1
|
De Meulemeester K, Meeus M, Dhooge I, Taevernier A, Van Elslander M, Cagnie B, Lenoir D, Keppler H. Comparing tinnitus, pain, psychosocial and cognitive factors between patients with tinnitus and pain: A systematic review. J Psychosom Res 2023; 168:111201. [PMID: 36863293 DOI: 10.1016/j.jpsychores.2023.111201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/30/2023] [Accepted: 02/13/2023] [Indexed: 02/19/2023]
Abstract
OBJECTIVE Tinnitus is a multifactorial symptom, which shows similarities with the involved mechanisms in chronic pain. The aim of this systematic review is to provide an overview of studies comparing patients with only tinnitus to patients with pain (headache, temporomandibular joint (TMJ) pain or neck pain) with or without tinnitus, regarding tinnitus-related, pain-related, psychosocial and cognitive factors. METHODS This systematic review was written following the PRISMA guidelines. To identify relevant articles, PubMed, Web of Science and Embase databases were searched. The risk of bias was rated using the Newcastle Ottawa scale for case-control studies. RESULTS Ten articles were included in the qualitative analysis. The risk of bias ranged from low to moderate. Low to moderate evidence shows that patients with tinnitus experience higher mean symptom intensity, but lower psychosocial and cognitive distress, compared to patients with pain. Inconsistent results were found for tinnitus-related factors. Low to moderate evidence points to a higher severity of hyperacusis and psychosocial distress in patients with both pain and tinnitus, compared to patients with tinnitus only, as well as for positive associations between tinnitus-related factors and the presence or intensity of pain. CONCLUSION This systematic review shows that psychosocial dysfunctions are more clearly present in patients with pain only, compared to patients with tinnitus only and the co-occurrence of tinnitus and pain increases psychosocial distress as well as hyperacusis severity. Some positive associations were identified between tinnitus-related and pain-related factors.
Collapse
Affiliation(s)
- Kayleigh De Meulemeester
- Spine, Head and Pain Research Unit Ghent, Ghent University, Belgium; Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium; Pain in Motion International Research Group, Ghent, Belgium.
| | - Mira Meeus
- Spine, Head and Pain Research Unit Ghent, Ghent University, Belgium; Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium; Pain in Motion International Research Group, Ghent, Belgium; MOVANT Research group, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
| | - Ingeborg Dhooge
- Department of Oto-Rhino-Laryngology, Ghent University Hospital, Ghent, Belgium; Department of Head and Skin, Ghent University, Ghent, Belgium
| | - Anja Taevernier
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium
| | - Mylène Van Elslander
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium
| | - Barbara Cagnie
- Spine, Head and Pain Research Unit Ghent, Ghent University, Belgium; Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium
| | - Dorine Lenoir
- Spine, Head and Pain Research Unit Ghent, Ghent University, Belgium; Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium; Pain in Motion International Research Group, Ghent, Belgium
| | - Hannah Keppler
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium; Department of Oto-Rhino-Laryngology, Ghent University Hospital, Ghent, Belgium
| |
Collapse
|
2
|
Karacay BC, Korkmaz MD. Investigation of Factors Associated with Dizziness, Tinnitus, and Ear Fullness in Patients with Temporomandibular Disorders. J Oral Facial Pain Headache 2023; 37:17-24. [PMID: 36917234 PMCID: PMC10586575 DOI: 10.11607/ofph.3286] [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: 06/24/2022] [Accepted: 09/10/2022] [Indexed: 03/16/2023]
Abstract
Aims: To determine differences between TMD subtypes in terms of clinical characteristics, dizziness, tinnitus, and ear fullness according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and to investigate the clinical conditions associated with dizziness, tinnitus, and ear fullness. Methods: Participants having TMDs aged 18 to 45 years were included in this study. They were classified and divided into three groups according to the DC/TMD Axis I criteria: group 1 = pain-related TMDs and headache; group 2 = intra-articular joint disorders; and group 3 = degenerative joint disease. Demographic data and dizziness, tinnitus, and ear fullness were assessed. Maximum mouth opening, opening/closing click, lateral click, fine/coarse crepitation, bruxism, and presence of pain were evaluated by physical examination. Results: A total of 129 participants were included: 68 (52.7%) in group 1, 40 (31%) in group 2, and 21 (16.3%) in group 3. In the comparison of all three diagnostic groups, there was a significant difference only in educational level (P = .013). The presence of dizziness, tinnitus, or ear fullness was not found to be significantly different among the three groups. When all participants were divided into two groups according to the presence of dizziness, low education levels (P = .007), being married (P = .040), presence of pain (P = .002), tinnitus (P = .008), ear fullness (P = .017), and presence of thin crepitation (P = .015) were related to having dizziness symptoms. In addition, patients with ear fullness (P = .042), dizziness (P = .008), and female sex (P = .008) reported more tinnitus. Conclusion: TMD subtype was not associated with dizziness, tinnitus, or ear fullness. Painful conditions were associated with dizziness in participants with TMDs.
