otolaryngologic disorders in Korean adults: A cross-sectional study. PLoS One 2018; 13:e0191336. [PMID: 29385182 PMCID: PMC5791977 DOI: 10.1371/journal.pone.0191336] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 01/03/2018] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Temporomandibular disorders (TMDs) are common musculoskeletal conditions in the maxillofacial area. Although strong relationships between TMDs and other pain and diseases exist, few studies have comprehensively assessed the association between chronic diseases, ophthalmologic and otolaryngologic disorders and TMD. METHODS Of 25,534 individuals included in the fifth Korea National Health and Nutrition Examination Survey (2010-2012), 17,575 aged ≥20 years who completed survey items on TMD symptoms were included for cross-sectional analysis. Logistic regression analysis was performed to assess the association between chronic diseases, ophthalmologic and otolaryngologic disorders and examination findings, and TMD symptoms after adjusting for various confounding variables. RESULTS Out of 17,575 participants, 2,059 (11.75%) reported experience of ≥1 TMD symptom(s). Compared to individuals without chronic disease, those with asthma (odds ratio (OR) 1.46; 95% confidence interval (CI) 1.09-1.96), migraine (1.44; 1.26-1.65), osteoarthritis (1.51; 1.20-1.89), thyroid dysfunction (1.49; 1.13-1.96), and depressive symptoms (1.51; 1.29-1.77) had higher ORs for TMD prevalence. Participants with tinnitus (1.97; 1.70-2.27), hearing difficulties (1.55; 1.29-1.87), dizziness (1.52; 1.27-1.82), rhinitis (1.46; 1.28-1.65), and xerophthalmia (1.82; 1.57-2.12) also displayed higher ORs for TMD prevalence. Patients diagnosed with chronic rhinosinusitis upon otolaryngologic examination exhibited an OR of 1.44 (95% CI 1.11-1.87) for TMD prevalence, while that for individuals with abnormal laryngoscopic results was 0.57 (95% CI 0.36-0.90). CONCLUSIONS These findings imply that TMDs, chronic diseases, and ophthalmologic and otolaryngologic disorders hold various correlations, suggesting the need for multitarget approaches to effectively address this phenomenon.
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Affiliation(s)
- Hyun-Seop Song
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Joon-Shik Shin
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Jinho Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Me-riong Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Jae-Heung Cho
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Koh-Woon Kim
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Yeoncheol Park
- Department of Acupuncture & Moxibustion, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Hyun Jin Song
- College of Pharmacy, University of Florida, Gainesville, Florida, United States of America
| | | | - Seoyoun Kim
- Korea University Graduate School of Public Health, Seoul, Republic of Korea
| | - Mia Kim
- Department of Cardiovascular and Neurological Diseases (Stroke Center), College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
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Lee SY, Park JW, Park SE, Nam DW, Lim HJ, Kim YH. Clinical implications of magnetic resonance imaging in temporomandibular disorders patients presenting ear fullness. Laryngoscope 2017; 128:1692-1698. [PMID: 29238986 DOI: 10.1002/lary.27043] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 10/31/2017] [Accepted: 11/10/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS The aim of this study was to investigate whether findings detected by temporomandibular joint magnetic resonance imaging (TMJ-MRI) can provide pathognomonic evidence of temporomandibular disorders (TMD) in patients with nonspecific ear fullness (EF). The association of nonspecific EF with clinical characteristics of TMD based on TMJ-MRI findings was examined. STUDY DESIGN Retrospective analysis. METHODS Thirty-four subjects (42 ears) who had no detectable otologic problems as a cause of EF were enrolled in this study. Each subject underwent TMJ-MRI to identify pathology of the TMJ as a possible cause of nonspecific EF. All subjects participated in the re-evaluation process following TMD treatment. RESULTS Anatomical abnormalities in TMJ-MRI, irrespective of TMD signs, were observed in 34 of the 42 ears (80.9%), such as degenerative change of the TMJ (16 ears), articular disc displacement (11 ears), and joint effusion (seven ears). Specific abnormalities of the TMJ were associated with nonspecific EF, and this symptom showed improvement following individualized TMD treatment in those with internal derangement and/or effusion of the TMJ. However, abnormal TMJ-MRI findings were also observed in seven of nine ears with no TMD signs, and there was no significant association between the presence of TMD signs and abnormal TMJ-MRI findings (χ2 = 0.075, P = .784). CONCLUSIONS Patients presenting with nonspecific EF may have TMD, which can be effectively diagnosed using TMJ-MRI. The present study revealed the causal relationship between nonspecific EF and abnormal TMJ findings based on MRI. Individualized TMD treatments based on TMJ-MRI led to improved treatment outcomes with special regard to nonspecific EF LEVEL OF EVIDENCE: 4. Laryngoscope, 128:1692-1698, 2018.
