Abnormal findings on digital vectoelectronystagmography in patients with temporomandibular disorders
Adriana Tresso; Gustavo José Luvizutto; Rodrigo Bazan; Heloisa Helena Caovilla; Maurício Malavasi Ganança
Abstract
Purpose: this study aimed to verify the occurrence of abnormal vectoelectronystagmography findings in patients with temporomandibular disorders (TMDs).
Methods: in this cross-sectional study, patients diagnosed with TMDs underwent an otorhinolaryngological examination, audiological evaluation, and balance and vestibular function examinations, using vectoelectronystagmography. The tests performed were 1) spontaneous nystagmus, 2) saccadic movements, 3) pendular tracking, 4) optokinetic nystagmus gain and velocity, 5) rotational chair testing, and 6) post-caloric vertigo and the direction and velocity of the slow component of nystagmus.
Results: thirty patients were selected (22 females and 8 males) with mean age of 30.8(14.9 years. Sensorineural hearing loss was seen in four patients (13.3%); the other patients (86.7%) had results within the normal range at all frequencies. Five patients (16.7%) showed abnormalities on the Romberg test and seven (23.3%) on the Tandem test. Abnormalities on the caloric test were seen in 40.0% of patients. More prevalence of headache (p<0.0001) and tinnitus (p<0.0001) was observed in patients with unilateral hyperreflexia, and dizziness, depression, anxiety, gait imbalance and falls in patients with bilateral hyperreflexia.
Conclusion: patients with TMDs may present vectoelectronystagmography abnormalities characterized by unilateral or bilateral hyperreflexia and unilateral hyporeflexia of post-caloric nystagmus.
Keywords
References
1. Fernández-de-las-Penas C, Svensson P. Myofascial temporomandibular disorder. Curr Rheumatol Rev. 2016;12(1):40-54.
2. Maixner W, Diatchenko L, Dubner R, Fillingim RB, Greenspan JD, Knott C et al. Orofacial pain prospective evaluation and risk assessment study -- the OPPERA study. J Pain. 2011;12(11 suppl):T4-T11.e1-2.
3. Durham J, Newton-John TR, Zakrzewska JM. Temporomandibular disorders. BMJ. 2015;350:h1154.
4. Edvall NK, Gunan E, Genitsaridi E, Lazar A, Mehraei G, Billing M et al. Impact of temporomandibular joint complaints on tinnitus-related distress. Front Neurosci. 2019;13:879.
5. Scharnweber B, Adjami F, Schuster G, Kopp S, Natrup J, Erbe C et al. Influence of dental occlusion on postural control and plantar pressure distribution. Cranio. 2017;35(6):358-66.
6. Villaça Avoglio JL. Dental occlusion as one cause of tinnitus. Med Hypotheses. 2019;130:109280.
7. Bousema EJ, Koops EA, van Dijk P, Dijkstra PU. Association between subjective tinnitus and cervical spine or temporomandibular disorders: a systematic review. Trends Hear. 2018;22:2331216518800640.
8. Skog C, Fjellner J, Ekberg E, Häggman-Henrikson B. Tinnitus as a comorbidity to temporomandibular disorders-A systematic review. J Oral Rehabil. 2019;46(1):87-99.
9. Vielsmeier V, Strutz J, Kleinjung T, Schecklmann M, Kreuzer PM, Landgrebe M et al. Temporomandibular joint disorder complaints in tinnitus: further hints for a putative tinnitus subtype. PLoS One. 2012;7(6):e38887.
10. Wright EF, Bifano SL. The relationship between tinnitus and temporomandibular disorder (TMD) Therapy. Int Tinnitus J. 1997;3(1):55-61.
11. Boniver R. Temporomandibular joint dysfunction in whiplash injuries: association with tinnitus and vertigo. Int Tinnitus J. 2002;8(2):129-31.
12. Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord. 1992;6(4):301-55.
13. Guzmán PV, Caovilla HH. Sintomas otoneurológicos: investigação por meio de um questionário. Acta AWHO. 2001;20(3):130-40.
14. Davies H. Audiometry: pure-tone and simple speech test. In: Davis H, Silverman R (eds). Hearing and deafness. New York: Holt, Rinehart and Winston; 1978. p. 183-221.
15. Jerger J. Clinical experience with impedance audiometry. Arch Otolaryngol. 1970;92(4):311-24.
16. Cohen HS. A review on screening tests for vestibular disorders. J Neurophysiol. 2019;122(1):81-92.
17. Pansini M, Padovan I. Three derivations in electronystagmography. Acta Otolaryngol. 1969;67(2):303-9.
18. Martin VT, Neilson D. Joint hypermobility and headache: the glue that binds the two together--part 2. Headache. 2014;54(8):1403-11.
19. Di Paolo C, D’Urso A, Papi P, Di Sabato F, Rosella D, Pompa G et al. Temporomandibular disorders and headache: a retrospective analysis of 1198 patients. Pain Res Manag. 2017;2017:3203027.
20. La Touche R, París-Alemany A, von Piekartz H, Mannheimer JS, Fernández-Carnero J, Rocabado M. The influence of cranio-cervical posture on maximal mouth opening and pressure pain threshold in patients with myofascial temporomandibular pain disorders. Clin J Pain. 2011;27(1):48-55.
21. Manni A, Brunori P, Giuliani M, Modoni M, Bizzi G. Oto-vestibular symptoms in patients with temporomandibular joint dysfunction. Electromyographic study. Minerva Stomatol. 1996;45(1-2):1-7.
22. Cuccia A, Caradonna C. The relationship between the stomatognathic system and body posture. Clinics. 2009;64(1):61-6.
23. Zeigelboim BS, Jurkiewicz AL, Martins-Bassetto J, Klagenberg KF. Avaliação vestibular em mulheres com disfunção temporomandibular. Rev. CEFAC. 2007;9(2):255-62.
24. Gonçalves DU, Felipe L, Lima TM. Interpretation and use of caloric testing. Braz J Otorhinolaryngol. 2008;74(3):440-6.
25. Chung SW, Kim MJ, Ahn JC, Suh MW, Rhee CK, Jung JY. Inflammation of temporomandibular joint increases neural activity in rat vestibular nucleus. Neurosci Lett. 2012;528(2):126-30.
Submitted date:
09/21/2020
Accepted date:
01/19/2021
Facebook
Twitter
LinkedIn
Mendeley
Email