Collapse
|
3
|
Mazurek B, Rose M, Schulze H, Dobel C. Systems Medicine Approach for Tinnitus with Comorbid Disorders. Nutrients 2022; 14:nu14204320. [PMID: 36297004 PMCID: PMC9611054 DOI: 10.3390/nu14204320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/26/2022] [Accepted: 10/06/2022] [Indexed: 11/07/2022] Open
Abstract
Despite the fact that chronic diseases usually occur together with a spectrum of possible comorbidities that may differ strongly between patients, they are classically still viewed as distinct disease entities and, consequently, are often treated with uniform therapies. Unfortunately, such an approach does not take into account that different combinations of symptoms and comorbidities may result from different pathological (e.g., environmental, genetic, dietary, etc.) factors, which require specific and individualised therapeutic strategies. In this opinion paper, we aim to put forward a more differentiated, systems medicine approach to disease and patient treatment. To elaborate on this concept, we focus on the interplay of tinnitus, depression, and chronic pain. In our view, these conditions can be characterised by a variety of phenotypes composed of variable sets of symptoms and biomarkers, rather than distinct disease entities. The knowledge of the interplay of such symptoms and biomarkers will provide the key to a deeper, mechanistic understanding of disease pathologies. This paves the way for prediction and prevention of disease pathways, including more personalised and effective treatment strategies.
Collapse
Affiliation(s)
- Birgit Mazurek
- Tinnitus Center, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
- Correspondence:
| | - Matthias Rose
- Medical Department, Division of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Holger Schulze
- Department of Otorhinolaryngology–Head and Neck Surgery, Universitätsklinikum Erlangen, 91054 Erlangen, Germany
| | - Christian Dobel
- Department of Otorhinolaryngology, Jena University Hospital, 07743 Jena, Germany
| |
Collapse
|
4
|
Chew AQA, Saigo L, Yap AU. Is there a comorbid relationship between temporomandibular disorders and otologic signs/symptoms?: An umbrella review. Cranio 2022:1-14. [PMID: 35543516 DOI: 10.1080/08869634.2022.2069639] [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 This umbrella review (UR) explored the possible associations between temporomandibular disorders (TMDs) and otologic signs/symptoms (OSs) and established the potential impact of TMD interventions on OSs. METHODS A systematic review of systematic reviews (SRs)/meta-analyses (MAs) was conducted according to the PRISMA guidelines and Joanna Briggs Institute UR protocol. Electronic search of the PubMed, Scopus, Web of Science, and Open Grey databases was conducted and the quality of the identified studies was assessed using the AMSTAR2 criteria. RESULTS Out of 923 and 157 articles screened for the first and second focus questions respectively, a total of 8 SRs/MAs fulfilled the eligibility criteria. The prevalence of OSs in TMD patients and contrariwise varied substantially up to 85.0-95.0%. Available evidence indicates that TMDs are associated with OSs, and TMD treatment reduced OSs. CONCLUSION Findings suggest that a comorbid relationship between TMDs and OSs exists, and therapeutic TMD interventions improve OSs.
