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Yu HZ, Gong JM, Hong GW, Zhou RQ, Fu XP, Fan T, Zheng YQ, Peng YQ, Li J, Wang YF. The Effect of Physical Therapy on Somatosensory Tinnitus. J Clin Med 2024; 13:3496. [PMID: 38930025 PMCID: PMC11204550 DOI: 10.3390/jcm13123496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/01/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open
Abstract
Objective: The objective of this work was to assess the effect of physical therapy in patients with somatosensory tinnitus (ST) and explore the influence of physical therapy on clinical variables obtained before treatment. Methods: A total of 43 patients with ST were randomized to the immediate-start group (n = 20) and delayed-start group (n = 23). All patients received physical therapy for 1 week (seven sessions). Each session lasted 60 min. The Visual Analogue Scale (VAS), Tinnitus Handicap Inventory (THI), and numerical pain rating scale (NPRS) scores were documented at baseline and after treatment (week 1) for all patients. For subjects in the immediate-start group, the THI, VAS, and NPRS scores were measured after therapy (weeks 6, 9, and 12, respectively). Medical history characteristic functional activity scale (HCFA) scores were measured at baseline to assess the association between somatic symptoms and tinnitus. Results: At week 1, VAS, THI, and NPRS scores of patients in the immediate-start group were improved by 1.25 ± 1.59, 11.10 ± 15.10, and 0.95 ± 1.54 points, respectively, and were significantly higher than those in the delayed-start group (p < 0.05). The change in VAS, THI, and NPRS scores in the treatment group was significantly positively correlated with the scores of the HCFA before treatment (r = 0.786, p < 0.001; r = 0.680, p = 0.001; r = 0.796, p < 0.001). There was no significant difference in THI, VAS, and NPRS scores among patients in the immediate-start group between weeks 1, 6, 9, and 12 after treatment (p > 0.05). Conclusions: Although more participants were necessary in the further study, the study implies that physical therapy can reduce physical pain, improve tinnitus symptoms, and quality of life in ST patients without hearing loss, and the short-term curative effect is stable, especially for tinnitus patients with clear somatic symptoms.
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Affiliation(s)
- Hong-Zhe Yu
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (H.-Z.Y.); (J.-M.G.); (G.-W.H.); (R.-Q.Z.); (X.-P.F.); (T.F.); (Y.-Q.P.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Jia-Min Gong
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (H.-Z.Y.); (J.-M.G.); (G.-W.H.); (R.-Q.Z.); (X.-P.F.); (T.F.); (Y.-Q.P.)
| | - Guo-Wei Hong
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (H.-Z.Y.); (J.-M.G.); (G.-W.H.); (R.-Q.Z.); (X.-P.F.); (T.F.); (Y.-Q.P.)
| | - Ruo-Qiao Zhou
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (H.-Z.Y.); (J.-M.G.); (G.-W.H.); (R.-Q.Z.); (X.-P.F.); (T.F.); (Y.-Q.P.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Xin-Ping Fu
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (H.-Z.Y.); (J.-M.G.); (G.-W.H.); (R.-Q.Z.); (X.-P.F.); (T.F.); (Y.-Q.P.)
| | - Ting Fan
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (H.-Z.Y.); (J.-M.G.); (G.-W.H.); (R.-Q.Z.); (X.-P.F.); (T.F.); (Y.-Q.P.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Yu-Qing Zheng
- Department of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou 310053, China;
| | - Ying-Qiu Peng
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (H.-Z.Y.); (J.-M.G.); (G.-W.H.); (R.-Q.Z.); (X.-P.F.); (T.F.); (Y.-Q.P.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Jian Li
- Clinical Laboratory Center, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai 201102, China
| | - Yun-Feng Wang
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (H.-Z.Y.); (J.-M.G.); (G.-W.H.); (R.-Q.Z.); (X.-P.F.); (T.F.); (Y.-Q.P.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
