Otalgia in patients with temporomandibular joint disorders

Abstract

Otalgia without organic causes is a common symptom in temporomandibular dysfunction (TMD) patients even though the etiology is controversial. Investigations of the influence of TMD treatment on otalgia are scarce. This follow-up study analyzed the clinical profile of TMD patients with otalgia and evaluated the treatment outcome. A total of 400 consecutive TMD patients (75% women) were divided in two groups: group 1 consisted of 233 patients (58%) with no complaint of ear symptoms and group 2 consisted of 167 patients (42%) with complaints of otalgia. The patients were examined with a standardized protocol and treated similarly with conservative methods. Group 2 was referred and examined by otolaryngologists. Otalgia patients (group 2) had statistically significantly higher pain scores ( p 0.02). They belonged to the greater dysfunction scores (Di III) according to the Helkimo Pain and Dysfunction index (41% vs. 24%; p < 0.001). There was a statistically significant association with pain on condyle palpation and otalgia ( p < 0.01). One year after the first examination, the patients exhibited no pain or occasionally mild pain in 66% (group 1) and 74% (group 2) ( p 0.35). Of the otalgia patients, 48% no longer had otalgia and 32% of the patients experienced mild or occasional otalgia. The changes in dysfunction scores after 1 year revealed significant improvement. No difference was found between group 1 and 2 in pain and dysfunction score. For the dysfunction index readings 0 and I,77% and 73% had no or only mild symptoms (Di 0 and I). The conclusions of this study are that TMD patients with otalgia are not a separate TMD group and they responded well to conservative treatment.