Secondary Otalgia Outcomes in Patients Treated for Temporomandibular Disorder: A Scoping Review
Date
2022-12-28
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Abstract
Ear pain, or otalgia, is one of the most common clinical presentations seen in primary care, emergency medicine, and Otolaryngology (Kozin et al. 2015). Otalgia is subdivided into two categories: primary and secondary otalgia. Primary otalgia refers to pain emanating from structures in the inner, middle, or outer ear and typically presents with additional otologic symptoms such as otorrhea, vertigo, and loss of hearing (Hwa and Brant 2021). Secondary otalgia refers to ear pain that is related to non-otologic etiologies and often does not present with other otologic symptoms as would be seen in primary otalgia. Secondary otalgia presentations comprise close to half of all otalgia cases (Hwa and Brant 2021).
A common etiology of secondary otalgia a group of conditions associated with musculoskeletal and neuromuscular pathology of the temporomandibular joint, muscles involved in mastication, and their associated structures, known collectively as Temporomandibular Disorder (TMD). It is reported that greater than 55% of adult patients with TMD report otalgia (Porto De Toledo et al. 2017). Anecdotally, a large number of care providers suggest management of possible TMD in patients presenting with secondary otalgia. However, the literature lacks consensus and strong evidence to suggest that TMD treatment results in resolution of secondary otalgia (Morell 2018; Hernández-Nuño de la Rosa et al. 2022). Further, the pathophysiology of TMD and secondary otalgia is also poorly understood . One recent systematic review linked several studies where patients experienced another otologic symptom, tinnitus, to an anatomic cause of TMD (Hernández-Nuño de la Rosa et al. 2022). While this review provided a brief overview on possible anatomical etiologies of secondary otalgia related to TMD, further investigation of the literature is warranted.
The objective of this study is to conduct a thorough literature review to synthesize a concise scoping review to explain the anatomical relationship between TMD, and in doing so provide an overview on how various treatments affect the outcome of patients with concomitant secondary otalgia due specifically to TMD related to anatomic causes. The intent of this scoping review is to aid clinicians in providing stronger recommendations to their patients who suffer with secondary otalgia due to TMD.
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Keywords
secondary otalgia, temporomandibular disorder, referred otalgia, Temporomandibular Joint Disorders, Temporomandibular Joint Dysfunction Syndrome, dental otalgia