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Cardon E, Jacquemin L, Vermeersch H, Joossen I, Moyaert J, Mertens G, Vanderveken OM, Lammers MJW, Van de Heyning P, Van Rompaey V, Gilles A. Dual-site transcranial direct current stimulation to treat tinnitus: a randomized controlled trial. Brain 2022; 145:4222-4231. [PMID: 36450310 PMCID: PMC9762937 DOI: 10.1093/brain/awac263] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/17/2022] [Accepted: 07/03/2022] [Indexed: 12/03/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) has been proposed as a potential intervention for subjective tinnitus, but supporting evidence remains limited. We aimed to investigate the effect of anodal high-definition tDCS of the left temporal area and right dorsolateral prefrontal cortex on tinnitus severity. This double-blind randomized controlled trial included 77 patients (age range 18-79, 43 male) with chronic subjective tinnitus as their primary complaint. Thirty-eight subjects received six consecutive sessions of dual-site sequential high-definition-tDCS with electrodes positioned over the left temporal area and right dorsolateral prefrontal cortex. Both areas were stimulated for 15 min per session, with total stimulation time amounting to 30 min. Thirty-nine subjects received sham stimulation. The primary outcome measure was the change in tinnitus severity, as evaluated by the Tinnitus Functional Index, from baseline to a follow-up visit at 8 ± 2 weeks after treatment completion. Secondary outcomes included changes in perceived tinnitus loudness, as measured with a visual analogue scale and a tinnitus matching procedure, as well as scores on the Hospital Anxiety and Depression Scale, and the Hyperacusis Questionnaire. No differences in Tinnitus Functional Index change scores were identified between the active treatment and sham control groups (linear regression: P = 0.86). The Tinnitus Functional Index scores decreased significantly over time in both groups (P = 0.0012), indicating the presence of a considerable placebo effect. These change scores were significantly influenced by sex (linear regression: P = 0.037) and baseline symptoms of anxiety (linear regression: P = 0.049) in both groups. In general, Tinnitus Functional Index scores decreased more profoundly in males and in subjects with a higher degree of anxiety at baseline. None of the included secondary measures differed significantly between experimental arms. Our results suggest that dual-site sequential high-definition-tDCS of the left temporal area and right dorsolateral prefrontal cortex does not alleviate tinnitus severity. Interestingly, in our study population, fluctuations in tinnitus severity were influenced by gender and concurrent mental condition. It is therefore important to take these factors into account when conducting or planning randomized controlled trials in tinnitus populations.
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Affiliation(s)
- Emilie Cardon
- Correspondence to: Emilie Cardon Department of Translational Neuroscience, Faculty of Medicine and Health Science University of Antwerp, Campus Drie Eiken, Antwerp, Belgium E-mail:
| | - Laure Jacquemin
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Hanne Vermeersch
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Iris Joossen
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Julie Moyaert
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Griet Mertens
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Olivier M Vanderveken
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Marc J W Lammers
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Paul Van de Heyning
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Vincent Van Rompaey
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Annick Gilles
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium,Department of Education, Health and Social Work, University College Ghent, Ghent, Belgium
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Theodoroff SM, McMillan GP, Frederick MT, Random C, Thielman E, Vergis S, Cherian K, Cherian N. Prevalence of Somatosensory Tinnitus in Veterans With Tinnitus. Ear Hear 2022; 43:1593-1596. [PMID: 35234171 DOI: 10.1097/aud.0000000000001210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The primary objective was to estimate the prevalence of somatosensory tinnitus (ST) among Veterans with tinnitus. DESIGN Three hundred four Veterans with tinnitus were phone screened for ST by performing and reporting on a series of head/neck/jaw maneuvers. A random sample of 12 individuals who screened positive and five who screened negative attended an in-person visit to confirm the presence/absence of ST. RESULTS Of the 304 Veterans, 12 could not complete the screening maneuvers, 205 screened positive, and 87 screened negative. A Bayesian estimator that combines phone screening and in-person exam results establishes the prevalence of ST among Veterans with tinnitus at 56% with a 90% Bayesian confidence interval of 45% to 65%. CONCLUSIONS At least half of Veterans with tinnitus have ST, suggesting that a sizable at-need population exists. Treatment addressing the biomechanical component has the potential to improve tinnitus symptoms.
