Aural Symptoms in Temporomandibular Disorder Patients Attending a Craniofacial Pain Unit

Aims: To determine (1) the prevalence of aural symptoms in orofacial pain patients and (2) a potential association between temporomandibular disorders (TMD) and aural health, while controlling for covariates known to be associated with TMD or auditory dysfunction. Methods: In a retrospective study, health questionnaires, medical histories, clinical findings, diagnoses, and treatments were systematically retrieved from the charts of 776 patients. The dates of initial assessment ranged from May 1987 to June 1999. Of the included subjects, 39.7% were female; the median age was 39 years; 16.4% displayed only aural symptoms (otalgia, tinnitus, vertigo, or perceived hearing loss); 26.4% had both TMD and aural symptoms; 17.8% had TMD but no aural complaints; and 39.4% had neither TMD nor aural symptoms. Results: Of the 344 subjects who had TMD, 59.9% complained of aural symptoms, versus 29.2% of the 432 patients without TMD. Of the subjects with otalgia, tinnitus, vertigo, or perceived hearing loss, 67%, 64.1%, 65.2%, and 62.2% had TMD, respectively. Subjects with aural symptoms were significantly more likely to be female; to consider themselves in poor health; to smoke; or to have TMD, orofacial pain, headaches (temporal, occipital, or frontal), neck and shoulder pain, altered vision and sensation, sleep disturbances, loss of appetite, memory loss, or low energy. Clinical findings indicated that pathognomonic signs of TMD were associated with an increased risk of aural complaints in this patient population. A significantly greater negative impact on normal life functions was found in subjects exhibiting aural symptoms versus those who only had TMD complaints. Conclusion: These findings indicate that TMD is significantly correlated to aural health, although no cause-and-effect relationship has yet been demonstrated. Aural symptoms were also found to have a measurable impact on the subjects' quality of life. Keywords: temporomandibular disorders, otalgia, tinnitus, vertigo, perceived hearing loss, quality of life