Collapse
Affiliation(s)
- Amelia Qin'An Anya Chew
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore Health Services, Singapore
| | - Leonardo Saigo
- Department of Oral and Maxillofacial Surgery, National Dental Centre Singapore, Singapore Health Services, Singapore
| | - Adrian Ujin Yap
- Medical School, Singapore Health Services, Singapore; Department of Dentistry, Ng Teng Fong General Hospital and Faculty of Dentistry, National University Health System SingaporeNational Dental Research Institute Singapore, National Dental Centre Singapore and Duke-NUS, Singapore
| |
Collapse
|
5
|
da Silva AP, Sassi FC, de Andrade CRF. The effects of treatment timing on the management of patients with multiple facial fractures and on the self-perception of TMD recovery. Cranio 2022:1-12. [PMID: 35257636 DOI: 10.1080/08869634.2022.2046910] [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 To investigate the effects of time on the orofacial functions and on the self-perception of temporomandibular disorders (TMD) recovery in a population of patients with multiple facial fractures. METHODS Orofacial functions and self-perception of TMD recovery was verified in patients with midface and/or lower face fractures. Patients were divided according to the time between fracture reduction and the clinical assessments: 0-1 month (Group 1), 1-3 months (Group 2), and 15 >3 months (Group 3). RESULTS Patients in Group 1 presented a greater compromise of swallowing and mastication when compared to patients with older fractures (p = 0.015), whereas patients in Group 3 presented a poorer TMD recovery (TMJ pain: p = 0.010 and tinnitus: p = 0.004). CONCLUSION Delays in functional treatments involving the myofunctional orofacial system have a negative impact on the recovery of essential orofacial functions and on TMD symptoms..
Collapse
Affiliation(s)
- Amanda Pagliotto da Silva
- Division of Orofacial Myology, Hospital Das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Fernanda Chiarion Sassi
- Department of Physiotherapy, Speech-language and Hearing Science and Occupational Therapy, School of Medicine, University of São Paulo, Brazil
| | - Claudia Regina Furquim de Andrade
- Department of Physiotherapy, Speech-language and Hearing Science and Occupational Therapy, School of Medicine, University of São Paulo, Brazil
| |
Collapse
|
6
|
Kong GS, Lee SH, Park KS, Cho JH, Kim KW, Ha IH. Association of temporomandibular disorders and tinnitus with health-related quality of life: A cross-sectional study using the Fifth Korea National Health and Nutrition Examination Survey. J Oral Rehabil 2021; 49:283-294. [PMID: 34862977 DOI: 10.1111/joor.13287] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/05/2021] [Accepted: 10/25/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Few studies have examined the associations of temporomandibular disorders (TMDs) and tinnitus with health-related quality of life on a national level. OBJECTIVE We aimed to investigate the associations of TMDs, tinnitus and quality of life among the Korean population, aged 19 years or older. METHODS Data were obtained from the fifth Korea National Health and Nutrition Examination Survey (2012; N = 5786). TMDs, tinnitus and health-related quality of life were assessed using self-report data from EuroQol-5 Dimension. Participants were divided into four groups: no TMD and no tinnitus, TMD present but no tinnitus, no TMD but tinnitus present and both TMD and tinnitus present. RESULTS Among the participants, 21.88% had TMD, 24.93% had tinnitus, and 7.74% had both. The prevalence of most TMD and all types of tinnitus was higher among females than among males. The group with both TMD and tinnitus reported the highest percentage of problems in the usual activity, pain/discomfort and anxiety/depression dimensions. Moreover, the odds ratio (OR) for lower quality of life was significantly higher in the group with both TMD and tinnitus compared to the group without TMD and tinnitus: mobility (OR = 1.527, 95% confidence interval [CI]: 1.014-2.300), pain/discomfort (OR = 2.072, 95% CI: 1.570-2.735), anxiety/depression (OR = 1.692, 95% CI: 1.034-2.767), EQ-5D score (OR = 1.651, 95% CI: 1.121-2.431) and EQ-VAS (OR = 1.682, 95% CI: 1.246-2.269). CONCLUSION The presence of both TMD and tinnitus has a considerable impact on HRQoL in the Korean population. In our study, the group with both TMD and tinnitus showed lower HRQoL than without TMD and tinnitus group. These results emphasise the need for a multilateral and comprehensive approach to address these disorders and provide baseline data for developing appropriate interventions.