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Affiliation(s)
- Sarah M Theodoroff
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon, USA
- Oregon Health & Science University, Department of Otolaryngology - Head & Neck Surgery, Portland, Oregon, USA
| | - Garnett P McMillan
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon, USA
| | - Melissa T Frederick
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon, USA
| | - Chan Random
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon, USA
| | - Emily Thielman
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon, USA
| | - Shiny Vergis
- VA Portland Health Care System, Physical Medicine and Rehabilitation Service, Portland, Oregon, USA
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The Rapid Screening for Somatosensory Tinnitus Tool: a Data-Driven Decision Tree Based on Specific Diagnostic Criteria. Ear Hear 2022; 43:1466-1471. [DOI: 10.1097/aud.0000000000001224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Random Forest Classification to Predict Response to High-Definition Transcranial Direct Current Stimulation for Tinnitus Relief: A Preliminary Feasibility Study. Ear Hear 2022; 43:1816-1823. [PMID: 35666538 PMCID: PMC9592176 DOI: 10.1097/aud.0000000000001246] [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] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Transcranial direct current stimulation (tDCS) of the right dorsolateral prefrontal cortex has been hypothesized to reduce tinnitus severity by modifying cortical activity in brain regions associated with the perception of tinnitus. However, individual response to tDCS has proven to be variable. We investigated the feasibility of using random forest classification to predict the response to high-definition (HD) tDCS for tinnitus relief. DESIGN A retrospective analysis was performed on a dataset consisting of 99 patients with subjective tinnitus receiving six consecutive sessions of HD-tDCS at the Antwerp University Hospital. A baseline assessment consisted of pure-tone audiometry and a set of questionnaires including the Tinnitus Functional Index (TFI), Hospital Anxiety and Depression Scale, and Edinburgh Handedness Inventory. Random forest classification was applied to predict, based on baseline questionnaire scores and hearing levels, whether each individual responded positively to the treatment (defined as a decrease of at least 13 points on the TFI). Further testing of the model was performed on an independent cohort of 32 patients obtained from the tinnitus center at the University of Regensburg. RESULTS Twenty-four participants responded positively to the HD-tDCS treatment. The random forest classifier predicted treatment response with an accuracy of 85.71% (100% sensitivity, 81.48% specificity), significantly outperforming a more traditional logistic regression approach. Performance of the classifier on an independent cohort was slightly but not significantly above chance level (71.88% accuracy, 66.67% sensitivity, 73.08% specificity). Feature importance analyses revealed that baseline tinnitus severity, co-occurrence of depressive symptoms and handedness were the most important predictors of treatment response. Baseline TFI scores were significantly higher in responders than in nonresponders. CONCLUSIONS The proposed random forest classifier predicted treatment response with a high accuracy, significantly outperforming a more traditional statistical approach. Machine learning methods to predict treatment response might ultimately be used in a clinical setting to guide targeted treatment recommendations for individual tinnitus patients.
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Demoen S, Jacquemin L, Timmermans A, Van Rompaey V, Vanderveken O, Vermeersch H, Joossen I, Van Eetvelde J, Schlee W, Marneffe W, Luyten J, Gilles A, Michiels S. Cost-effectiveness of a smartphone Application for Tinnitus Treatment (the CATT trial): a study protocol of a randomised controlled trial. Trials 2022; 23:435. [PMID: 35606823 PMCID: PMC9125968 DOI: 10.1186/s13063-022-06378-7] [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: 02/18/2022] [Accepted: 05/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tinnitus is a highly prevalent symptom, affecting 10-15% of the adult population. Tinnitus influenced by alterations in somatosensory afference from the neck or jaw is referred to as somatic tinnitus (ST). ST is known to respond positively to physiotherapy treatment; however, it is challenging to motivate patients to systematically perform home exercises correctly, and the necessary tinnitus counselling is often lacking. The aim of this study is twofold, namely to investigate both the effectiveness and cost-effectiveness of a blended physiotherapy program for ST, including a smartphone application designed to increase exercise therapy compliance and provide tinnitus counselling. METHODS This study is designed as a single-blind two-arm 1:1 randomised controlled trial (RCT). Adult patients diagnosed with ST, without psychiatric comorbidities and with experience in using a smartphone, will be recruited at the Ear Nose Throat (ENT) department of the Antwerp University Hospital (UZA). Patients will be randomised into two groups. The experimental group will receive the blended physiotherapy program comprising six in-clinic physiotherapy sessions over a period of 12 weeks (1x/2 weeks) and an exercise and counselling program provided by the smartphone application. The control group will receive the standard care program comprising twelve weekly in-clinic physiotherapy sessions. Each physiotherapy session has a duration of 30 min. The primary outcome measure is the change in Tinnitus Functional Index (TFI) score. Additionally, a cost-effectiveness analysis will be performed from a societal perspective considering both direct and indirect costs. There will be follow-up assessments at one and 3 months after the final treatment session. DISCUSSION Our study is the first to combine both tinnitus counselling and neck/jaw treatment provided by a digital application in a blended physiotherapy program. This, in order to empower ST patients to improve and better manage their own health and, possibly, reduce economic costs by alleviating the tinnitus burden that ST patients experience. The strengths of the planned RCT are the high-quality methodological design, the large sample size and the expertise of the involved multidisciplinary research team. TRIAL REGISTRATION Clinicaltrials.gov NCT05245318 . Registered on 26 January 2022.
