[The "Costen Syndrome" - Which Symptoms Suggest that the Patient may Benefit from Dental Therapy?]

Since the thirties the hypothesis of a direct connection between temporomandibular disorders (TMD) and tinnitus/otalgia has been discussed. The thesis of this possible connection is often named after one of the earliest and most vehement supporters as "Costen Syndrome". This review is aimed to elucidate the present state of the discussion from the Dentist's point of view.

Diagnostic research criteria which define TMD are not standardized. Despite high prevalence and strong demand for treatment of TMD there is still a lack of a commonly accepted standard therapy and the potential benefit from a therapeutic point of view is still controversial. TMD AND TINNITUS/OTALGIA:: Concurrence of TMD and tinnitus by a common underlying cause is still unproven. By contrast a causal link between certain forms of TMD and otalgia is obvious.

A lack of clear definitions and standards for the diagnosis of TMD is the main hinderance to prove a causal relationship especially between TMD otalgia. However patients seeking care for otalgia with no identifiable otologic cause may benefit from dental therapy. Therefore future studies should focus on well defined subgroups of TMD to investigate a link between otalgia/tinnitus and TMD.