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躯体感觉性耳鸣:当前证据与未来展望。

Somatosensory tinnitus: Current evidence and future perspectives.

作者信息

Ralli Massimo, Greco Antonio, Turchetta Rosaria, Altissimi Giancarlo, de Vincentiis Marco, Cianfrone Giancarlo

机构信息

1 Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Italy.

2 Department of Sense Organs, Sapienza University of Rome, Italy.

出版信息

J Int Med Res. 2017 Jun;45(3):933-947. doi: 10.1177/0300060517707673. Epub 2017 May 28.

Abstract

In some individuals, tinnitus can be modulated by specific maneuvers of the temporomandibular joint, head and neck, eyes, and limbs. Neuroplasticity seems to play a central role in this capacity for modulation, suggesting that abnormal interactions between the sensory modalities, sensorimotor systems, and neurocognitive and neuroemotional networks may contribute to the development of somatosensory tinnitus. Current evidence supports a link between somatic disorders and higher modulation of tinnitus, especially in patients with a normal hearing threshold. Patients with tinnitus who have somatic disorders seems to have a higher chance of modulating their tinnitus with somatic maneuvers; consistent improvements in tinnitus symptoms have been observed in patients with temporomandibular joint disease following targeted therapy for temporomandibular disorders. Somatosensory tinnitus is often overlooked by otolaryngologists and not fully investigated during the diagnostic process. Somatic disorders, when identified and treated, can be a valid therapeutic target for tinnitus; however, somatic screening of subjects for somatosensory tinnitus is imperative for correct selection of patients who would benefit from a multidisciplinary somatic approach.

摘要

在一些个体中,耳鸣可通过颞下颌关节、头颈部、眼睛及四肢的特定动作来调节。神经可塑性似乎在这种调节能力中起核心作用,这表明感觉模态、感觉运动系统以及神经认知和神经情感网络之间的异常相互作用可能导致躯体感觉性耳鸣的发生。目前的证据支持躯体疾病与耳鸣的更高调节之间存在联系,尤其是在听力阈值正常的患者中。患有躯体疾病的耳鸣患者似乎更有可能通过躯体动作来调节其耳鸣;在针对颞下颌关节疾病进行靶向治疗后,颞下颌关节疾病患者的耳鸣症状得到了持续改善。躯体感觉性耳鸣常常被耳鼻喉科医生忽视,在诊断过程中未得到充分调查。当识别并治疗躯体疾病时,它可以成为耳鸣的一个有效的治疗靶点;然而,对躯体感觉性耳鸣患者进行躯体筛查对于正确选择能从多学科躯体治疗方法中获益的患者至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d372/5536427/e387fb08b599/10.1177_0300060517707673-fig1.jpg

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