TINNITUS AND TEMPOROMANDIBULAR JOINT DISORDER SUBTYPES

Abstract

University of Washington ABSTRACT Tinnitus And Temporomandibular Joint Disorder Subtypes Oral Medicine OBJECTIVE: The purpose of this study was to assess the prevalence of tinnitus within a TMD population and to determine an association between the presence of tinnitus and type of TMD diagnoses. METHODS: A secondary data analysis was performed using data from ‘Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) baseline (Validation project) study and follow up (Impact project) study. Self-reported questionnaires for reporting tinnitus and medical history and gold standard diagnoses after clinical examination were used. Log-binomial regression was used to compute risk ratios for tinnitus by TMD subtype and adjusted for patient characteristics. All statistical analysis was performed using SAS 9.3 software (SAS Institute), and a two-sided significance level of 0.05 to determined statistical significance (p<0.05). RESULTS: At baseline, 614 subjects met required criteria for TMD diagnosis. Prevalence of tinnitus within sample was 41% (253 of 614). Approximately 80% of TMD subjects received a MPD diagnosis. Tinnitus frequency in the MPD group was 48% (238/495) while subjects without MPD diagnosis the rate of tinnitus was 13% (15 of 119). Using log-binomial regression analysis, the risk ratio for tinnitus was calculated. The relative risk for tinnitus by number of sites painful to palpation by TMD diagnosis for MPD, DD and DJD groups was 1.03 (95% CI: 0.97, 1.10; p=0.28), 1.24 (95% CI: 1.05, 1.46; p = .0086) and 1.20 (95% CI: 1.01, 1.43; p = .033), respectively, when adjusted for age, gender, study site and somatization. Among the population, 207 subjects received a TMD diagnosis also reported headaches. The adjusted risk ratio for tinnitus among subjects with TMD diagnosis and headache was 4.52 (95% CI: 1.67, 12.19; p = .0002) higher than in subjects with only TMD diagnosis (RR=3.8) or only headaches (RR=1.4) Similarly, the adjusted risk ratio for tinnitus among subjects with an MPD diagnosis and headaches was 3.59 (95%CI: 1.82, 7.06) higher than in subjects with only MPD diagnosis (RR=3.02) and only headaches (RR= 1.75) CONCLUSION: These findings suggest higher rate of tinnitus among subjects with MPD than other forms of TMD. Moreover, the risk for tinnitus is six times higher if subject has TMD diagnosis and headache and three times higher in myofascial group with headaches.