SUMMARY:For many years otic symptoms have been closely observed in TMD clinical practice. This review includes trials that meet eligibility criteria in the field of otic symptoms diagnosed and treated by a stomatognathic focal point. The aim is centered on the implications of the debated cause-effect connection between otic symptoms and TMD offering a probable bond between the TMJ, ear and adjacent structures. The rationalization is based on an embryological and anatomical approach that offers explanations on the otic pathogenic mechanisms symptoms interconnected with TMD. The accompanying reciprocity among disciplines of odontology and otolaryngology is brought together by TMD and otic referred mutual symptomatology as is showed in multiple trials. This research is an attempt that targets the integration of these two health specialties in the diagnosis and treatment of this type of population.
Para los médicos de atención primaria, el paciente con sintomatología compatible con síndromes vestibulares constituye un desafío, debido a su amplia variedad de presentaciones y la dificultad en la diferenciación de las diversas patologías que ocasionan los síntomas. La necesidad de tener conceptos claros y actualizados sobre los mecanismos patológicos del vértigo surge en el momento de evaluar al paciente, para esto es necesario realizar un adecuado interrogatorio y un examen físico neurotológico completo que permita dilucidar un abordaje diagnóstico certero. El objetivo del presente artículo es presentar una revisión de la literatura actual, de las diferentes etiologías desencadenantes del vértigo periférico y a partir de sus características clínicas desarrollar un algoritmo diagnóstico que permita al profesional médico entender el mecanismo patológico del vértigo y proporcionar el tratamiento adecuado.
The disco-malleolar and anterior malleolar ligaments are common to the middle ear, the temporomandibular joint and the jaw, all of them sharing a common embryological origin; these ligaments' morphometric and functional aspects were studied in 23 temporal bones. Experimental design: The epitympanum roof and the temporomandibular joint roof were elevated by micro-dissection of the middle cranial fossa, exposing both disco-malleolar and anterior malleolar ligaments and their association with the malleus, the temporomandibular joint disc and the mandibular lingula. Principal observations: Both ligaments start in the malleus and take anterior and divergent routes towards the temporomandibular joint and lingula, passing through Huguier's canal. The disco-malleolar and anterior malleolar ligaments' mean lengths were 6.88 mm (SD 0.81) and 4.22mm (SD 1.17), respectively, no statistically significant difference being revealed between the sides. Temporomandibular joint disc traction was applied for verifying malleus mobility; malleus movement was observed when applying disco-malleolar traction in 30.5% of the samples. Correlation was observed between malleus movement and disco-malleolar length (R2=-0.499, p<0.05). Both ligaments common to the stomatognathic system and middle ear were present in all specimens. Conclusions: There was an anatomical and functional relationship between human TMJ and the middle ear.
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