From the Guidelines
Somatosensory tinnitus is a type of tinnitus where the perception of sound is influenced by physical movements or touch, particularly in the head, neck, jaw, or upper limbs, and is characterized by abnormal neural connections between the auditory and somatosensory systems in the brain. This condition is not explicitly mentioned in the provided study 1, but based on general medical knowledge, it is known to occur due to cross-modal interactions between these systems. In somatosensory tinnitus, patients may experience changes in their tinnitus symptoms when they perform certain movements, such as clenching their jaw, turning their head, or touching specific areas of their face or neck. The neurophysiological basis involves abnormal connections between the dorsal cochlear nucleus and the trigeminal nerve or upper cervical nerves. Some key points about somatosensory tinnitus include:
- It is often associated with temporomandibular joint disorders, neck injuries, or muscle tension in the head and neck region
- Treatment typically involves addressing underlying musculoskeletal issues through physical therapy, jaw exercises, or muscle relaxants, alongside conventional tinnitus management strategies
- Some patients may benefit from specialized treatments like cervical spine manipulation or trigger point therapy Although the study 1 does not specifically discuss somatosensory tinnitus, it emphasizes the importance of a targeted history and clinical examination in evaluating tinnitus, which would be crucial in identifying and managing somatosensory tinnitus.
From the Research
Definition of Somatosensory Tinnitus
- Somatosensory tinnitus is a subtype of tinnitus associated with activation of the somatosensory, somatomotor, and visual-motor systems 2.
- It is characterized by modulation of tinnitus by physical contact or movement, such as maneuvers of the temporomandibular joint, head and neck, eyes, and limbs 3.
- Somatosensory tinnitus can be influenced by somatic disorders, such as temporomandibular joint disease, and can be treated with targeted therapy for these disorders 3.
Diagnosis of Somatosensory Tinnitus
- A decision tree using four clinical criteria has been proposed to diagnose somatosensory tinnitus with an accuracy of 82.2%, a sensitivity of 82.5%, and a specificity of 79% 4.
- Somatic testing, such as identifying co-varying tinnitus and neck complaints, can help diagnose somatosensory tinnitus and predict treatment outcomes 5.
Treatment of Somatosensory Tinnitus
- Musculoskeletal physical therapy treatment, including counseling, exercises, and manual techniques, can be effective in treating somatosensory tinnitus 4.
- Cervical spine treatment, such as manipulations, exercises, and trigger point treatment, can decrease tinnitus severity 6.
- Temporomandibular joint treatment, such as splints, occlusal adjustments, and jaw exercises, can also decrease tinnitus severity 6.
- Prognostic indicators for decrease in tinnitus severity after cervical physical therapy include co-varying tinnitus and neck complaints, and a combination of low-pitched tinnitus and increasing tinnitus during inadequate cervical spine postures 5.