title: Somatosensory Tinnitus: Correlation between Cranio-Cervico-Mandibular Disorder History and Somatic Modulation.
abstract: In a subpopulation of patients, tinnitus can be modulated by movements of the jaw or head and neck due to complex somatosensory-auditory interactions. In some of these subjects, tinnitus could be related to an underlying temporomandibular (TMJ) or craniocervical (NECK) dysfunction that, if correctly identified, could streamline treatment and increase chances of tinnitus improvement. However, it is still unclear whether somatic modulation of tinnitus could be used as a screening tool for identifying such patients. In this study, we included 310 tinnitus patients with normal hearing, no psychiatric comorbidities, and a positive history of TMJ and/or NECK dysfunction and/or a positive modulation of tinnitus to evaluate the characteristics of somatic modulation, investigate the relationship between positive history and positive modulation, and identify factors most strongly associated with somatic modulation. Tinnitus modulation was present in 79.67% of the patients. We found a significant association within the same subjects between a positive history and a positive tinnitus modulation for the same region, mainly for TMJ in unilateral tinnitus patients and for TMJ + NECK in bilateral tinnitus patients. A strong correlation between history and modulation in the same somatic region within the same subgroups of subjects was also identified. Most TMJ maneuvers resulted in an increased loudness, while NECK maneuvers showed an increase in tinnitus loudness in about 59% of cases. High-pitched tinnitus and male gender were associated with a higher prevalence of modulation; no differences were found for tinnitus onset, Tinnitus Handicap Inventory score, and age. In this paper, we report a strong association between history and modulation for the same regions within the same patients; such an association should always be investigated to improve chances of a correct diagnosis of somatosensory tinnitus.
authors.affiliation: Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Ralli
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Altissimi
authors.forename: Rosaria
authors.initials: R
authors.lastname: Turchetta
authors.forename: Filippo
authors.initials: F
authors.lastname: Mazzei
authors.forename: Massimo
authors.initials: M
authors.lastname: Salviati
authors.forename: Francesca
authors.initials: F
authors.lastname: Cianfrone
authors.forename: Maria Patrizia
authors.initials: MP
authors.lastname: Orlando
authors.forename: Valeria
authors.initials: V
authors.lastname: Testugini
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Cianfrone
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000503:physiopathology; D015897:Comorbidity; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology / Q000503:physiopathology*; D009333:Neck / Q000503:physiopathology; D012737:Sex Factors; D013705:Temporomandibular Joint Disorders / Q000453:epidemiology / Q000503:physiopathology*; D014012:Tinnitus / Q000453:epidemiology / Q000503:physiopathology*; D055815:Young Adult
keywords: Head disorders; Neck disorders; Somatosensory tinnitus; Temporomandibular disorders; Tinnitus modulation