Collapse
Affiliation(s)
| | - Sook-Hyun Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Korea
| | | | - Jae-Heung Cho
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - Koh-Woon Kim
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Korea
| |
Collapse
|
7
|
Hilgenberg-Sydney PB, Saldanha ADD, Lopes AC, Conti PCR. Audiological Evaluation of Patients With Somatosensory Tinnitus Attributed to Temporomandibular Disorders. Am J Audiol 2020; 29:930-934. [PMID: 33197332 DOI: 10.1044/2020_aja-20-00133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose Tinnitus and temporomandibular disorders have already been associated in the literature, but despite many studies, it is still an intriguing discussion point. This study aimed to evaluate the prevalence of hearing loss among somatosensory tinnitus patients with temporomandibular disorders and to assess the influence of tinnitus on patients' quality of life. Method An otolaryngologist examined 585 patients in order to detect and evaluate the presence of tinnitus. Subjects were evaluated using the Portuguese version of the Research Diagnostic Criteria for Temporomandibular Disorders. An analysis of the somatic component of tinnitus was performed. Tinnitus was rated according to its onset (at least 6 months) and intensity with a visual analog scale. The sample was composed of 100 patients with somatosensory tinnitus divided into two groups: Group 1 (with temporomandibular disorder, n = 85) and Group 2 (without temporomandibular disorder, n = 15). The audiological evaluation was composed of pure-tone audiometry, high-frequency audiometry, tympanometry, and transient-evoked otoacoustic emissions. The impact of tinnitus on quality of life was assessed by the Tinnitus Handicap Inventory adapted and validated to Portuguese language. Results Pure-tone audiometry did not differ with statistical significance between groups (p = .29), neither did the high-frequency audiometry results (p = .74). Tinnitus Handicap Inventory scores also did not show any differences between Groups 1 and 2 (p = .67). Conclusions Subjects with somatosensory tinnitus, who also have temporomandibular disorders, do not seem to have hearing impairment. Also, they do not have a higher quality of life handicap when compared to those without tinnitus and temporomandibular disorder.
Collapse
Affiliation(s)
| | | | - Andréa Cintra Lopes
- Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brasil
| | | |
Collapse
|
8
|
Boecking B, von Sass J, Sieveking A, Schaefer C, Brueggemann P, Rose M, Mazurek B. Tinnitus-related distress and pain perceptions in patients with chronic tinnitus - Do psychological factors constitute a link? PLoS One 2020; 15:e0234807. [PMID: 32584841 PMCID: PMC7316290 DOI: 10.1371/journal.pone.0234807] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 06/02/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To investigate the co-occurrence of tinnitus-related distress and pain experiences alongside psychological factors that may underlie their association. METHOD Patients with chronic tinnitus (N = 1238) completed a questionnaire battery examining tinnitus-related distress and affective and sensory pain perceptions. A series of simple, parallel- and serial multiple mediator models examined indirect effects of psychological comorbidities as well as -process variables including depressivity, perceived stress and coping attitudes. Moderator and moderated mediation analyses examined differential relational patterns in patients with decompensated vs. compensated tinnitus. RESULTS There were significant associations between tinnitus-related distress and pain perceptions. These were partially mediated by most specified variables. Psychological comorbidities appeared to influence tinnitus-pain associations through their impact on depressivity, perceived stress, and coping attitudes. Some specific differences in affective vs. sensory pain perception pathways emerged. Patients with decompensated tinnitus yielded significantly higher symptom burden across all measured indices. Tinnitus decompensation was associated with heightened associations between [1] tinnitus-related distress and pain perceptions, depressivity and negative coping attitudes; and [2] most psychological comorbidities and sensory, but not affective pain perception. Moderated mediation analyses revealed stronger indirect effects of depressivity and anxiety in mediating affective-, and anxiety in mediating sensory pain perception in patients with decompensated tinnitus. CONCLUSION Psychological constructs mediate the co-occurrence of tinnitus- and pain-related symptoms across different levels of tinnitus-related distress. Psychological treatment approaches should conceptualize and address individualised interactions of common cognitive-emotional processes in addressing psychosomatic symptom clusters across syndromatic patients with varying distress levels.
