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干针疗法对颞下颌关节紊乱症患者耳鸣感知中咬肌的影响

Effect of Dry Needling on the Masseter Muscle in the Tinnitus Perception of Patients with Temporomandibular Disorder.

作者信息

Sirikaku Katia, Watinaga Gilson Kazuo, de Souza Moraes Samuel, Guimarães Thatiana Bastos, Onishi Ektor Tsuneo

机构信息

Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Universidade Federal de São Paulo - UNIFESP, Rua Pedro de Toledo, 947 - Vila Clementino, São Paulo, SP 04039-002 Brazil.

Departamento de Pós-Graduação da Faculdade de Odontologia, Faculdade de Medicina e Odontologia São Leopoldo Mandic, Campinas, Brazil.

出版信息

J Maxillofac Oral Surg. 2023 Sep;22(3):571-578. doi: 10.1007/s12663-022-01696-4. Epub 2022 Feb 28.

Abstract

OBJECTIVE

To evaluate the effect of dry needling on the masseter muscle in the perception of tinnitus in patients with temporomandibular disorder.

METHODS

Twenty-five patients with tinnitus and muscular temporomandibular disorders were randomly assigned to groups study ( = 13) and control ( = 12). Three sessions of dry needling (study) and sham (control) were performed. Follow-up was performed 30, 60 and 90 days after the end of treatment. The Analog Visual Scale and Tinnitus Handicap Inventory (THI) were used to evaluate the treatment.

RESULTS

In study group, 76.9% presented a reduction in the intensity and tinnitus discomfort and total THI. In control group, 66.7% presented a decrease in tinnitus intensity and total THI, and 58.3% reported a decrease in tinnitus discomfort. After 90 days, in the study group, 84.6% maintained improvement in pain intensity and reduction in THI score and 69.2% reported improvement in both intensity and discomfort caused by tinnitus. In control group, 75% achieved improvement in pain intensity, 33.2% maintained improvement in tinnitus intensity, and 41.7% maintained improvement in discomfort caused by tinnitus and total THI. In the total THI score, the study group presented improvement ( = 0.041).

CONCLUSION

Dry needling combined with counseling was associated with improvement in pain intensity and tinnitus, decrease in tinnitus discomfort and reduction in total THI score.

摘要

目的

评估干针疗法对颞下颌关节紊乱症患者咬肌在耳鸣感知方面的影响。

方法

25名患有耳鸣和肌肉型颞下颌关节紊乱症的患者被随机分为研究组(n = 13)和对照组(n = 12)。对研究组进行了3次干针治疗,对对照组进行了假治疗。在治疗结束后30、60和90天进行随访。采用视觉模拟量表和耳鸣障碍量表(THI)对治疗效果进行评估。

结果

研究组中,76.9%的患者耳鸣强度、不适程度及THI总分降低。对照组中,66.7%的患者耳鸣强度降低,THI总分降低,58.3%的患者耳鸣不适程度降低。90天后,研究组中84.6%的患者疼痛强度持续改善,THI评分降低,69.2%的患者耳鸣强度和不适程度均有所改善。对照组中,75%的患者疼痛强度有所改善,33.2%的患者耳鸣强度持续改善,41.7%的患者耳鸣不适程度及THI总分持续改善。在THI总分方面,研究组有改善(P = 0.041)。

结论

干针疗法结合咨询与疼痛强度和耳鸣的改善、耳鸣不适程度的降低以及THI总分的降低相关。

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1
Relationship between Otological Symptoms and TMD.耳科症状与颞下颌关节紊乱病的关系。
Int Tinnitus J. 2018 Jun 1;22(1):30-34. doi: 10.5935/0946-5448.20180005.
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Masseter muscle measurement performed by ultrasound: a systematic review.超声测量咬肌:一项系统评价。
Dentomaxillofac Radiol. 2017 Aug;46(6):20170052. doi: 10.1259/dmfr.20170052. Epub 2017 Jun 8.
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Treatment of tinnitus.耳鸣的治疗。
Curr Opin Otolaryngol Head Neck Surg. 2015 Oct;23(5):361-8. doi: 10.1097/MOO.0000000000000185.
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Evid Based Complement Alternat Med. 2013;2013:946597. doi: 10.1155/2013/946597. Epub 2013 Aug 26.
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Tinnitus: causes and clinical management.耳鸣:病因与临床管理。
Lancet Neurol. 2013 Sep;12(9):920-930. doi: 10.1016/S1474-4422(13)70160-1.
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