TMJ Disorder Complaints in Tinnitus: Further Hints for a Putative Tinnitus SubType

http://www.ncbi.nlm.nih.gov/pubmed/22723902

Abstract​

OBJECTIVE:​

Tinnitus is considered to be highly heterogeneous with respect to its etiology, its comorbidities and the response to specific interventions. Subtyping is recommended, but it remains to be determined which criteria are useful, since it has not yet been clearly demonstrated whether and to which extent etiologic factors, comorbid states and interventional response are related to each other and are thus applicable for subtyping tinnitus. Analyzing the Tinnitus Research Initiative Database we differentiated patients according to presence or absence of comorbid temporomandibular joint (TMJ) disorder complaints and compared the two groups with respect to etiologic factors.​

METHODS:​

1204 Tinnitus patients from the Tinnitus Research Initiative (TRI) Database with and without subjective TMJ complaints were compared with respect to demographic, tinnitus and audiological characteristics, questionnaires, and numeric ratings. Data were analysed according to a predefined statistical analysis plan.​

RESULTS:​

Tinnitus patients with TMJ complaints (22% of the whole group) were significantly younger, had a lower age at tinnitus onset, and were more frequently female. They could modulate or mask their tinnitus more frequently by somatic maneuvers and by music or sound stimulation. Groups did not significantly differ for tinnitus duration, type of onset (gradual/abrupt), onset related events (whiplash etc.), character (pulsatile or not), hyperacusis, hearing impairment, tinnitus distress, depression, quality of life and subjective ratings (loudness etc.).​

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CONCLUSION:​

Replicating previous work in tinnitus patients with TMJ complaints, classical risk factors for tinnitus like older age and male gender are less relevant in tinnitus patients with TMJ complaints. By demonstrating group differences for modulation of tinnitus by movements and sounds our data further support the notion that tinnitus with TMJ complaints represents a subgroup of tinnitus with clinical features that are highly relevant for specific therapeutic management.​

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I wonder what kind of therapeutic management since this is type I have....​

 

Subtyping of tinnitus seems to me to be a largely unfooted field.^

 

I found this about TMJ today.

Association Between Tinnitus and Temporomandibular Disorders: A Systematic Review and Meta-Analysis
https://doi.org/10.1177/0003489419842577

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.

 

I found this today about TMJ and tinnitus.
The structure that connect tmj and middle ear: petrotympanic fissure. correlation between anatomy, function and aural symptoms
Impossible to copy and paste, so below is the link:
https://www.ijoms.com/article/S0901-5027(19)30968-3/abstract

 

The article is inline with Science Direct.
From Science Direct.
When asked to indicate the location of pain, patients with TMJ pain typically point to a small area in front of the ear, whereas the myalgia patient will place his or her hands over the entire side of the face, Myalgia is pain originating in the muscles of mastication and differs from TMJ.

Myalgia does not cause tinnitus.

 

Autonomic and Psychologic Risk Factors for Development of Tinnitus in Patients with Chronic Temporomandibular Disorders.
https://europepmc.org/abstract/med/31247060
DOI: 10.11607/ofph.2237

Abstract
AIMS:To investigate the roles of autonomic regulation and psychologic condition in the development of tinnitus in patients with chronic temporomandibular disorders (TMD).

METHODS:In total, 55 participants (mean age 36.4 ± 12.6 years; 7 men, 48 women) were involved: 13 with no signs of painful TMD or tinnitus (CON), 15 with painful TMD without tinnitus (pTMD), and 27 with both painful TMD and tinnitus (TMDTIN). The Research Diagnostic Criteria for TMD and the Tinnitus Handicap Inventory (THI) were used to classify painful TMD and self-reported tinnitus, respectively. Measures of arterial heart rate (HR) and blood pressure (BP) were assessed at rest and in response to orthostatic challenges, cold-stress vasoconstriction, Valsalva maneuver, and psychologic stress. The sympathetic variables (BP responses to standing, cold stress, and psychologic stress) and parasympathetic variables (HR response to Valsalva maneuver [Valsalva ratio] and active standing [30:15 ratio]) were estimated.

RESULTS: Parasympathetic measures demonstrated significant differences between pTMD and TMDTIN. The period of pain duration showed significant positive correlations with BP variables during orthostatic challenges and/or cold stress in both pTMD and TMDTIN. THI scores showed significant positive correlations with results from the psychologic analysis. The range of motion of the mandible demonstrated a greater correlation with results from the psychologic analysis in TMDTIN compared to pTMD.

CONCLUSION: Dysregulated psychophysiologic interactions may affect the development of tinnitus in patients with chronic TMD.

 

Thanks for your interesting articles @Frédéric. I have had TMJ for years.