Management of tinnitus and jaw-muscle tenderness using an intraoral appliance and acupuncture.

Associations between signs and symptoms from the masticatory system and tinnitus have been reported.The aim of the study was to evaluate the effect of intraoral splint therapy and acupuncture on jaw-muscle tenderness and tinnitus. The study comprised 45 patients (24 men, 21 women; mean age 48 +/- 12 years) with long-standing tinnitus (duration 6.5 +/- 5.9 years).The patients were referred from the audiology department at the University hospital in Orebro, Sweden, where a complete audiological survey was performed. Jaw muscles were palpated and the subjective tinnitus evaluated on a 100 mm scale (VAS) at baseline and after one year. All patients received stabilization (Michigan type) splints at start of treatment. After 6 months, nonresponders (n=25) were subjected to acupuncture (6 sessions with duration of 30 minutes). Standard statistical methods were used. All patients had tender jaw muscles at palpation. Patients reported a significant decrease of the intensity of tinnitus during the observation period (from 78 +/- 20 mm to 52 +/- 24 mm after one year; P < 0.001). Only 6 (13%) of the 45 patients did not report any improvement of their tinnitus.The number of jaw muscles tender to palpation also decreased significantly from 7.9 +/- 5.9 to 4.6 +/- 5.3; (P<0.001). In conclusion, all 45 patients with tinnitus had tenderjaw muscles. Intraoral splint therapy and acupuncture had a favorable effect on tinnitus and the jaw muscle symptoms. One year after the start of treatment, all but 6 of the 45 patients reported improvement of their tinnitus. Based on the results it is suggested that many tinnitus patients with jaw muscle tenderness can benefit by a treatment including intraoral splint and acupuncture.