[Otalgia and tinnitus in patients with craniomandibular dysfunctions]

The high prevalence of ear, nose, and throat symptoms in patients with craniomandibular disorders seems to depend on the connection between both phenomena. The present study evaluates the connection between craniomandibular disorders (CMD) and otalgia or tinnitus, investigates the correlation between specific diagnoses of CMD with otalgia or tinnitus, and estimates the effects of treatment of CMD on these ear symptoms.

The information from case histories, clinical examinations, and treatment results of 221 patients with CMD were coded and evaluated by computer. All patients received conservative treatment with occlusal splints, training in self-observation of parafunction, massage of the masticatory muscles, and heat therapy. At least 1 year after the first examination, all patients were reevaluated. According to their complaints, the patients could be divided into three groups: (1) CMD patients without ear symptoms (n = 134 = 61%), (2) CMD patients with otalgia (n = 80 = 37%), and (3) CMD patients with tinnitus (n = 8 = 3.8%) (one patient with tinnitus and otalgia).

Otalgia correlated significantly with CMD and the specific CMD diagnoses of anterior disk displacement (ADD) without reduction and osteoarthrosis. Of the reevaluated patients with otalgia, 90% had no ear pain and 10% reported reduced or less frequent ear pain. Only one of the eight cases with tinnitus noted reduced noises; the remaining seven perceived no influence on their ear noises from therapy.

Due to the treatment results, otalgia has to be interpreted as a possible symptom of CMD and not as a separate diagnosis.