Tinnitus in patients with temporo-mandibular joint disorder: Proposal for a new treatment protocol

Attanasio, Giuseppe; Leonardi, Alessandra; Arangio, Paolo; Minni, Antonio; Covelli, Edoardo; Pucci, Resi; Russo, Francesca; Seta, Elio De; Paolo, Carlo Di; Cascone, Piero

doi:10.1016/j.jcms.2015.02.009

Cited by 27 publications

(49 citation statements)

References 19 publications

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“…One form of TMD treatment is occlusal splint therapy (Attanasio et al, 2015). In their study involving this treatment in patients presenting with chronic subjective tinnitus Attanasio et al (2015) divided patients into three groups according to whether TMD was absent, present, or the patient was considered predisposed to TMD.…”

Section: Resultsmentioning

confidence: 99%

“…In their study involving this treatment in patients presenting with chronic subjective tinnitus Attanasio et al (2015) divided patients into three groups according to whether TMD was absent, present, or the patient was considered predisposed to TMD. Patients were subjected to treatment with a neuromuscular occlusal splint for 6 months (using the splint at night time) and rated for the severity of tinnitus using 10-point visual analog scale and Tinnitus Handicap Inventory (THI; Newman et al, 2004) questionnaire.…”

Section: Resultsmentioning

confidence: 99%

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Pathophysiology, Diagnosis and Treatment of Somatosensory Tinnitus: A Scoping Review

Haider¹,

Hoare

Costa

et al. 2017

Front. Neurosci.

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Somatosensory tinnitus is a generally agreed subtype of tinnitus that is associated with activation of the somatosensory, somatomotor, and visual-motor systems. A key characteristic of somatosensory tinnitus is that is modulated by physical contact or movement. Although it seems common, its pathophysiology, assessment and treatment are not well defined. We present a scoping review on the pathophysiology, diagnosis, and treatment of somatosensory tinnitus, and identify priority directions for further research.Methods: Literature searches were conducted in Google Scholar, PubMed, and EMBASE databases. Additional broad hand searches were conducted with the additional terms etiology, diagnose, treatment.Results: Most evidence on the pathophysiology of somatosensory tinnitus suggests that somatic modulations are the result of altered or cross-modal synaptic activity within the dorsal cochlear nucleus or between the auditory nervous system and other sensory subsystems of central nervous system (e.g., visual or tactile). Presentations of somatosensory tinnitus are varied and evidence for the various approaches to treatment promising but limited.Discussion and Conclusions: Despite the apparent prevalence of somatosensory tinnitus its underlying neural processes are still not well understood. Necessary involvement of multidisciplinary teams in its diagnosis and treatment has led to a large heterogeneity of approaches whereby tinnitus improvement is often only a secondary effect. Hence there are no evidence-based clinical guidelines, and patient care is empirical rather than research-evidence-based. Somatic testing should receive further attention considering the breath of evidence on the ability of patients to modulate their tinnitus through manouvers. Specific questions for further research and review are indicated.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Pathophysiology, Diagnosis and Treatment of Somatosensory Tinnitus: A Scoping Review

Haider¹,

Hoare

Costa

et al. 2017

Front. Neurosci.

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“…Anatomical theory: based on anatomical contiguity between auricular-temporal nerve and the condyle-disc complex, widely discussed in the literature, Cascone 18,19 has recently recovered the value of the theory for potential situations of "impingement" at the anteromedial subluxation of TMJ disc, possibly at the base of atypical trigeminal symptoms. In fresh adult cadavers, the demonstration of the close anatomic relationship between the course of the auriculo-temporal nerve and anterior and medial aspect of the joint capsule of the TMJ may in fact explain the extension by contiguity of the effects of TMD on the territory of the trigeminal competence 20 .…”

Section: Resultsmentioning

confidence: 99%

Tinnitus in Temporomandibular Joint Disorders: Is it a Specific Somatosensory Tinnitus Subtype?

