Mejersjö Christina, Näslund Ingrid
Swed Dent J. 2016;40(1):13-20.
With the aim of studying frequency of aural symptoms and associations with symptoms of TMD new patients referred to the Orofacial Pain Clinic, Odontologen, Göteborg, were asked, at their first appointment and before meeting a specialist, to report any symptoms regarding pain or fullness/swelling of the ear, impaired hearing, sensitivity to sound, and irritation/itching of the ear. They also answered a standardized questionnaire regarding temporomandibular pain and/or dysfunction, and classified their degree of TMD symptoms on a five-point verbal scale and a visual analogue scale. 108 consecutive patients were included in the study, they completed the questionnaires and were examined and diagnosed by different specialists at the clinic. Any ear symptoms were reported by 68% of the patients, fullness of ear by 44% and impaired hearing by 37%. 38% of the patients had previously consulted a physician, and most of them had had pharmacological treatment due to their ear symptoms. Females reported more pain in the ear (P = 0.034) and more sensitivityto sound (P = 0.046) than men. No significant association was found between age and aural symptoms. The degree of TMD- symptoms, as reported by the five grade scale, showed significant association with aural symptoms (P < 0.001), as did the clinical dysfunction index of Helkimo (P = 0.005). The diagnoses of myalgia, arthralgia, arthritis and headache showed significant association with aural symptoms, while no association with crepitus (osteoartrosis) and disc displacement. Itching in the ear was frequently reported (24%) and was associated with myalgia (P = 0.003) and tension headache (P = 0.018). A medical examination by an ear-nose-throat specialist of 19 patients reporting a sensation of fullness of ear, did not reveal any objectifiable ear disease. To conclude, aural symptoms are common in patients with temporomandibular pain and/or dysfunction, are associated with TMD-symptoms and should be regarded as possible symptoms of TMD. A cooperation between physicians and dentists can give these patients a good treatment.
为了研究耳症状的发生率以及与颞下颌关节紊乱症（TMD）症状的关联，哥德堡Odontologen口腔颌面疼痛诊所的新患者在首次就诊且尚未见到专科医生之前，被要求报告任何有关耳痛、耳闷胀/肿胀、听力减退、对声音敏感以及耳部刺激/瘙痒的症状。他们还回答了一份关于颞下颌疼痛和/或功能障碍的标准化问卷，并使用五点言语量表和视觉模拟量表对其TMD症状的程度进行分类。108名连续的患者被纳入研究，他们完成了问卷，并由诊所的不同专科医生进行检查和诊断。68%的患者报告有耳症状，44%的患者有耳闷胀感，37%的患者有听力减退。38%的患者此前曾咨询过医生，其中大多数人因耳部症状接受过药物治疗。女性报告耳部疼痛（P = 0.034）和对声音更敏感（P = 0.046）的情况比男性更多。未发现年龄与耳症状之间存在显著关联。根据五级量表报告的TMD症状程度与耳症状存在显著关联（P < 0.001），Helkimo临床功能障碍指数也是如此（P = 0.005）。肌痛、关节痛、关节炎和头痛的诊断与耳症状存在显著关联，而与关节摩擦音（骨关节炎）和盘移位无关联。耳部瘙痒的报告频率较高（24%），且与肌痛（P = 0.003）和紧张性头痛（P = 0.018）有关。对19名报告有耳闷胀感的患者进行耳鼻喉专科医生的医学检查，未发现任何可客观证实的耳部疾病。总之，耳症状在患有颞下颌疼痛和/或功能障碍的患者中很常见，与TMD症状相关，应被视为TMD的可能症状。医生和牙医之间的合作可以为这些患者提供良好的治疗。
