| Patients with otologic symptoms (otalgia, vertigo, tinnitus, fullness, and hearing loss) associated with temporomandibular disorders (TMD) are reported as a subpopulation of 29% in the literature, a phenomenon confirmed by subsequent relief after treatment for TMD. Though pain may be accounted for by shared neuronal pathways, the other symptoms are not easily explained.;Gross anatomical study of thirty-four human cadaver heads ascertained the presence of the discomalleolar ligament. However, these studies by bony dissection, decalcified sections, and microscopic section proved that tight adherence of the ligament to the walls of the petrotympanic fissure precludes that traction upon the ligament could cause any of the otologic symptoms. The temporomandibular joint's relationship to the tympanic tube was also considered by sectional and radiographic study and measurement. These studies showed a well-protected tube, quite distant from the movements of the condyle and ramus, although a medial pterygoid fascial connection was shown that could pull on the tube in extreme mandibular openings.;Five TMD patients with otologic symptoms and two controls were tested using electromyographic methods to record the functions of masseter and tensor veli palatini during five different mandibular motions. Graphic and numerical analysis of data were performed and results showed a hypoactive tensor and hyperactive masseter in TMD patients. A hypoactive tensor could account for vertigo, tinnitus, or diminished hearing in these patients. |
