Abstract
IntroductionSubjective tinnitus that is influenced by the somatosensory system is called somatosensory tinnitus (ST). When ST is related to the temporomandibular area, multidisciplinary orofacial treatment can reduce tinnitus severity. It is, however, unknown if we can predict this positive outcome. The aim of this study is to look for prognostic indicators that can predict a positive outcome after multidisciplinary orofacial treatment in patients with ST.MethodsPatients were included when they were diagnosed with temporomandibular-related ST and received a maximum of 18 sessions of orofacial treatment during a 9-week program. Predictors for positive treatment outcome were identified using univariate and multiple logistic regression analyses with the Tinnitus Questionnaire (TQ) and the Tinnitus Functional Index (TFI) as dependent variables.ResultsThe results of 101 patients were included in the analysis. Immediately after multidisciplinary orofacial treatment, a clinically relevant decrease in TQ score was significantly associated with “shorter duration of tinnitus” [odds ratio (OR) 0.99], “higher initial score on the TQ somatic subscale” (OR 1.52), and “painful palpation of the temporomandibular joint (TMJ)” (OR 2.46). After 9 weeks of follow-up, the “higher initial score on the TQ somatic subscale” remained as the sole predictor (OR 1.44). A clinically relevant decrease on TFI after 9 weeks of follow-up was predicted by “female gender” (OR 2.70), “younger age” (OR 0.96), “shorter duration of the tinnitus” (OR 0.99), “lower pressure pain thresholds (PPT) on TMJ” (OR 0.99), “lower PPT on sternocleidomastoid origin” (OR 0.99), and “better speech in noise perception” (OR 0.88). A multivariate model comprising “shorter duration of tinnitus” and “higher initial score on the somatic subscale of the TQ” correctly predicts the clinically relevant decrease in TQ score after treatment in 68.5%. A second multivariate model comprising “female gender,” “younger age,” and “shorter duration of the tinnitus” correctly predicts a clinically significant decrease on TFI after follow-up in 68.1%.ConclusionWe were able to identify various prognostic indicators. “Younger female patients” with a “shorter duration of tinnitus” and a “higher initial score on the TQ somatic subscale” appear to have the best prognosis after multimodal orofacial therapy.
Highlights
Subjective tinnitus that is influenced by the somatosensory system is called somatosensory tinnitus (ST)
We used data collected for a randomized controlled trial (RCT) (80 patients) investigating the effect of multidisciplinary orofacial treatment
Most patients (81.2%) were diagnosed with myalgia, and 24.8% of the patients had both myalgia and arthralgia according to the DC-temporomandibular disorders (TMD) (Schiffman et al, 2014)
Summary
Subjective tinnitus that is influenced by the somatosensory system is called somatosensory tinnitus (ST). The perception of tinnitus is not constant and can vary (Schlee et al, 2016) This fluctuation of tinnitus can depend on various factors, such as stress (Mazurek et al, 2015), emotional state (Probst et al, 2016), anxiety (Bhatt et al, 2017), depression (Bhatt et al, 2017), cervical spine dysfunction (Michiels et al, 2015), and temporomandibular disorders (TMD) (Buergers et al, 2014). Tinnitus can be evoked or modulated by inputs from the somatosensory system through increased muscle tension in the masticatory muscles or the muscles of the cervical spine or pressure on myofascial trigger points (Sanchez and Rocha, 2011; Ralli et al, 2017) This mechanism explains the larger prevalence of tinnitus in patients with temporomandibular disorders (TMD) (30.4–64%; Lam et al, 2001; Manfredini et al, 2015) compared to the general population
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