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Affiliation(s)
- Sang Yeon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul Metropolitan Government, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Ji Woon Park
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Seo Eun Park
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Dong Woo Nam
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul Metropolitan Government, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Hyun Jung Lim
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul Metropolitan Government, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Young Ho Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul Metropolitan Government, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
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Sogebi OA, Adedeji TO, Ogunbanwo O, Oyewole EA. Sub-clinical middle ear malfunctions in elderly patients; prevalence, pattern and predictors. Afr Health Sci 2017; 17:1229-1236. [PMID: 29937897 PMCID: PMC5870273 DOI: 10.4314/ahs.v17i4.34] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Little is known about functioning of the middle ear with advancing age. Objectives To estimate the prevalence and describe tympanometric patterns of sub-clinical middle ear malfunctions,( S-MEM) in elderly patients. It also assessed clinical factors that could predict S-MEM. Methods Cross-sectional, analytical study of patients aged ≥ 60 years in a tertiary hospital in Nigeria between 2011–2014. Pure tone audiometry (PTA), tympanometry and acoustic reflexes were recorded. S-MEM was based on audiometric and tympanometric evident abnormalities. Descriptive, univariate and multivariate analyses performed to detect independent clinical predictors of S-MEM at p-value of <0.05. Results 121 patients , M: F of 1.1:1. Mean age was 70.1 ± 6.2 years, 77.7% were married. Prevalence of S-MEM was 21.5%. Abnormal tympanometric tracings were type AS>C>B>AD. The parameters that were statistically-significant on univariate analyses were subjected to logistic regression analysis which confirmed previous head injury, diabetes, osteoarthritis of knee joint, and absent acoustic reflex as clinical predictors for S-MEM. Conclusion 21.5% of elderly Africans had subclinical abnormalities in their middle ear functioning, mostly with type AS tympanogram. Independent clinical predictors of S-MEM included previous head injury, diabetes, history of osteoarthritis of knee joints, and absent acoustic reflex.
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Maciejewska-Szaniec Z, Maciejewska B, Mehr K, Piotrowski P, Michalak M, Wiskirska-Woźnica B, Klatkiewicz T, Czajka-Jakubowska A. Incidence of Otologic Symptoms and Evaluation of the Organ of Hearing in Patients with Temporomandibular Disorders (TDM). Med Sci Monit 2017; 23:5123-5129. [PMID: 29077689 PMCID: PMC5673028 DOI: 10.12659/msm.905510] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Numerous studies have discussed cases of concomitant temporomandibular disorders (TMD) and otologic symptoms (OS). However, attempts to determine the true origin of these symptoms combined with assessments of the condition of the organ of hearing are relatively rare. This study aimed to evaluate the frequency and type of OS in patients with TMD, and attempted to determine the origin of the OS in the studied group of patients. Material/Methods 246 patients, aged 40.08±11.12 years (F=147, M=99) with TMD, from the Department of Oral Rehabilitation of Poznan University of Medical Sciences. Methods: dental history interviews and clinical examinations. There were 2 groups–G1 and G2–selected on the basis of the presence or absence of OS in the medical history stage. After audiological evaluation, 2 subgroups were identified: G1.1 and G1.2. Results OS were observed in 36.18% (G1). In 48 patients (53.93%), the audiological evaluation found there was no impairment of the organ of hearing (G1.2). Audiological abnormalities were found in 46.07% (n=41) of the patients (G1.1). The OS which differentiated the 2 groups were a plugging sensation as well as otalgia (more frequent in group G1.2) and hearing impairment (more frequent in group G1.1). Conclusions 1. The OS which most frequently accompany with TMD were fullness and otalgia. 2. It is recommended that a subjective assessment of hearing loss in patients with TMD and concomitant OS should be included in the medical history stage. 3. Clicking and popping are significantly more frequent in patients without concomitant hearing impairment.
