Temporomandibular Joint Disorder Complaints in Tinnitus: Further Hints for a Putative Tinnitus Subtype

Veronika Vielsmeier,Berthold Langguth,Michael Landgrebe,Tobias Kleinjung,Jürgen Strutz,Peter Michael Kreuzer,Martin Schecklmann,Ulrich Thiem

doi:10.1371/journal.pone.0038887

Veronika Vielsmeier, Berthold Langguth + Show 6 more

Open Access

https://doi.org/10.1371/journal.pone.0038887

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Journal: PloS one	Publication Date: Jun 19, 2012
Citations: 105	License type: CC BY 4.0

Affiliation: University of Regensburg, University of Zurich

Abstract

ObjectiveTinnitus 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.Methods1204 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.ResultsTinnitus 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.).ConclusionReplicating 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.

Highlights

Tinnitus is the perception of sound in the absence of any external sound source and it is considered to be a very heterogeneous condition [1]
In a recent pilot study we found that tinnitus patients with temporomandibular joint (TMJ) problems tend to be younger, more frequently female and to have better hearing function in contrast to those with tinnitus but without TMJ symptoms [12]
261 patients complained about problems of the TMJ (22%), whereas 943 (78%) reported that they have no symptoms of the temporomandibular joint

Summary

Introduction

Tinnitus is the perception of sound in the absence of any external sound source and it is considered to be a very heterogeneous condition [1]. Tinnitus can be perceived unilaterally, bilaterally or centrally in the head, the perceived sound can be tone-like or noise-like and tinnitus can be accompanied by many comorbidities such as hyperacusis, insomnia, anxiety or depression [2,3,4]. In face of such heterogeneity, subtyping of different forms of tinnitus has been proposed as a strategy to facilitate both diagnosis and therapy of tinnitus [5]. There is an important need to identify clinical criteria for useful subtyping of tinnitus patients

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Conclusion