The Temporomandibular Joint Compromise (TMJC) as a Cause of Otoneurological Symptoms: Headaches, Dizziness and Tinnitus

Abstract

Introduction The prevalence of temporomandibular disorders in the population with chronic or recurrent headaches is too high for a relationship not to exist. Publications propose the examination of the masticatory system in all patients with headache. Objective To introduce a new entity within temporomandibular disorders, temporomandibular joint compromise (TMJC), mandibular movement limiting pathology of extra-articular traumatic cause, and evaluate the response rate and safety of treatment. The limiting cause of mandibular movement is the lack of space between the mandibular ramus and maxilla. The main symptoms of TMJC include headache, dizziness, and tinnitus. In many cases, the headache is previously diagnosed as a migraine. Methods Data were collected from 54 patients aged between 6 and 59 years who had a confirmed diagnosis of migraine (according to the the International Classification of Headache Disorders, 3rd edition [ICHD3]) and were treated for TMJC in a dental clinic. They also presented other otolaryngological symptoms. A retrospective quasi-experimental study without a control group was carried out due to ethical considerations related to the harmless nature of the treatment. Results After treatment of TMJC, migraine symptoms disappeared in 52 patients (96.3%, p < 0.001) and persisted, although with clinical improvement, in 2 (3.7%). There was also an improvement in the other associated symptoms: dizziness disappeared in 23 out of the 27 affected patients (85.21%, p < 0.001) and tinnitus disappeared in the 31 affected patients (100%, p < 0.001). No significant treatment-related side effects were observed. Conclusion The present study shows the high rate of response and safety of the treatment of TMJC.