Otologic symptom improvement through TMD therapy

Objectives: Some patients with a temporomandibular disorder (TMD) and coexisting otologic symptoms desire to know the probability of TMD therapy improving their otologic symptoms. The aim of this study was to determine a clinically valid method for identifying which otologic symptoms have a high probability of improving as a result of satisfactory TMD symptom improvement. Method and Materials: Two hundred TMD patients with coexisting tinnitus, otalgia, dizziness, and/or vertigo were asked about their otologic symptom characteristics and associations and were given clinical tests, which were speculated to predict otologic symptom response from TMD therapy. The subjects received conservative TMD therapy in a manner thought to be most advantageous for their disorders. These potential assessment instruments were then evaluated for their ability to predict otologic symptom improvement. Results: After satisfactory TMD symptom improvement was obtained, the percent of subjects reporting significant improvement or resolution of their tinnitus, otalgia, dizziness, and vertigo was 83%, 94%, 91%, and 100%, respectively. The chi-square and Fisher exact probability tests identified significant correlations for tinnitus, otalgia, and dizziness improvement with younger age; for tinnitus and otalgia improvement with subjects who related that the otologic symptom began when the TMD symptoms began, was worse when the TMD symptoms were worse, and was related to stress; and for dizziness improvement with subjects relating more severe TMD symptoms. Conclusion: Asking TMD patients with coexisting otologic symptoms these specific questions will help practitioners identify which otologic symptoms have a high probability of benefiting from TMD therapy. Keywords: dizziness, earache, prospective study, temporomandibular joint disorder, temporomandibular joint disorder therapy, tinnitus, treatment outcome, vertigo