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Affiliation(s)
- Sara Demoen
- Rehabilitation Research Center, REVAL, faculty of Rehabilitation Sciences, Hasselt University, 3500, Hasselt, Belgium. .,Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, 2650, Edegem, Belgium. .,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University Antwerp, 2000, Antwerp, Belgium.
| | - Laure Jacquemin
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, 2650, Edegem, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University Antwerp, 2000, Antwerp, Belgium
| | - Annick Timmermans
- Rehabilitation Research Center, REVAL, faculty of Rehabilitation Sciences, Hasselt University, 3500, Hasselt, Belgium
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, 2650, Edegem, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University Antwerp, 2000, Antwerp, Belgium
| | - Olivier Vanderveken
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, 2650, Edegem, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University Antwerp, 2000, Antwerp, Belgium
| | - Hanne Vermeersch
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, 2650, Edegem, Belgium
| | - Iris Joossen
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, 2650, Edegem, Belgium
| | - Julie Van Eetvelde
- Rehabilitation Research Center, REVAL, faculty of Rehabilitation Sciences, Hasselt University, 3500, Hasselt, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, 2650, Edegem, Belgium
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053, Regensburg, Germany
| | - Wim Marneffe
- Faculty of Business Economics, Hasselt University, 3500, Hasselt, Belgium
| | - Janis Luyten
- Faculty of Business Economics, Hasselt University, 3500, Hasselt, Belgium
| | - Annick Gilles
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, 2650, Edegem, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University Antwerp, 2000, Antwerp, Belgium.,Department of Human and Social Welfare, University College Ghent, 9000, Ghent, Belgium
| | - Sarah Michiels
- Rehabilitation Research Center, REVAL, faculty of Rehabilitation Sciences, Hasselt University, 3500, Hasselt, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, 2650, Edegem, Belgium
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van der Wal A, Michiels S, Van de Heyning P, Gilles A, Jacquemin L, Van Rompaey V, Braem M, Visscher CM, Topsakal V, Truijen S, De Hertogh W. Reduction of Somatic Tinnitus Severity is Mediated by Improvement of Temporomandibular Disorders. Otol Neurotol 2022; 43:e309-e315. [PMID: 35020685 DOI: 10.1097/mao.0000000000003446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Successful orofacial treatment can reduce tinnitus severity in patients with somatic tinnitus (ST). However, it is still unclear to what extent the degree of reduction in temporomandibular disorders (TMD) actually contributes to the decrease in tinnitus severity after orofacial treatment. Therefore, the aim of this study was to analyze the mediating effect of reduction in TMD pain on the improvement of tinnitus severity after multidisciplinary orofacial treatment. METHODS A total of 80 patients with moderate to severe ST attributed to the temporomandibular region, were recruited from a tertiary tinnitus clinic. At baseline, patients were randomly assigned to the orofacial treatment group or to the control group. Both groups received a minimum of information and advice regarding their tinnitus complaints. The orofacial treatment group received orofacial physical therapy complemented with occlusal splints when needed, while the control group received no other treatment. A mediation analysis was performed according to the steps described by Baron and Kenny and the proportion of the mediating effect was calculated for the potential mediator: "change in TMD pain," measured by a one-point decrease in TMD pain screener score. RESULTS Our analysis showed that 35% of the observed decrease in tinnitus severity can be attributed to a reduction in TMD pain. A significant total effect of orofacial treatment compared with control on the change in tinnitus functional index (TFI) score was found (B = 0.253 p = 0.025 Cl for B = 1.265-18.576). Orofacial treatment was also significantly related to the change in TMD pain (Exp (B) = 2.800, p = 0.034 Cl for Exp B 1.081-7.251). Additionally, the change in TMD pain screener score was significantly related to the change in TFI score (B = -0.273 p = 0.016 Cl for B = -19.875 to -2.119). CONCLUSION Reduction of TMD pain is a mediating factor in the decrease of tinnitus severity after multidisciplinary orofacial treatment. PRACTICAL IMPLICATIONS Orofacial treatment can be used to decrease tinnitus severity in patients with TMD related somatic tinnitus.
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Affiliation(s)
- Annemarie van der Wal
- Department of Rehabilitation Sciences and Physiotherapy
- Department of Otorhinolaryngology, Antwerp University Hospital
| | - Sarah Michiels
- Department of Rehabilitation Sciences and Physiotherapy
- Department of Otorhinolaryngology, Antwerp University Hospital
- Faculty of Rehabilitation Sciences, REVAL, University of Hasselt, Hasselt
- Department of Translational Neurosciences
| | - Paul Van de Heyning
- Department of Otorhinolaryngology, Antwerp University Hospital
- Department of Translational Neurosciences
| | - Annick Gilles
- Department of Otorhinolaryngology, Antwerp University Hospital
- Department of Translational Neurosciences
| | - Laure Jacquemin
- Department of Otorhinolaryngology, Antwerp University Hospital
- Department of Translational Neurosciences
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology, Antwerp University Hospital
- Department of Translational Neurosciences
| | - Marc Braem
- Lab Dental Materials
- Special Care Dentistry, University Hospital Antwerp, Edegem
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp
| | - Corine Mirjam Visscher
- Department of Oral Health Sciences, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Research Institute MOVE Amsterdam, Amsterdam, The Netherlands
| | - Vedat Topsakal
- Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Brussels, Free University Brussels, Brussels Health Campus Belgium, Jette, Belgium
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