Collapse
Affiliation(s)
- Benjamin Boecking
- Tinnitus Center, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | | | - Antonia Sieveking
- Tinnitus Center, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | | | - Petra Brueggemann
- Tinnitus Center, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Matthias Rose
- Division of Psychosomatic Medicine, Medical Department, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Birgit Mazurek
- Tinnitus Center, Charité–Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
9
|
Nascimento GC, de Paula BB, Lowry CA, Leite-Panissi CRA. Temporomandibular inflammation mobilizes parvalbumin and FosB/deltaFosB neurons of amygdala and dorsal raphe. ACTA ACUST UNITED AC 2020; 53:e9950. [PMID: 32578721 PMCID: PMC7307894 DOI: 10.1590/1414-431x20209950] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/04/2020] [Indexed: 11/21/2022]
Abstract
Pathophysiological mechanisms involved in orofacial pain and their relationship with emotional disorders have emerged as an important research area for multidisciplinary studies. In particular, temporomandibular disorders (TMD) have been evaluated clinically from both physiological and psychological perspectives. We hypothesized that an altered neuronal activity occurs in the amygdala and the dorsal raphe nucleus (DR), encephalic regions involved in the modulation of painful and emotional information. Adult male Wistar rats were used in an experimental complete Freund's adjuvant (CFA)-induced temporomandibular joint (TMJ) inflammation model. CFA was applied for 1 or 10 days, and the animals were euthanized for brain samples dissection for FosB/ΔFosB and parvalbumin (PV) immunostaining. Our results were consistent in showing that the amygdala and DR were activated in the persistent inflammatory phase (10 days) and that the expression of PV+ interneurons in the amygdala was decreased. In contrast, in the DR, the expression of PV+ interneurons was increased in persistent states of CFA-induced TMJ inflammation. Moreover, at 10 days of inflammation, there was an increased co-localization of PV+ and FosB/ΔFosB+ neurons in the basolateral and central nucleus of the amygdala. Different nuclei of the amygdala, as well as portions of the DR, were activated in the persistent phase (10 days) of TMJ inflammation. In conclusion, altered activity of the amygdala and DR was detected during persistent inflammatory nociception in the temporomandibular joint. These regions may be essential for both sensory and affective dimensions of orofacial pain.
Collapse
Affiliation(s)
- G C Nascimento
- Departamento de Fisiologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - B B de Paula
- Departamento de Psicologia, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - C A Lowry
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - C R A Leite-Panissi
- Departamento de Psicologia, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
Omidvar S, Jafari Z. Association Between Tinnitus and Temporomandibular Disorders: A Systematic Review and Meta-Analysis. Ann Otol Rhinol Laryngol 2019; 128:662-675. [PMID: 30991812 DOI: 10.1177/0003489419842577] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Tinnitus is one of the most common otological symptoms in patients with temporomandibular disorders. This study aimed to investigate the possible association between tinnitus and temporomandibular disorders. METHODS The online databases of PubMed, Ovid, ScienceDirect, and Web of Science were explored for all English articles published until September 2018 using the combined keywords tinnitus and temporomandibular. Cross-sectional, cohort, or case-control studies that investigated the association between tinnitus and temporomandibular disorders (TMDs) were considered. The quality of the included papers was assessed by the Crowe Critical Appraisal Tool. RESULTS Twenty-two papers met the eligibility criteria and were included in the systematic review. Meta-analysis was performed on 8 papers to investigate the possible relationship between tinnitus and TMDs by calculating the odds ratios. Odds ratios ranged from 1.78 to 7.79 in the studies related to tinnitus frequency in temporomandibular disorders and from 1.80 to 7.79 in the papers linked to temporomandibular disorder frequency in tinnitus, indicating a significant association between tinnitus and temporomandibular disorders. CONCLUSIONS There was a strong relationship between tinnitus occurrence and TMDs. The findings implied the significance of exploring the signs of TMDs in patients with tinnitus as well as tinnitus in those who complain from temporomandibular disorders.