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Affiliation(s)
- Zofia Maciejewska-Szaniec
- Department of Oral Rehabilitation, Division of Prosthodontics, Poznań University of Medical Sciences, Poznań, Poland
| | - Barbara Maciejewska
- Department and Clinic of Phoniatrics and Audiology, Poznań University of Medical Sciences, Poznań, Poland
| | - Katarzyna Mehr
- Department of Oral Rehabilitation, Division of Prosthodontics, Poznań University of Medical Sciences, Poznań, Poland
| | - Paweł Piotrowski
- Department of Oral Rehabilitation, Division of Prosthodontics, Poznań University of Medical Sciences, Poznań, Poland
| | - Michał Michalak
- Department of Computer Science and Statistics , Poznań University of Medical Sciences, Poznań, Poland
| | - Bożena Wiskirska-Woźnica
- Department and Clinic of Phoniatrics and Audiology, Poznań University of Medical Sciences, Poznań, Poland
| | - Tomasz Klatkiewicz
- Department of Oral Rehabilitation, Division of Prosthodontics, Poznań University of Medical Sciences, Poznań, Poland
| | - Agata Czajka-Jakubowska
- Department of Oral Rehabilitation, Division of Prosthodontics, Poznań University of Medical Sciences, Poznań, Poland
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Peng Y. Temporomandibular Joint Disorders as a Cause of Aural Fullness. Clin Exp Otorhinolaryngol 2017; 10:236-240. [PMID: 28103655 PMCID: PMC5545700 DOI: 10.21053/ceo.2016.01039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 12/17/2016] [Accepted: 12/27/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Temporomandibular joint disorders (TMD) are often associated with aural manifestations. However, it is not clear whether aural fullness could be induced by TMD. The purpose was to investigate the TMD and effectiveness of TMD treatments in patients with mainly or exclusively aural fullness complaint. METHODS One hundred and twelve patients, who had aural fullness as the main or sole complaint, presented to the Otolaryngology Department, PLA Army General Hospital, Beijing, China, between January 2010 and January 2015. Patients' medical history indicated that they had previously been diagnosed and treated for otitis media or sensorineural hearing loss but without positive results. Patients were subjected to pure tone audiometry and acoustic immittance screening using GSI-61 clinical audiometer and GSI TympStar middle ear analyzer respectively. Patients were examined by questionnaire, X-ray and/or computed tomography scan of temporomandibular joint. TMD was categorized according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Patients were then treated for TMD. RESULTS All the patients showed normal eardrum and type A tympanogram. The patients of 60.7% (68/112) were classified as group I TMD disorders (muscle disorders), 34.8% (39/112) were group II (disc displacements), and 4.5% (5/112) were group III (arthralgia, osteoarthritis, and osteoarthrosis). Aural fullness was completely resolved or significantly improved in 67 and 34 patients respectively following treatments aimed at improving TMD, with a combined effectiveness of 90.2% (101/112). TMD treatments are especially effective (94.1%) in group I TMD. CONCLUSION TMD as a potential cause of aural fullness should be considered in otolaryngology practice.
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Affiliation(s)
- Yongxin Peng
- Otolaryngology Department, PLA Army General Hospital, Beijing, China
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Otological symptoms and audiometric findings in patients with temporomandibular disorders: Costen's syndrome revisited. The Journal of Laryngology & Otology 2016; 130:1137-1141. [DOI: 10.1017/s0022215116009300] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
AbstractObjective:Otological symptoms (otalgia, subjective hearing loss, blocked ear sensation, tinnitus and vertigo) associated with temporomandibular disorders are documented features of Costen's syndrome. However, the origin of these symptoms and the causes of hearing loss are unknown. This study aimed to characterise hearing loss in a large number of patients with temporomandibular disorders. The causes of these symptoms were explored in patients with otological symptoms and normal audiometric findings.Methods:A prospective case study and literature review were performed. The audiometric features of 104 temporomandibular disorder patients were compared with those of 110 control participants.Results:A large proportion of temporomandibular disorder patients had several otological symptoms. Twenty-five per cent of unilateral or bilateral temporomandibular disorder patients had either unilateral (ipsilateral) or bilateral hearing loss; respectively, which was usually mild (p = 0.001). Hearing loss was predominantly sensorineural.Conclusion:The main cause of otological symptoms (apart from otalgia) and of audiometric findings in temporomandibular disorder patients is postulated to be an altered middle-ear to inner-ear pressure equilibrium.
