[Functional disturbances of the cervical spine in tinnitus]

A total of 189 patients with tinnitus, Meniere's disease, and sudden hearing loss underwent manual therapeutic examination at the Department of Physical Medicine and Rehabilitation in the setting of an interdisciplinary program for the management of patients of the tinnitus daycare center and inpatients of the ENT department of the Charité Medical School.

In all patients, global and segmental joint mobility of the cervical spine, cervicothoracic junction, first rib, and craniomandibular system was assessed using standardized documentation. Muscle extensibility and trigger points were determined for the sternocleidomastoid muscle, the descending part of the trapezius muscle, the levator muscle of the scapula, and the masseter muscle.

Results of the statistical analysis show that patients with tinnitus have characteristic and specific patterns of abnormalities in the joints and paravertebral muscles. The dominant finding is an overall impairment of cervical spine mobility, to which various factors contribute. These include disturbed function of segmental joints of the head and the cervicothoracic junction as well as muscular imbalances of the shoulder and neck muscles.

Our results corroborate the clinical significance of manual therapeutic findings as part of the diagnostic workup for tinnitus. They show that a uniform and standardized examination protocol is needed, and that appropriate physical therapeutic measures should be incorporated into the interdisciplinary therapeutic management of patients with tinnitus.