Tinnitus and craniomandibular disorders--is there a link?

Associations between tinnitus and craniomandibular disorders (CMD) were investigated in an epidemiological sample, in tinnitus patients, and in patients attending a 'CMD-clinic'. Natural course of tinnitus was explored in a longitudinal epidemiological study of an elderly population. Several findings indicating a relatively strong relationship between CMD, tinnitus and subjective hearing loss were noted. This relationship seemed to be independent of objectively assessed degree of hearing loss, occupational noise exposure, general morbidity, medication or socioeconomic status. The prevalence of frequent headaches and fatigue or tenderness in jaw muscles was higher in tinnitus patients than would be expected if these conditions were unrelated. About one third of the individuals affected by tinnitus reported influence on tinnitus by jaw movements or pressure on the temporomandibular joint (TMJ). Diurnal bruxism and jaw fatigue appeared to be related to fluctuating tinnitus, vertigo, and hyperacusis. Stomatognathic and biofeedback treatment seemed to be able to reduce or eliminate tinnitus in some patients. Relatively low severity of tinnitus, normal hearing, fluctuating tinnitus, and some signs and symptoms of CMD are believed to constitute predictors of successful treatment outcome. Substantial longitudinal fluctuations with a high occurrence of spontaneous remissions of tinnitus were found in elderly people.