Department of Otorhinolaryngology, Medical School of the University of São Paulo, Rua Mato Grosso no. 306, São Paulo, SP, Brazil.
Braz J Otorhinolaryngol. 2012 Dec;78(6):21-6. doi: 10.5935/1808-8694.20120028.
Chronic pain in areas surrounding the ear may influence tinnitus.
To investigate the efficacy of myofascial trigger point deactivation for the relief of tinnitus.
A double-blind randomized clinical trial enrolled 71 patients with tinnitus and myofascial pain syndrome. The experimental group (n = 37) underwent 10 sessions of myofascial trigger point deactivation and the control group (n = 34), 10 sessions with sham deactivation.
Treatment of the experimental group was effective for tinnitus relief (p < 0.001). Pain and tinnitus relieves were associated (p = 0.013), so were the ear with worst tinnitus and the side of the body with more pain (p < 0.001). The presence of temporary tinnitus modulation (increase or decrease) upon initial muscle palpation was frequent in both groups, but its temporary decrease was related to the persistent relief at the end of treatment (p = 0.002).
Besides medical and audiological investigation, patients with tinnitus should also be checked for: 1) presence of myofascial pain surrounding the ear; 2) laterality between both symptoms; 3) initial decrease of tinnitus during muscle palpation. Treating this specific subgroup of tinnitus patients with myofascial trigger point release may provide better results than others described so far.
耳部周围的慢性疼痛可能会影响耳鸣。
研究肌筋膜触发点灭活治疗耳鸣的疗效。
一项双盲随机临床试验纳入了 71 例耳鸣伴肌筋膜疼痛综合征患者。实验组(n=37)接受 10 次肌筋膜触发点灭活治疗,对照组(n=34)接受 10 次假灭活治疗。
实验组治疗耳鸣缓解有效(p<0.001)。疼痛和耳鸣缓解相关(p=0.013),因此耳鸣最严重的耳朵和疼痛侧别也相关(p<0.001)。两组初始触诊时均出现短暂耳鸣调制(增加或减少)的情况较为常见,但暂时减少与治疗结束时的持续缓解相关(p=0.002)。
除了医学和听力学检查外,耳鸣患者还应检查:1)耳部周围是否存在肌筋膜疼痛;2)两个症状的侧别;3)触诊时耳鸣的初始减少。与目前描述的其他方法相比,用肌筋膜触发点释放治疗这种特定的耳鸣患者亚组可能会提供更好的效果。