No potential conflict of interest relevant to this article was reported. Original Article. Clinical and Experimental Otorhinolaryngology ; 10 3 : Published online: January 21, Yongxin Peng. Abstract Objectives Temporomandibular joint disorders TMD are often associated with aural manifestations. Common signs and symptoms of TMD include temporomandibular joint or masticatory muscle pain, restricted mouth opening, clicking or crepitus of the temporomandibular joint, headache in the temporal region, otalgia, tinnitus, and hearing loss [ 2 ].
Numerous studies have reported a link between the aural symptoms and TMD [ 3 - 8 ]. However, TMD as a potential cause of otologic symptoms, in particular aural fullness, is often neglected in clinical practice by otolaryngologists. As a result, patients with aural fullness as the main or sole complaint could be misdiagnosed, leading to ineffective treatment and prolonged suffering.
This study examined the presence of TMD and effectiveness of TMD treatment in Chinese patients, who presented to the otolaryngology clinics for aural fullness and had been diagnosed and treated for otitis media or sensorineural hearing loss without positive results.
The patient cohort includes 40 males and 72 females with ages ranging from 12 to 76 years old and an average of 38 years. Of the patients, 94 had unilateral aural fullness and 18 had bilateral aural fullness. Seventy nine identified aural fullness as the main complaint and 33 indicated aural fullness as the sole symptom. The course of aural fullness was between 2 days to 2 months. The medical history indicated that 90 patients had been treated as otitis media using a combination of antibiotics and steroids for 7 to 14 days, of which 15 underwent tympanum puncture, and the remaining 22 patients were treated as sensorineural deafness for 7 to 25 days with regimens to improve blood supply to the cochlea and neural loss.
None of the treatments was effective of improving aural fullness. The criteria are as follows. Grade 1 mild aural fullness is present but not affecting daily activities and patients do not actively seek therapy. Grade 2 moderate aural fullness is obvious but tolerable, interfering with daily activities, and patients actively seek therapy. Grade 3 severe aural fullness is intolerable and severely disrupting daily activities; patients are irritable, experiencing insomnia and seeking immediate therapy.
Treatment is considered effective if the aural fullness grade is reduced by at least 1. A reduction less by 1 or recurrence of aural fullness is indicative of ineffective treatment. TMD diagnosis Patients were questioned for presence of common TMD symptoms such as restricted mouth opening, temporomandibular joint pain, clicking or crepitus of the temporomandibular joint, etc.
Treatments Based on the clinical manifestations and responsiveness to therapy, patients were treated for TMD at the Otolaryngology Department for 2 days to 4 months, using the following approaches in a sequential manner: physiotherapy heat therapy, acupuncture and massage , intra-articular injection of glucocorticoid and sodium hyaluronate, orthodontics and occlusal equilibration.
Physiotherapy was first used given its noninvasive nature, low cost, and the ease to perform. If physiotherapy failed to improve the aural fullness symptom, glucocorticoid injection was used in those showing group I disorders muscle disorders.
Sodium hyaluronate injection was used to treat patients showing joint structure abnormalities. Due the adverse effect associated with sodium hyaluronate injection, only 11 patients consented to this treatment. Orthodontics and occlusal equilibration were used to treat occlusion disorders. Finally, elastic bondage wrapping and surgery were used to treat recurrent joint dislocation or bone fracture in 3 patients.
Forty-five patients voluntarily participated in follow-up surveys 10—18 months posttreatments and were examined for aural fullness. X-ray scan was performed to examine the temporomandibular joint of all the patients. Three patients were also examined by CT scan. Forty patients showed abnormalities including narrowing or widening of the joint space, extrusion of the articular disk of mandibular joint, roughing of the joint surface, or cortical bone loss and adhesion.
The remaining 4 patients were classified to group II disorders disc displacements based on their history of temporomandibular joint injury, together with other 35 patients a total of Five patients belong to group III disorders arthralgia, osteoarthritis, and osteoarthrosis.
A grading system was established to assess the severity of aural fullness. Correlation between aural fullness and TMD classification was shown in Table 2. These problems can be caused by other illnesses, and it's important to get an accurate diagnosis as soon as possible.
Semicircular canals and otolith organs — the utricle and saccule — in your inner ear contain fluid and fine, hairlike sensors that help you keep your eyes focused on a target when your head is in motion and assist in helping you maintain your balance.
The cause of Meniere's disease is unknown. Symptoms of Meniere's disease appear to be the result of an abnormal amount of fluid endolymph in the inner ear, but it isn't clear what causes that to happen. Because no single cause has been identified, it's likely that Meniere's disease results from a combination of factors.
The unpredictable episodes of vertigo and the prospect of permanent hearing loss can be the most difficult problems of Meniere's disease. The disease can unexpectedly interrupt your life, causing fatigue and stress. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Meniere's disease is a disorder of the inner ear that can lead to dizzy spells vertigo and hearing loss.
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