Recurrent tinnitus and associated ear symptoms in adults.

This study aimed to reveal in general population the prevalence, associations, and statistical model of recurrent tinnitus by means of a mailed questionnaire. The study sample consisted of 1720 randomly selected adults who were classified into three subgroups: recurrent (once a month or more often), occasional (less often than once a month), and no tinnitus. According to age and gender standardized prevalence, recurrent tinnitus was reported in 15% of the sample. It was statistically highly significantly associated with earache, fullness of ears shoulder pain, the 25-years age group, and visits to a physician. The strongest predictor of recurrent tinnitus was fullness of ears followed by earache, shoulder ache, and temporomandibular disorder pain. We conclude that recurrent tinnitus seems to be quite common in adults and associated with earache and fullness of ears In patients with tinnitus without clinical findings, the examination of the stomatognathic system and cervical spine is recommended.

Characteristics of subjects with secondary otalgia.

AIMS: To investigate whether secondary otalgia is associated with cervical spine disorder (CSD), temporomandibular disorders (TMD), or both, and to describe the pain characteristics and the comorbidity of secondary otalgia in subjects with and without CSD and TMD. METHODS: A mailed questionnaire was sent to a random sample of 2,500 people aged 25 to 65 years. Altogether 1,720 recipients responded. Inclusion criteria were pain inside or around the ear without infection, tumor, or trauma, of 6 or more months duration, and a pain frequency of at least once a month. Altogether 152 respondents fulfilled the criteria, and of these 100 participated in the clinical examinations and interviews. RESULTS: Based on standardized examinations and interviews, 91 subjects had secondary otalgia and 9 had primary otalgia. Most (85%) of the 91 subjects with secondary otalgia also had signs and symptoms of TMD and/or CSD and were therefore classified into 3 groups: CSD (35%), TMD (20%), or "Combination," ie, signs and symptoms of both TMD and CSD (30%). Subjects without CSD or TMD (15%) reported the same level of intensity and impact of otalgia on daily living and psychological distress as the others but less frequent head and neck pain and fewer sleep-related problems. CONCLUSIONS: Most of the subjects reporting secondary otalgia also suffered from CSD or TMD or both. Thus, in patients with secondary otalgia, an examination of the cervical spine and the stomatognathic system should be routinely performed.

Efficiency of occlusal appliance therapy in secondary otalgia and temporomandibular disorders.

In clinical practice, it is commonly assumed that occlusal splints have therapeutic value in the treatment of temporomandibular disorders CTMD), but the evidence based on randomized controlled trials is scarce. This study evaluated the short-term (10-week) efficacy of a stabilization splint in subjects with recurrent secondary otalgia and active TMD treatment need using a randomized, controlled, double-blind design. Thirty-six subjects were randomly allocated to the two treatment groups: the stabilization splint and the control splint group. After 10 weeks' treatment, the intensity of secondary otalgia, measured on a VAS scale (from 0 to 100 mm), decreased statistically significantly in the stabilization splint group (t 2.12; P 0.006), but not in the control group. Improvement in active TMD treatment need in subjects showing moderate or severe signs and symptoms of TMD was reported significantly more often in the stabilization splint group than in the control splint group (chi2 5.71; P.017). A statistically significant decrease in the Helkimo clinical dysfunction index was seen in the subjects with stabilization splint (Z-2.63; P.009), but not in the subjects with control splint. The results indicate that the use of a stabilization splint is beneficial with regard to secondary otalgia and active TMD treatment need.