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[内耳疾病与颞下颌关节疾病之间的相关性]

[Correlation between inner ear disorders and temporomandibular joint diseases].

作者信息

Kempf H G, Roller R, Mühlbradt L

机构信息

HNO-Klinik, Universität Tübingen.

出版信息

HNO. 1993 Jan;41(1):7-10.

PMID:8449789
Abstract

Acute and chronic inner ear diseases involve many etiological factors, some as yet unknown. ENT-specific, orthopedic, hemorrheological, immunological and neurological disorders can affect the cochleovestibular system and induce hearing loss, vertigo and/ortinnitus. We performed a prospective study to analyze factors of the dentognathological system and of the temporomandibular joint that can influence acute and chronic inner ear dysfunctions. A total of 138 patients (49.3% female, 50.9% male) receiving clinical treatment for inner ear dysfunctions (12.3% chronic sensorineural hearing loss, 15.2% Ménière's disease, 52.2% sudden hearing loss, 13.8% isolated tinnitus, 6.5% recurrent hearing loss) underwent a prospective dental and gnathological examination. In particular, the patient's dental status and a functional investigation of the masticatory muscles and the temporomandibular joint were analyzed. In 20.3% patients the examination showed no pathology of the dentognathological system. In contrast, there were pathological findings in 110 patients (79.7%): in 43.5% a temporomandibular joint syndrome was diagnosed, in 29% parafunction of the occlusion, and in 35% a myopathy of the masticatory muscles. Additionally 32.6% patients showed dental disorders that required treatment; 11.65% had problems with dentures and 20.3% malpositioned wisdom teeth. In 16 patients the recommended dental treatment was followed up and improvement of otological symptoms was found in 56.6%. The present investigation shows that many patients with inner ear dysfunction suffer from dentognathological disorders. For a subgroup of patients there exists the possibility of improving otological symptoms by dental treatment. Therefore we recommend a dentognathological examination in patients with inner ear dysfunctions of unknown etiology.

摘要

急慢性内耳疾病涉及许多病因,其中一些尚不明确。耳鼻喉科特异性、骨科、血液流变学、免疫学和神经学疾病可影响耳蜗前庭系统,并导致听力损失、眩晕和/或耳鸣。我们进行了一项前瞻性研究,以分析牙颌系统和颞下颌关节中可能影响急慢性内耳功能障碍的因素。共有138例接受内耳功能障碍临床治疗的患者(女性49.3%,男性50.9%)(12.3%为慢性感音神经性听力损失,15.2%为梅尼埃病,52.2%为突发性听力损失,13.8%为单纯耳鸣,6.5%为复发性听力损失)接受了前瞻性牙科和颌骨学检查。特别是,分析了患者的牙齿状况以及咀嚼肌和颞下颌关节的功能。20.3%的患者检查显示牙颌系统无病变。相比之下,110例患者(79.7%)有病理发现:43.5%被诊断为颞下颌关节综合征,29%为咬合异常功能,35%为咀嚼肌肌病。此外,32.6%的患者有需要治疗的牙齿疾病;11.65%有假牙问题,20.3%有智齿错位。对16例患者进行了推荐的牙科治疗随访,发现56.6%的患者耳科症状有所改善。目前的调查表明,许多内耳功能障碍患者患有牙颌疾病。对于一部分患者来说,通过牙科治疗有可能改善耳科症状。因此,我们建议对病因不明的内耳功能障碍患者进行牙颌学检查。

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