Algieri¹,

Leonardi

Arangio

et al. 2016

The International Tinnitus Journal

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The most significant otologic symptoms, consisting of ear pain, tinnitus, dizziness, hearing loss and auricolar "fullness", generally arise within the auditory system, often are associated with extra auricolar disorders, particularly disorder of the temporo-mandibular joint. In our study we examined a sample of 200 consecutive patients who had experienced severe disabling symptom. The patiens came to maxillofacial specialist assessment for temporomandibular disorder. Each patient was assessed by a detailed anamnestic and clinical temporomandibular joint examination and they are divided into five main groups according classification criteria established by Wilkes; tinnitus and subjective indicators of pain are evaluated. The results of this study provide a close correlation between the joint pathology and otologic symptoms, particularly regarding tinnitus and balance disorders, and that this relationship is greater the more advanced is the stage of joint pathology. Moreover, this study shows that TMD-related tinnitus principally affects a younger population (average fifth decade of life) and mainly women (more than 2/3 of the cases). Such evidence suggests the existence of a specific tinnitus subtype that may be defined as "TMD-related somatosensory tinnitus".

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“…Only after such an assessment, it was possible to perform orthodontic, gnathologic, and surgical treatment in a balanced manner for any patient. [252627282930]…”

Section: Discussionmentioning

confidence: 99%

Evaluation of temporomandibular disorders before and after orthognathic surgery: Therapeutic considerations on a sample of 76 patients

Paolo¹,

Pompa²,

Arangio³

et al. 2017

J Int Soc Prevent Communit Dent

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Objectives:Temporomandibular disorders may be associated with dental and facial malformations. The aim of this study is to record the prevalence of TMDs in patients scheduled for orthognathic surgery, reporting the development of TMDs and symptoms during the entire period of the treatment, and demonstrating the benefits of a team effort on this population.Materials and Methods:Assessment of temporomandibular status was performed using the RDC/TMD criteria at T0 (prior to orthodontic therapy), T1 (3 months after the surgery), and T2 post-therapeutic cycle (6 to 12 months postoperatively). A total of 76 participants were included in the study; all the patients underwent surgical treatment: 12 had bilateral sagittal split osteotomy, 6 with condylar position devices; 64 had Le Fort I + bilateral sagittal split osteotomy, and 15 with condylar position devices. Results were evaluated with a paired-sample t-test and segmentation analysis.Results:Forty-seven patients were affected by TMDs. At T0, 25 patients experienced TMJ pain, 27 had muscular pain, 31 suffered headaches, 42 had disc dislocation with reduction, and 5 were affected by disc dislocation without reduction. Thirty-five patients had occlusal signs of parafunctions, 8 reported tinnitus, and 7 dizziness. At T1, TMJ pain changed from 33.3% to 4.44%, muscular pain changed from 35.5% to 11.1%, headaches improved from 40% to 6.67%, and disc dislocation from 55.2% to 17.7%. Segmentation analysis highlighted improvement after therapy; 57 patients were considered recovered, 14 improved, none were considered stable, whereas 5 patients demonstrated some worsening, 3 of whom had not presented disc dislocation before surgery. At T2, 71 patients were considered completely recovered or improved.Conclusions:Our data indicates beyond any doubt that both functional status and pain levels related to TMDs can be significantly improved with a multi-disciplinary approach. We concluded that surgeon's intervention need to be modified in the presence of presurgical TMDs.

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Tinnitus in patients with temporo-mandibular joint disorder: Proposal for a new treatment protocol

Cited by 27 publications

References 19 publications

Pathophysiology, Diagnosis and Treatment of Somatosensory Tinnitus: A Scoping Review

Pathophysiology, Diagnosis and Treatment of Somatosensory Tinnitus: A Scoping Review

Tinnitus in Temporomandibular Joint Disorders: Is it a Specific Somatosensory Tinnitus Subtype?

Evaluation of temporomandibular disorders before and after orthognathic surgery: Therapeutic considerations on a sample of 76 patients

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