颞下颌关节紊乱症与耳鸣之间的关联——一项系统综述
Associations between temporomandibular disorders and tinnitus - a systematic review.
作者信息
De La Torre Canales Giancarlo, Christidis Nikolaos, Grigoriadis Anastasios, Strandberg Tilde, Montan Veronica, Medina Flores Dyanne, Al-Moraissi Essam Ahmed, Christidis Maria
机构信息
Division of Oral Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
Egas Moniz Center for Interdisciplinary Research (CiiEM); Egas Moniz School of Health & Science, Caparica, Almada, Portugal.
出版信息
Cranio. 2024 Sep 17:1-17. doi: 10.1080/08869634.2024.2404270.
OBJECTIVES
Temporomandibular disorders (TMD) and tinnitus are highly prevalent conditions, that affects about 10-30% of the adult population and seem to co-exist. The primary objective of this systematic review was to investigate any associations between TMD and tinnitus. The secondary objective was to investigate if the associations differ between painful and non-painful TMDs.
METHODS
An electronic literature search in five databases was performed, from the inception of the databases until 26th of October 2022. This was to identify clinical trials with prevalence numbers of patients with TMD, with and without tinnitus and vice versa. From 1240 studies, a total number of 32 studies were included in the meta-analysis. A risk of bias analysis was made using the Methodological Evaluation of Observational Research (MORE).
RESULTS
Seventeen studies showed low risk of bias, while fifteen studies showed some risk of bias. Among patients with TMD, 57.5% also displayed tinnitus. In contrast, among patients with tinnitus, 92.9% also suffered from TMD. There was a strong association between patients with TMD that also had tinnitus, and patients with tinnitus that also had TMD (p's < 0.001). The odds ratio for TMD-patients also having tinnitus was 1.556 ( < .05), while it for tinnitus-patients also having TMD was 2.859 ( < .05). Six studies examined the psychological status, and there was a higher degree of psychosocial distress among patients with TMD and TMD/tinnitus.
CONCLUSIONS
There is a strong significant association between TMD and tinnitus, but further research is needed to unravel the nature of this association and its clinical implication.
目的
颞下颌关节紊乱病(TMD)和耳鸣是非常常见的病症,影响着约10%至30%的成年人口,且似乎并存。本系统评价的主要目的是调查TMD与耳鸣之间的任何关联。次要目的是调查疼痛性和非疼痛性TMD之间的关联是否存在差异。
方法
对五个数据库进行电子文献检索,检索时间从数据库建立之初至2022年10月26日。目的是识别有关患有TMD(伴或不伴有耳鸣)以及患有耳鸣(伴或不伴有TMD)患者患病率的临床试验。从1240项研究中,共有32项研究被纳入荟萃分析。使用观察性研究的方法学评价(MORE)进行偏倚风险分析。
结果
17项研究显示偏倚风险较低,而15项研究显示存在一定偏倚风险。在患有TMD的患者中,57.5%也有耳鸣。相比之下,在患有耳鸣的患者中,92.9%也患有TMD。患有TMD且伴有耳鸣的患者与患有耳鸣且伴有TMD的患者之间存在很强的关联(p值<0.001)。患有TMD且伴有耳鸣的患者的优势比为1.556(<0.05),而患有耳鸣且伴有TMD的患者的优势比为2.859(<0.05)。六项研究考察了心理状态,TMD患者以及TMD/耳鸣患者的心理社会困扰程度更高。
结论
TMD与耳鸣之间存在很强的显著关联,但需要进一步研究来阐明这种关联的性质及其临床意义。