颅颌功能紊乱的耳症及治疗研究  

Ear symptoms in patients with craniomandibular disorders and treatment outcome

作　　者：焦国良[1] 王永海[1] 李国宏 

机构地区：[1]白求恩国际和平医院口腔科,050082

出　　处：《现代口腔医学杂志》1999年第4期276-277,302,共3页Journal of Modern Stomatology

摘　　要：目的　研究颅颌功能紊乱(CMD) 者耳症的发生率、临床特征及对肌位牙合板的治疗反应。方法　将208 例CMD 者分为耳症组(n = 55) 与非耳症组(n = 153) 进行研究, 临床症状以Helkimo 指数( Di) 计算。结果　CMD 者耳症发生率26 .4 % , 女性明显高于男性, 其中耳鸣发生率14 .9 % , 耳痛发生率10 .6 % , 耳症组盘突关系异常者显著多于非耳症组, 临床症状表现为DiⅡ者明显高于非耳症组, 耳症出现与颞颌关节结构紊乱密切相关而与髁突器质性改变无明确关系。经夜间戴用肌位牙合板3 ～6 个月后, 两组间CMD 症状均明显好转或消失,症状变化在两组间无显著差异, 随CMD 症状的变化,耳症也随之消失, 耳鸣消失率77 .4 % ,耳痛消失率77 .3 % 。结论　颞颌关节结构紊乱是CMD 者出现耳症的主要原因, 肌位牙合板不仅能使CMD 症状缓解, 而且也能使耳症随之缓解或消失。本研究提示耳科医生, 对不能明确病理基础的耳症应详细检查颞颌关节及咀嚼肌功能。Objective To investigate the incidence of ear symptoms in patients with craniomandibular disorders(CMD) and the clinical characteristics and treatment outcome. Methods 208 consecutive patients in temporomandibular joint (TMJ) clinic was divided into two groups : group one with ear symptoms (n=55), group two without ear symptoms (n=153). The severity of symptoms of CMD was calculated according to the dysfunction index (Di) proposed by Helkimo. Results It was discovered that the incidence of ear symptoms was 26.4%, with tinnitus 14.9%and earache 10.6%, and it was significantly higher in female. It was found that the patients with abnormal discondyle relationship were significantly more in group one than that in group two, and more patients in group one presenting dim. After wearing the muscular position splint during night for 3 to 6 months, the CMD symptoms in both groups were releived or disappeared, with 77.4% of tinnitus and 77.3% of earache was cured. Conclusion The results suggest that TMJ Interval derangement (TMJ ID)is the main cause for the occurrence of ear symptoms. The muscular position splint releives not only the CMD symptoms, but also the ear symptoms. It is indicated that when the otolaryngologist could not find apparent pathological basis for ear symptoms, they shouly have the masticatory muscles and the TMJs evaluated.

关 键 词：颅颌功能紊乱 耳鸣 耳痛 咬合板 

分 类 号：R782.6[医药卫生—口腔医学] R764.45[医药卫生—临床医学]