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Master's Dissertation
DOI
https://doi.org/10.11606/D.25.2009.tde-01062009-155059
Document
Author
Full name
Priscila Brenner Hilgenberg
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Bauru, 2009
Supervisor
Committee
Conti, Paulo Cesar Rodrigues (President)
Felicio, Claudia Maria de
Lopes, Andréa Cintra
Title in Portuguese
Estudo da participação de sinais e sintomas de disfunção temporomandibular (DTM) e sintomas otológicos em pacientes portadores de zumbido subjetivo
Keywords in Portuguese
Disfunção temporomandibular
Otalgia
Perda auditiva
Tontura
Zumbido
Abstract in Portuguese
A presenca de sintomas otologicos em pacientes com Disfunção Temporomandibular (DTM) e uma constante. Apesar de ainda nao existir um consenso sobre a origem desses sintomas, a literatura apresenta uma serie de trabalhos que comprovam essa associacao. O presente estudo avaliou a prevalencia de DTM em pacientes portadores de zumbido e a associacao deste com outros sintomas otologicos, como otalgia, plenitude auricular, tontura/vertigem, hipoacusia e hiperacusia. Tambem foi estudada a prevalência de perda auditiva entre os portadores de zumbido, com e sem DTM. Alem disso, foi avaliado indice de depressao dos pacientes e a influencia do zumbido na qualidade de vida dos mesmos. Foram selecionados 200 pacientes, 100 portadores de zumbido e 100 sem zumbido. Para avaliar a presenca de sintomas otologicos, os pacientes foram avaliados por um Otorrinolaringologista atraves da utilizacao do Protocolo de Zumbido e Hiperacusia do HC-FMUSP. Os pacientes responderam a questionarios e foram submetidos a anamese, exames clinico e fisico. Para classificar os pacientes em portadores de DTM ou nao, foi utilizado o Research Diagnostic Criteria for Temporomadibular Disorders (RDC/TMD). Para avaliar o indice de depressao foi utilizado o questionario Eixo II do RDC/TMD. A severidade da DTM tambem foi determinada atraves de um questionario. Para avaliar o impacto do zumbido na qualidade de vida dos pacientes, foi utilizado o Tinnitus Handicap Inventory (THI), validado para a lingua portuguesa. A avaliação audiologica foi feita em 48 dos pacientes com zumbido e realizada por um Fonoaudiologo. Os dados obtidos foram submetidos a analise estatistica Quiquadrado, Mann-Whitney, Spearman) com um nivel de significancia de 5%. Dos 100 pacientes portadores de zumbido subjetivo 84 eram mulheres e 16 homens que tinham idade media de 39,16 anos. Os outros 100 pacientes nao possuíam zumbido, eram 65 mulheres e 35 homens, com idade media de 34,33 anos. A prevalencia de DTM no grupo de pacientes com zumbido foi de 85% e no grupo sem zumbido de 55% e essa diferenca foi estatisticamente significante (p0,001). A prevalencia dos sintomas otologicos foi avaliada e todos foram estatisticamente associados (p0,001) com a presenca de zumbido: otalgia 27%; tontura/vertigem 52%; plenitude auricular 61%; hipoacusia 62% e hiperacusia 26%. A severidade da DTM foi associada positivamente com a presenca de zumbido (p0,001). A prevalencia de DTM na amostra total foi de 70% (n=140). Para todos os sintomas otologicos houve uma associacao estatisticamente significante com a presenca de DTM (p0,05). Nao houve diferenca entre as medias dos valores do THI entre os pacientes com e sem DTM do grupo com zumbido (p=0,67). Tambem nao houve correlacao estatisticamente significante entre o tempo de zumbido e qualidade de vida (p=0,73). Os pacientes com zumbido apresentaram maiores niveis de depressao (p0,001). A prevalencia de perda auditiva entre os pacientes com zumbido foi de 4,17% e nos pacientes portadores de DTM foi de 2,63%. A presenca de DTM parece nao influenciar os resultados dos exames audiologicos.
Title in English
A cross-sectional study of the influence of signs ans symptoms of temporomandibular disorders and otologic symptoms in tinnitus patients
Keywords in English
Dizziness
Earache
Hearing loss
Temporomandibular disorder
Tinnitus
Abstract in English
The aim of this study was to determinate the prevalence of signs and symptoms of TMD and otologic symptoms in tinnitus patients. The association between the severity of TMD and tinnitus and the influence of tinnitus in patient´s quality of life and the level of depression were also addressed. Audiologic evaluation in tinnitus patients was performed in order to verify the association of hearing loss and TMD. Two hundred patients participated on this study, divided into two groups by an experimented Otolaryngologist. The experimental group was comprised of 100 tinnitus patients and control group was comprised of 100 individuals without tinnitus. All subjects were evaluated using RDC/TMD in order to determinate the presence of TMD. The severity of the TMD was determinated by using a self-reported anamnestic questionnaire. The influence of tinnitus in quality of life was determinated by the Tinnitus Handicap Inventory (THI). Depression level was determinate by the SCL-90 from RDC/TMD axis II. Audiologic evaluation was performed in 48 tinnitus patients with and without TMD. Chi-square, Mann-Whitney and Spearman tests were used in statistical analysis, with a 5% significance level. The prevalence of signs and symptoms of TMD in tinnitus patients was 85% and statistical association was found (p0.001). Stuffy sensations were found in 61% of patients (p0.001), dizziness in 52% of patients (p0.001), otalgia in 27% of patients (p0.001), hypoacusis and hyperacusis in 62% and 27% of patients (p0.001), respectively. The severity of TMD was positively associated with tinnitus (p0.001). The mean THI value for TMD was 33.38 while for non-TMD patients was 34.93, with no statistical difference (p=0.67) between them. Depression levels for tinnitus patients were statistically higher than non-tinnitus patients (p0.001). The prevalence of hearing loss in tinnitus patients was 4.17% and among TMD patients was 2.63%. It was concluded that tinnitus is associated with TMD, as well as with higher depression levels. On the other hand, hearing loss was not associated with TMD.
 
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Publishing Date
2009-06-02
 
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