Collapse
Affiliation(s)
- Shaghayegh Omidvar
- 1 Department of Audiology, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Fars, Iran.,2 Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Zahra Jafari
- 3 Department of Neuroscience, Canadian Center for Behavioral Neuroscience (CCBN), University of Lethbridge, Lethbridge, AB, Canada
| |
Collapse
|
12
|
Skog C, Fjellner J, Ekberg E, Häggman-Henrikson B. Tinnitus as a comorbidity to temporomandibular disorders-A systematic review. J Oral Rehabil 2018; 46:87-99. [PMID: 30126027 DOI: 10.1111/joor.12710] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 07/30/2018] [Accepted: 08/15/2018] [Indexed: 02/02/2023]
Abstract
The aim of this systematic review was to evaluate the prevalence of tinnitus in patients with temporomandibular disorders (TMD) and the possible effects of TMD treatment on tinnitus symptoms. A search of the PubMed, Web of Science and Cochrane databases from inception of each database up to January 2017 found 222 articles. After independent screening of abstracts by two of the authors, we assessed 46 articles in full text. The inclusion and exclusion criteria reduced these to 25 articles of which 22 studies reported prevalence based on 13 358 patients and 33 876 controls, and eight studies reported effect of TMD treatment on tinnitus based on 536 patients and 18 controls. The prevalence of tinnitus in patients with TMD varied from 3.7% to 70% (median 42.3%) whereas the prevalence in control groups without TMD varied between 1.7% and 26% (median 12%). The eight treatment studies indicated that treatment of TMD symptoms may have a beneficial effect on severity of tinnitus. However, only one treatment study included a control group, meaning that the overall level of evidence is low. The finding that tinnitus is more common in patients with TMD means that it can be regarded as a comorbidity to TMD. However, in view of the lack of evidence currently available, further well-designed and randomised studies with control groups are needed to investigate whether possible mechanisms common to tinnitus and TMD do exist and whether TMD treatment can be justified to try to alleviate tinnitus in patients with TMD and comorbidity of tinnitus.
Collapse
Affiliation(s)
- Caroline Skog
- Department of Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden
| | - Jesper Fjellner
- Department of Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden
| | - EwaCarin Ekberg
- Department of Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden
| | - Birgitta Häggman-Henrikson
- Department of Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden.,Department of Odontology/Clinical Oral Physiology, Umeå University, Umeå, Sweden
| |
Collapse
|
13
|
Temporomandibular disorder: otologic implications and its relationship to sleep bruxism. Braz J Otorhinolaryngol 2018; 84:614-619. [PMID: 28966039 PMCID: PMC9452254 DOI: 10.1016/j.bjorl.2017.07.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 07/09/2017] [Accepted: 07/22/2017] [Indexed: 11/24/2022] Open
Abstract
Introduction Temporomandibular disorder is an umbrella term for various clinical problems affecting the muscles of mastication, temporomandibular joint and associated structures. This disorder has a multifactor etiology, with oral parafunctional habits considered an important co-factor. Among such habits, sleep bruxism is considered a causal agent involved in the initiation and/or perpetuation of temporomandibular disorder. That condition can result in pain otologic symptoms. Objective The aim of the present study was to investigate the relationship between temporomandibular disorder and both otologic symptoms and bruxism. Methods A total of 776 individuals aged 15 years or older from urban areas in the city of Recife (Brazil) registered at Family Health Units were examined. The diagnosis of temporomandibular disorder was determined using Axis I of the Research Diagnostic Criteria for temporomandibular disorders, addressing questions concerning myofascial pain and joint problems (disk displacement, arthralgia, osteoarthritis and osteoarthrosis). Four examiners had previously undergone training and calibration exercises for the administration of the instrument. Intra-examiner and inter-examiner agreement was determined using the Kappa statistic. Individuals with a diagnosis of at least one of these conditions were classified as having temporomandibular disorder. The diagnosis of otologic symptoms and bruxism was defined using the same instrument and a clinical exam. Results Among the individuals with temporomandibular disorder, 58.2% had at least one otologic symptom and 52% exhibited bruxism. Statistically significant associations were found between the disorder and both otologic symptoms and bruxism (p < 0.01 for both conditions; OR = 2.12 and 2.3 respectively). Otologic symptoms and bruxism maintained statistical significance in the binary logistic regression analysis, which demonstrated a 1.7 fold and twofold greater chance of such individuals have temporomandibular disorder, respectively. Conclusion The logistic regression analysis demonstrated strong associations between the disorder and both otologic symptoms and bruxism when analyzed simultaneously, independently of patient age and gender.
