A STUDY FOR EAR SYMPTOMS IN TMD PATIENTS AND THOSE RELATION TO OCCLUSAL FACTORS

耳鸣、耳痛、眩晕等耳部症状常见于颞下颌关节紊乱病(TMD)。本研究的目的是阐明TMD患者耳部症状的特点及其与咬合因素的关系。TMD患者25例，年龄16~69岁，平均43.4±17.1岁。由牙科医生检查TMD的体征和症状。对患者的TMJ进行磁共振成像检查。所有患者的耳部症状均由耳科检查确诊。所有患者的耳鸣症状与TMD的主要症状相吻合。诊断为耳功能障碍12例，耳鸣侧感音聋10例，前庭功能障碍2例。15例关节盘移位患者的耳鸣评分明显高于10例关节盘位置正常的患者。有椎间盘移位的15人中有8人有耳部疾病，10人中有2人有耳部疾病。听力障碍的比例在这些组之间有显著差异。调牙术、夹板疗法等咬合治疗对TMD患者的耳部症状有较好的改善作用。咬合治疗后的耳科检查显示，治疗前诊断的耳部疾患有所改善。提示TMD患者耳鸣等耳部症状与TMD有关，可能与TMJ的后支撑丧失、颌位移位等咬合因素所致的髁突位置、关节盘位置有关。

The aural symptoms such as tinnitus, earache, vertigo, are commonly observed in Temporomandibular Disorders (TMD). The purpose of this study was to clarify the ological characteristics of aural symptoms in TMD and the relationship to the occlusal factors as an etiological factor. Twenty-five TMD patients (age ranged 16-69, mean 43.4+17.1y) with tinnitus were involved in this study. Signs and symptoms of TMD were examined by dentists. TMJs of the patients were examined by MR imaging. Aural symptoms in the patients were diagnosed with otologic examinations.Side with tinnitus were coincided with the main symptomatic side of TMD in allpatients. Twelve patients were diagnosed with disorders of ear function ; 10 patients had sensory hearing loss at tinnitus side, 2 patients had vestibular dysfunction. Tinnitusscore in 15 patients with disc displacement of TMJ were significantly higher than thosein 10 patients with normal disc position. Eight out of 15 with disc displacement had ear disorders and 2 out of 10 with normal disc had ear disorders. The ratio of ear disorders was significantly different between these groups. Occlusal treatment, such as occlusaladjustment, splint therapy, for TMD were effective on the aural symptoms. Otologicexamination after occlusal treatment indicated improvement of ear disorders diagnosed before treatment. These results indicate that aural symptoms such as tinnitus observed in TMD are related to TMD.Those might be related to condylar position and disc position in TMJ, which are caused by occlusal factors such as loss of posterior support and displacement of jaw position.