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Şahin C, Varım C, Karacaer C, Acar BA, Acar T, Tamer A. Incidence of ‘headache attributed to temporomandibular disease’ in patients with clicking sound in the region temporomandibular joint. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2016. [DOI: 10.4103/1110-7782.174940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Tinnitus and its relationship with muscle tenderness in patients with headache and facial pain. J Laryngol Otol 2015; 129:638-43. [PMID: 26091105 DOI: 10.1017/s0022215115001425] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study aimed to examine tinnitus prevalence in patients with different types of headache and the relationship between tinnitus and the pericranial muscle tenderness and cervical muscle tenderness scores. METHODS A cross-sectional study was conducted of 1251 patients with migraine and/or myogenous pain, arthrogenous temporomandibular joint disorders and tension-type headache. Standardised palpation of the pericranial and cervical muscles was carried out and univariable and multivariable analysis was used to measure the odds ratio of suffering tinnitus by the different diagnoses and muscular tenderness grade. RESULTS A univariable analysis showed that myogenous pain, pericranial muscle tenderness and cervical muscle tenderness scores, sex, and age were associated with tinnitus. When a multivariable model including only age, sex and a headache diagnosis was used, myogenous pain, migraine and age were found to be associated with tinnitus. When muscle tenderness scores were also included, only the cervical muscle tenderness and pericranial muscle tenderness scores were found to be significantly associated with tinnitus. CONCLUSION In a population of patients with headache and craniofacial pain, tinnitus was related to increased cervical muscle tenderness and pericranial muscle tenderness scores, rather than to any particular form of headache.
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Noreña AJ. Revisiting the cochlear and central mechanisms of tinnitus and therapeutic approaches. Audiol Neurootol 2015; 20 Suppl 1:53-9. [PMID: 25997584 DOI: 10.1159/000380749] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
This short review aims at revisiting some of the putative mechanisms of tinnitus. Cochlear-type tinnitus is suggested to result from aberrant activity generated before or at the cochlear nerve level. It is proposed that outer hair cells, through their role in regulating the endocochlear potential, can contribute to the enhancement of cochlear spontaneous activity. This hypothesis is attractive as it provides a possible explanation for cochlear tinnitus of different aetiologies, such as tinnitus produced by acute noise trauma, intense low-frequency sounds, middle-ear dysfunction or temporomandibular joint disorders. Other mechanisms, namely an excitatory drift in the operating point of the inner hair cells and activation of NMDA receptors, are also briefly reported. Central-type tinnitus is supposed to result from aberrant activity generated in auditory centres, i.e. in these patients, the tinnitus-related activity does not pre-exist in the cochlear nerve. A reduction in cochlear activity due to hearing loss is suggested to produce tinnitus-related plastic changes, namely cortical reorganisation, thalamic neuron hyperpolarisation, facilitation of non-auditory inputs and/or increase in central gain. These central changes can be associated with abnormal patterns of spontaneous activity in the auditory pathway, i.e. hyperactivity, hypersynchrony and/or oscillating activity. Therapeutic approaches aimed at reducing cochlear activity and/or tinnitus-related central changes are discussed.
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Samji A, Thiagarajan V, Yeoh R. Whiplash injury and neuro-otological sequelae: An evidence based systematic review. HEARING, BALANCE AND COMMUNICATION 2014. [DOI: 10.3109/21695717.2014.910896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Saldanha ADD, Hilgenberg PB, Pinto LMS, Conti PCR. Are Temporomandibular Disorders and Tinnitus Associated? Cranio 2014; 30:166-71. [DOI: 10.1179/crn.2012.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Kosiakov SI, Gunenkov AV. [The modern view of the clinical significance of tensor tympani muscle]. Vestn Otorinolaringol 2014:81-83. [PMID: 25785293 DOI: 10.17116/otorino2014681-83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The objective of the present work was analyse the modern views of the role of tensor tympani muscle in the development of otic pathology. In this context, the authors discuss tenotomy of the middle ear muscles for the treatment of Meniere's disease, diagnostics and clinical aspects of middle ear myoclonus, and tonic tensor tympani syndrome.
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Affiliation(s)
- S Ia Kosiakov
- Kafedra otorinolaringologii Rossiĭskoĭ meditsinskoĭ akademii poslediplomnogo obrazovaniia, Moskva, Rossiia, 125367
| | - A V Gunenkov
- Kafedra otorinolaringologii Rossiĭskoĭ meditsinskoĭ akademii poslediplomnogo obrazovaniia, Moskva, Rossiia, 125367
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Abstract
A child's difficulty in verbalizing the precise location and nature of facial pain and jaw dysfunction often results in a nondefinitive history, increasing the importance of the dentist's awareness of the early signs and symptoms of temporomandibular joint disorders (TMD). A focused examination of the masticatory musculature, the temporomandibular joints, and associated capsular and ligamentous structures can reveal if a patient's symptoms are TMD in origin. An accurate differential diagnosis enables timely referral to appropriate health care providers and minimizes the use of diagnostic imaging.
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Affiliation(s)
- James A Howard
- Center for Pediatric Dentistry, School of Dentistry, University of Washington, 6222 NE 74th St, Seattle, WA 98115, USA.
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