Collapse
|
14
|
Demirkol N, Usumez A, Demirkol M, Sari F, Akcaboy C. Efficacy of Low-Level Laser Therapy in Subjective Tinnitus Patients with Temporomandibular Disorders. Photomed Laser Surg 2017; 35:427-431. [PMID: 28294697 DOI: 10.1089/pho.2016.4240] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE AND BACKGROUND Tinnitus is an apparent sound, perceived in the ear with no stimulus. It has been described as a sound originating from the brain. It affects 17% of the general population. Etiological factors for tinnitus include temporomandibular joint disorders (TMJ, TMD) and Costen's syndrome. The aim of treatment is to eliminate the tinnitus or at least decrease its apparent volume. MATERIALS AND METHODS In total, 46 patients referred to our department with bilateral subjective tinnitus with TMDs were selected for this study. Low-level laser therapy (LLLT) with an neodymium-doped yttrium aluminum garnet (Nd:YAG) (1064 nm) laser, LLLT with a diode laser (810 nm), and placebo treatment were applied to the patients. There were 15 patients each in the Nd:YAG and placebo groups and 16 patients in the 810 nm diode laser group. LLLT was applied for 10 days, once per day. A visual analog scale (VAS) was used, with values between 0 and 10. VAS scores were recorded before treatment, on the last day of treatment, and 1 month after treatment. The VAS scores were the same on the last day of treatment and 1 month after treatment. The VAS scores before treatment and at 1 month after treatment were compared in a statistical analysis. RESULTS There were statistically significant differences in the Nd:YAG laser (p = 0.001) and 810 nm diode laser groups (p = 0.005), but no difference in the placebo group (p = 0.065). CONCLUSIONS Both the Nd:YAG and 810 nm diode lasers were effective for the treatment of subjective tinnitus related to TMDs.
Collapse
Affiliation(s)
- Nermin Demirkol
- 1 Department of Prosthodontics, Faculty of Dentistry, Gaziantep University , Gaziantep, Turkey
| | | | - Mehmet Demirkol
- 3 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gaziantep University , Gaziantep, Turkey
| | - Fatih Sari
- 1 Department of Prosthodontics, Faculty of Dentistry, Gaziantep University , Gaziantep, Turkey
| | - Cihan Akcaboy
- 4 Department of Prosthodontics, Faculty of Dentistry, Gazi University , Ankara, Turkey
| |
Collapse
|
15
|
de-Pedro-Herráez M, Mesa-Jiménez J, Fernández-de-Las-Peñas C, de-la-Hoz-Aizpurua JL. Myogenic temporomandibular disorders: Clinical systemic comorbidities in a female population sample. Med Oral Patol Oral Cir Bucal 2016; 21:e784-792. [PMID: 27694784 PMCID: PMC5116122 DOI: 10.4317/medoral.21249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Accepted: 05/24/2016] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Myogenic temporomandibular disorders (MTMD) frequently coexist with other clinical conditions in the same individual. In the last decades, several authors have analyzed these comorbidities looking for the origin of this overlapping. Objetives: The aim of this study was to perform a comparative anaylisis between a group of patients with MTMD and a control group of dental patients without dysfunctional pathology to assess whether there are significant differences in the presence of systemic medical comorbidities between the two groups. MATERIAL AND METHODS Restrospective epidemiological analysis, based on medical questionnaires in a group of 31 patients, women, aged from 24 to 58 (average 39.96 years), diagnosed with MTMD (Masticatory Myofascial Pain), with a control group with the same number of individuals, gender and age range to evaluate if there is a significant statistical difference in the presence of medical comorbidities in this group of patients with MTMD and if they are in a higher risk of suffering different pathological conditions. RESULTS It was found that the group affected by MTMD presented many more associated medical conditions than the control group: health changes during the last year, medical evaluations and treatments, presence of pain, sinus disease, tinnitus, headache, joint pain, ocular disorders, fatigue, dizziness, genitourinary disorders and xerostomia among others; and they were also in a higher risk to suffer other pathological entities as headaches and articular pain. CONCLUSIONS These results reinforce our hypothesis that MTMD belong to a group of medical conditions triggered by a loss of equilibrium of the individual's Psycho-Neuro-Endocrine-Immune (PNEI) Axis that produces alterations in the response against external stimuli in some genetically predisposed individuals. It is, therefore, necessary to change the way of diagnosing and managing these individual's medical conditions, being mandatory to look from a more multidisciplinary perspective than the one we are currently offering.
