Theories on Otic Symptoms in Temporomandibular Disorders: Past and Present

Abstract

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.

Otologic symptomatology associated with the temporomandibular joint disorder

“…Masseter and ear muscles have a common embryological origin, the first pharyngeal arch being mentioned in studies as a factor contributing to this correlation between otological symptoms and TMJ pathology 10,11 . Muscle involvement in the occurrence of otic symptomatology in patients with TMJ pathology is supported by many other studies 6,[19][20][21] . Also, edentation, pathological attrition or occlusal trauma may be factors contributing to a posterior posi- tion of the mandibular condyle, causing compression of the tympanic artery and vein.…”

“…In their study, Ren and Isberg show a significant correlation between the unilateral presence of tinnitus and the movement of the condyle from the temporomandibular joint 12 . Another theory invokes the irritating potential of the mandibular condyle on the auriculotemporal nerve 6,13 . Frequent mention is also made of the common innervation of the mandibular muscles and the tensor tympani muscle 14,15 .…”

“…One of these is based on the possibility of mechanical transmission of forces from the temporomandibular joint to the middle ear, via the discomalleolar ligament 6,12 . In their study, Ren and Isberg show a significant correlation between the unilateral presence of tinnitus and the movement of the condyle from the temporomandibular joint 12 .…”

“…Referring to the literature, one can say that the temporomandibular joint disorder (TMJD) is accompanied by a series of otological symptoms such as otalgia, tinnitus and vertigo [1][2][3][4][5][6][7][8] . For this reason, for a correct diagnosis, a complex clinical examination is required both on the acoustic-vestibular analyzer and on neighbouring structures.…”

Acoustic shock injury (ASI)

“…Additionally, there is evidence that the tensor tympani contracts immediately preceding the sounds produced during selfvocalization [15,16]. This pre-vocalization reflex, implicated as a mechanism to prevent over-stimulation of the cochlea by the sounds produced by the voice, suggests that the tensor tympani has an established protective function.…”