伴耳鸣的颞下颌关节病患者临床症状与偏侧咀嚼习惯相关性的初步探讨
Preliminary study on the correlation between the clinical symptoms of temporomandibular disorder with tinnitus and chewing-side preference habits
作者：马博文, 黄东宗, 徐鑫宇, 王一涵, 李晓星, 胡一帆, 杨淑芝, 李鸿波, 胡敏, 刘洪臣, 姜华
Author：Ma Bowen, Huang Dongzong, Xu Xinyu, Wang Yihan, Li Xiaoxing, Hu Yifan, Yang Shuzhi, Li Hongbo, Hu Min, Liu Hongchen, Jiang Hua
收稿日期：2024-10-13 年卷（期）页码：2025,43(3):416-416-421
期刊名称：华西口腔医学杂志
Journal Name：West China Journal of Stomatology
关键字：颞下颌关节病,耳鸣,偏侧咀嚼,关节盘移位,关节区疼痛,
Key words：temporomandibular disorder,tinnitus,chewing-side preference,disc displacement of temporomandibular joint,pain in the temporomandibular joint area,
基金项目：国家重点研发计划(2023YFC3605600);国家自然科学基金项目(8237030766)
中文摘要
目的 探讨伴耳鸣的颞下颌关节病（TMD）患者临床症状和偏侧咀嚼习惯的相关性。 方法 纳入2020年12月—2024年5月于中国人民解放军总医院第一医学中心口腔科就诊并明确诊断为TMD的患者285例，分为耳鸣组和非耳鸣组。分析2组患者中偏侧咀嚼习惯的占比、耳鸣发生侧与偏侧咀嚼侧的相关性、TMD临床症状（弹响、关节疼痛、张口受限）与耳鸣的相关性、偏侧咀嚼习惯与耳鸣的相关性、关节盘移位类型与偏侧咀嚼和耳鸣的相关性。 结果 在耳鸣组中，偏侧咀嚼者的比例为90.70%（39/43），无偏侧咀嚼者的比例为9.30%（4/43）。在无耳鸣组中，偏侧咀嚼者的比例为76.03%（184/242），无偏侧咀嚼者的比例为23.97%（58/242）。耳鸣组出现偏侧咀嚼的比例高于无耳鸣组，差异具有统计学意义（χ2= 4.613，P<0.05）。耳鸣与偏侧咀嚼习惯相关性分析结果显示：耳鸣与偏侧咀嚼习惯呈正相关（P<0.05）。在左侧耳鸣组中，左侧偏侧咀嚼者的比例［54.55%（12/22）］高于右侧偏侧咀嚼者的比例［45.45%（10/22）］；在右侧耳鸣组中，右侧偏侧咀嚼者的比例［81.82%（9/11）］高于左侧偏侧咀嚼者的比例［18.18%（2/11）］。耳鸣发生侧与偏侧咀嚼习惯侧分布比例差异有统计学意义（χ2=7.282，P<0.05）。耳鸣发生侧与偏侧咀嚼习惯侧相关性分析结果显示：耳鸣发生侧与偏侧咀嚼习惯侧呈正相关（P<0.05）。耳鸣组患者的疼痛比例显著高于无耳鸣组，差异有统计学意义（P<0.05）。耳鸣组与无耳鸣组患者中发生关节弹响、张口受限的比例差异无统计学意义（P>0.05）。耳鸣组与无耳鸣组患者发生关节盘移位（无关节盘移位、单侧关节盘移位、双侧关节盘移位）比例差异均无统计学意义（P>0.05）；耳鸣组与无耳鸣组患者发生关节盘移位（无关节盘移位、可复性关节盘移位、不可复性关节盘移位）比例差异均无统计学意义（P>0.05）。 结论 伴偏侧咀嚼习惯的TMD可能是不明原因耳鸣的诱发因素，不明原因耳鸣与TMD患者的关节区疼痛具有一定的相关性。
英文摘要
ObjectiveThis study aimed to investigate the correlation between clinical symptoms and unilateral chewing habits in patients with temporomandibular disorder (TMD) accompanied by tinnitus.MethodsA total of 285 patients diagnosed with TMD at the Department of Stomatology of the First Medical Center of Chinese People’s Liberation Army General Hospital between December 2020 and May 2024 were included and divided into two groups: tinnitus group and non-tinnitus group. Analysis was conducted on the proportion of patients with unilateral chewing habits in both groups, the correlation between the side of tinnitus and the side of unilateral chewing, and the correlation of tinnitus with TMD clinical symptoms (joint clicking, joint pain, and limited mouth opening) and unilateral chewing habits. The correlation of the type of disc displacement with unilateral chewing and tinnitus was also examined.ResultsIn the tinnitus group, the proportions of patients with and without unilateral chewing habits were 90.70% (39/43) and 9.30% (4/43), respectively. In the non-tinnitus group, the proportions of patients with and without unilateral chewing habits were 76.03% (184/242) and 23.97% (58/242), respectively. The proportion of patients with unilateral chewing habits in the tinnitus group was significantly higher than in the non-tinnitus group (χ2=4.613,P<0 .05). correlation analysis showed a positive correlation between tinnitus and unilateral chewing habits (P<0 .05). in the left-sided tinnitus group, the proportion of left-sided unilateral chewers [54.55% (12/22)] was higher than that of right-sided unilateral chewers [45.45% (10/22)]. in the right-sided tinnitus group, the proportion of right-sided unilateral chewers [81.82% (9/11)] was higher than that of left-sided unilateral chewers [18.18% (2/11)]. the difference was statistically significant (χ2=7.282,P<0 .05). a positive correlation was also found between the side of tinnitus and the side of unilateral chewing habits (P<0 .05). the proportion of patients with pain was significantly higher in the tinnitus group than in the non-tinnitus group (P<0 .05). no significant difference in the proportion of joint clicking or limited mouth opening and disc displacement (no disc displacement, unilateral disc displacement, bilateral disc displacement, reducible disc displacement, or irreducible disc displacement) was found between the tinnitus and non-tinnitus groups (P>0.05).ConclusionTMD with unilateral chewing habits may be a contributing factor to unexplained tinnitus. Unexplained tinnitus is correlated with joint pain in patients with TMD.
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