Collapse
Affiliation(s)
- M de-Pedro-Herráez
- Máster en Dolor Orofacial y Disfunción Craneomandibular, Facultad de Medicina, Universidad CEU San Pablo, Urbanización Montepríncipe 28668, Boadilla del Monte, Madrid, Spain,
| | | | | | | |
Collapse
|
16
|
Costa YM, Porporatti AL, Hilgenberg-Sydney PB, Bonjardim LR, Conti PCR. Deep pain sensitivity is correlated with oral-health-related quality of life but not with prosthetic factors in complete denture wearers. J Appl Oral Sci 2016; 23:555-61. [PMID: 26814457 PMCID: PMC4716693 DOI: 10.1590/1678-775720150174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 07/31/2015] [Indexed: 11/22/2022] Open
Abstract
Low pressure Pain Threshold (PPT) is considered a risk factor for Temporomandibular Disorders (TMD) and is influenced by psychological variables. Objectives To correlate deep pain sensitivity of masticatory muscles with prosthetic factors and Oral-Health-Related Quality of Life (OHRQoL) in completely edentulous subjects. Material and Methods A total of 29 complete denture wearers were recruited. The variables were: a) Pressure Pain Threshold (PPT) of the masseter and temporalis; b) retention, stability, and tooth wear of dentures; c) Vertical Dimension of Occlusion (VDO); d) Oral Health Impact Profile (OHIP) adapted to orofacial pain. The Kolmogorov-Smirnov test, the Pearson Product-Moment correlation coefficient, the Spearman Rank correlation coefficient, the Point-Biserial correlation coefficient, and the Bonferroni correction (α=1%) were applied to the data. Results The mean age (standard deviation) of the participants was of 70.1 years (9.5) and 82% of them were females. There were no significant correlations with prosthetic factors, but significant negative correlations were found between the OHIP and the PPT of the anterior temporalis (r=-0.50, 95% CI-0.73 to 0.17, p=0.005). Discussion The deep pain sensitivity of masticatory muscles in complete dentures wearers is associated with OHRQoL, but not with prosthetic factors.
Collapse
Affiliation(s)
- Yuri Martins Costa
- Departamento de Prótese, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brasil
| | - André Luís Porporatti
- Departamento de Prótese, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brasil
| | | | - Leonardo Rigoldi Bonjardim
- Departamento de Ciências Biologicas, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brasil
| | | |
Collapse
|
17
|
McKelvey L, Shorten GD, O'Keeffe GW. Nerve growth factor-mediated regulation of pain signalling and proposed new intervention strategies in clinical pain management. J Neurochem 2013; 124:276-89. [PMID: 23157347 DOI: 10.1111/jnc.12093] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Revised: 10/16/2012] [Accepted: 11/07/2012] [Indexed: 01/29/2023]
Abstract
Nerve growth factor (NGF) is the founding member of the neurotrophins family of proteins. It was discovered more than half a century ago through its ability to promote sensory and sympathetic neuronal survival and axonal growth during the development of the peripheral nervous system, and is the paradigmatic target-derived neurotrophic factor on which the neurotrophic hypothesis is based. Since that time, NGF has also been shown to play a key role in the generation of acute and chronic pain and in hyperalgesia in diverse pain states. NGF is expressed at high levels in damaged or inflamed tissues and facilitates pain transmission by nociceptive neurons through a variety of mechanisms. Genetic mutations in NGF or its tyrosine kinase receptor TrkA, lead to a congenital insensitivity or a decreased ability of humans to perceive pain. The hereditary sensory autonomic neuropathies (HSANs) encompass a spectrum of neuropathies that affect one's ability to perceive sensation. HSAN type IV and HSAN type V are caused by mutations in TrkA and NGF respectively. This review will focus firstly on the biology of NGF and its role in pain modulation. We will review neuropathies and clinical presentations that result from the disruption of NGF signalling in HSAN type IV and HSAN type V and review current advances in developing anti-NGF therapy for the clinical management of pain.
Collapse
Affiliation(s)
- Laura McKelvey
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | | | | |
Collapse
|