[The "Costen Syndrome" - Which Symptoms Suggest that the Patient may Benefit from Dental Therapy?]

Occlusal problems: Hearing symptoms in subjects with temporomandibular disorder

OBJECTIVE

This study aimed to investigate the relationship between occlusal problems and hearing symptoms.

METHODS

Electromyography, occlusion analysis, and hearing tests were performed on 24 patients with temporomandibular disorders and concurrent ear symptoms and 16 subjects in the control group.

RESULTS

The null hypothesis of no statistically significant relationship between pure tone audiometry (PTA) values and disclusion times (DT) > 0.40 s and <0.40 s was rejected. There were statistically significant correlations between 0.25, 0.5, 1, 6, and 8 kHz airways of the right and left ear and 1 and 2 kHz bone conduction for disclusion times >0.40 s.

CONCLUSION

Reducing disclusion time to <0.40 s may ameliorate ear symptoms.

[Comprehensive treatment of Costen syndrome]

OBJECTIVE

To develop an integrated therapy for the combination of pain syndrome and cochleovestibular syndrome (CVS) in patients with temporomandibular joint (TMJ) dysfunction.

MATERIAL AND METHODS

Forty-five patients (42 women and 3 men), aged from 23 to 54 years, with TMJ dysfunction, signs of CVS and complaints of pain in the ear area were stratified into three groups (15 patients each). Patients received pharmacological and osteopathic therapy (group 1); splint therapy followed by orthodontic treatment (group 2) and a combination of the abovementioned methods (group 3). Re-examination was carried out 3 months after completion of treatment.

RESULTS

After treatment, complaints of pain, tinnitus, dizziness and nystagmus, the degree of TMJ dysfunction decreased significantly (p<0,05) compared to baseline in groups 1 and 2. In group 3, the most significant and persistent results were obtained, which significantly differed not only from the initial level, but also from the final level of indicators in the first and second groups (p<0,05), including a decrease in the degree of maladaptation associated with vertigo and trait anxiety.

CONCLUSIONS

Differential diagnosis of CVS in patients with TMJ dysfunction requires the joint participation of dentist, neurologist and ENT doctor and should be comprehensive, including medical, orthodontic and osteopathic components.