Investigation of the Interaction Between Temporomandibular Joint and Tinnitus Using CBCT and Audiological Methods: A Prospective Cross-Sectional Study
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 50
- 试验地点
- 1
- 主要终点
- Frequency of Petrotympanic Fissure (PTF) Morphological Types
研究概览
简要总结
The aim of this study is to investigate the relationship between Temporomandibular Disorders (TMD) and subjective tinnitus at both morphological and functional levels. Current literature suggests that somatosensory inputs from the temporomandibular joint (TMJ) and masticatory muscles can modulate auditory pathways, a phenomenon known as Somatosensory Tinnitus. However, the specific role of TMJ bone morphology and critical neighboring structures, such as the Petrotympanic Fissure (PTF), in this interaction remains unclear.
In this clinical study, patients with tinnitus will undergo a comprehensive evaluation including Cone Beam Computed Tomography (CBCT) to quantitatively analyze condylar morphology and osteoarthritic changes. Additionally, audiological tests will be performed to assess the functional state of the auditory system. This multidisciplinary approach aims to clarify the biological link between TMD and tinnitus, potentially improving diagnostic protocols and highlighting the importance of TMJ stabilization in tinnitus management.
详细描述
Background and Rationale:
Tinnitus is defined as the conscious perception of sound in the absence of an external acoustic source. Subjective tinnitus, the most common form, is often associated with neuroplastic changes in the central auditory pathways. A specific subtype, Somatosensory Tinnitus (ST), occurs when afferent somatosensory input from the upper cervical or temporomandibular region modulates tinnitus perception. This interaction is mediated through neural connections between the Dorsal Cochlear Nucleus (DCN) and somatosensory nuclei in the brainstem. Clinical observations indicate a high prevalence of Temporomandibular Disorders (TMD) among tinnitus patients, suggesting a biological link where TMD symptoms (pain, restricted movement, and muscle activity) influence the spontaneous neuronal firing rates in the auditory centers.
Study Objectives:
While evidence points to a strong interaction between TMJ somatosensory input and tinnitus, the roles of auditory function and TMJ bone morphology-specifically condylar changes and the Petrotympanic Fissure (PTF)-remain under-investigated. This study aims to provide a comprehensive multidisciplinary analysis by evaluating the auditory system through audiological tests and examining morphological changes in TMJ bone tissues using Cone Beam Computed Tomography (CBCT).
Methodology:
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients aged 18 years and older.
- •Patients presenting with otological symptoms such as tinnitus and ear pain.
- •Patients diagnosed with Temporomandibular Disorders (TMD) based on clinical and radiographic examination.
- •Patients who have been referred for CBCT imaging as part of their routine diagnostic process for TMD.
- •Willingness to provide written informed consent to participate in the study.
排除标准
- •Presence of objective tinnitus (e.g., vascular or muscular origin).
- •History of chronic otitis media or other middle ear pathologies that could cause hearing loss or tinnitus.
- •Previous history of temporomandibular joint surgery or major maxillofacial trauma.
- •Presence of systemic metabolic bone diseases or inflammatory rheumatic diseases (e.g., Rheumatoid Arthritis).
- •History of malignancy in the head and neck region.
- •Pregnancy (due to CBCT imaging contraindication).
- •Neurological or psychological disorders that would prevent cooperation during clinical and audiological examinations.
研究组 & 干预措施
TMD with Tinnitus (Case Group)
Patients diagnosed with Temporomandibular Disorders (TMD) based on clinical examination and history, who also report co-existing subjective tinnitus. This group will be evaluated for both TMJ morphological changes (via CBCT) and audiological status.
干预措施: Cone Beam Computed Tomography (CBCT) (Diagnostic Test)
TMD with Tinnitus (Case Group)
Patients diagnosed with Temporomandibular Disorders (TMD) based on clinical examination and history, who also report co-existing subjective tinnitus. This group will be evaluated for both TMJ morphological changes (via CBCT) and audiological status.
干预措施: Audiological Assessment (Diagnostic Test)
TMD with Tinnitus (Case Group)
Patients diagnosed with Temporomandibular Disorders (TMD) based on clinical examination and history, who also report co-existing subjective tinnitus. This group will be evaluated for both TMJ morphological changes (via CBCT) and audiological status.
干预措施: Clinical TMJ Examination (Other)
TMD without Tinnitus (Control Group)
Patients diagnosed with Temporomandibular Disorders (TMD) but who do not experience any form of tinnitus (subjective or objective). This group serves as a control to compare the specific TMJ morphological variations and audiological findings associated with the presence of tinnitus.
干预措施: Cone Beam Computed Tomography (CBCT) (Diagnostic Test)
TMD without Tinnitus (Control Group)
Patients diagnosed with Temporomandibular Disorders (TMD) but who do not experience any form of tinnitus (subjective or objective). This group serves as a control to compare the specific TMJ morphological variations and audiological findings associated with the presence of tinnitus.
干预措施: Audiological Assessment (Diagnostic Test)
TMD without Tinnitus (Control Group)
Patients diagnosed with Temporomandibular Disorders (TMD) but who do not experience any form of tinnitus (subjective or objective). This group serves as a control to compare the specific TMJ morphological variations and audiological findings associated with the presence of tinnitus.
干预措施: Clinical TMJ Examination (Other)
结局指标
主要结局
Frequency of Petrotympanic Fissure (PTF) Morphological Types
时间窗: Baseline (at the time of the single CBCT scan during the initial clinical visit).
The morphology of the PTF will be categorized into three types according to the Sato et al. classification: Type 1 (Open), Type 2 (Partially Open), and Type 3 (Closed) using CBCT imaging.
次要结局
- Presence of Osteoarthritic Changes in the Mandibular Condyle(Baseline.)
- Pure Tone Thresholds(Baseline)
- Maximum Pain-Free Mouth Opening(Baseline.)
研究者
EDA İZGİ
Asst. Prof.
Kutahya Health Sciences University