Efeito do agulhamento seco no zumbido em pacientes com disfunção temporomandibular muscular
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Data
2023
Autores
Silvano, Nathália Prudencio [UNIFESP]
Orientadores
Onishi, Ektor Tsuneo [UNIFESP]
Tipo
Dissertação de mestrado
Título da Revista
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Resumo
Este ensaio clínico, duplo-cego, tem como objetivo avaliar o impacto do tratamento da disfunção temporomandibular (DTM) muscular no zumbido associado a esta desordem. A população estudada foi constituída por pacientes do Ambulatório de Disfunção Temporomandibular e Dor Orofacial do Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço da Universidade Federal de São Paulo (UNIFESP), que receberam o diagnóstico de DTM muscular por meio do questionário Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) e apresentavam zumbido. Neste estudo, avaliamos os pacientes com relato de zumbido associado a esta disfunção. Os pacientes selecionados foram submetidos à anamnese, exame otorrinolaringológico, otoneurológico, avaliação auditiva (audiometria tonal, vocal e imitanciometria), e alocados em dois grupos: grupo de estudo (GE) e grupo controle (GC). Após a identificação de pontos-gatilho miofasciais (PGMs) em músculo masseter, foram submetidos ao tratamento com agulhamento seco (AS) no GE e agulhamento sham no GC, em três sessões com intervalos de sete dias. Antes de iniciar a intervenção, estes pacientes foram submetidos à avaliação por termografia do músculo masseter, avaliação do impacto do zumbido através do Tinnitus Handicap Inventory (THI) e Escala Visual Analógica (EVA). Estes mesmos instrumentos foram aplicados novamente após a última sessão, com objetivo de comparar os resultados do pós-tratamento no GC e GE. Nossos resultados não mostraram diferenças no impacto do zumbido após tratamento, porém, observamos diferença estatisticamente significativa (p < 0,05) na análise da termografia do músculo masseter, com aumento da temperatura, no GE após AS.
This double-blind clinical trial aimed to evaluate the impact of treatment for muscular Temporomandibular Disorder (TMD) on the tinnitus associated with this dysfunction. The studied population consisted of patients at the Temporomandibular Disorder and Orofacial Pain Outpatient Clinic of the Otorhinolaryngology and Head and Neck Surgery Department at the Federal University of São Paulo (UNIFESP), who were diagnosed with muscular TMD using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) questionnaire and presented tinnitus. This study assessed patients who reported tinnitus associated with this dysfunction. The selected patients underwent anamnesis, otorhinolaryngological and otoneurological examination, and hearing assessment (tonal and vocal audiometry and immitanciometry). They were allocated into two groups: a study and control. After identifying myofascial trigger points in the masseter muscle, they underwent treatment with dry needling in the study group and sham needling in the control group, in 3 sessions at 7-day intervals. Before starting the intervention, these patients underwent an evaluation by thermography of the masseter muscle and an assessment of the impact of tinnitus using the Tinnitus Handicap Inventory (THI) and the Visual Analog Scale (VAS). These same instruments were applied again after the last session to compare the post-treatment results in the control and study groups. Our results showed no differences in the impact of tinnitus after treatment, however, we observed a statistically significant difference (p < 0.05) in the analysis of masseter muscle thermography, with an increase in temperature in the study group after dry needling.
This double-blind clinical trial aimed to evaluate the impact of treatment for muscular Temporomandibular Disorder (TMD) on the tinnitus associated with this dysfunction. The studied population consisted of patients at the Temporomandibular Disorder and Orofacial Pain Outpatient Clinic of the Otorhinolaryngology and Head and Neck Surgery Department at the Federal University of São Paulo (UNIFESP), who were diagnosed with muscular TMD using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) questionnaire and presented tinnitus. This study assessed patients who reported tinnitus associated with this dysfunction. The selected patients underwent anamnesis, otorhinolaryngological and otoneurological examination, and hearing assessment (tonal and vocal audiometry and immitanciometry). They were allocated into two groups: a study and control. After identifying myofascial trigger points in the masseter muscle, they underwent treatment with dry needling in the study group and sham needling in the control group, in 3 sessions at 7-day intervals. Before starting the intervention, these patients underwent an evaluation by thermography of the masseter muscle and an assessment of the impact of tinnitus using the Tinnitus Handicap Inventory (THI) and the Visual Analog Scale (VAS). These same instruments were applied again after the last session to compare the post-treatment results in the control and study groups. Our results showed no differences in the impact of tinnitus after treatment, however, we observed a statistically significant difference (p < 0.05) in the analysis of masseter muscle thermography, with an increase in temperature in the study group after dry needling.
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Citação
SILVANO, Nathália Prudencio. Efeito do agulhamento seco no zumbido em pacientes com disfunção temporomandibular muscular. 2023. 69 f. Dissertação (Mestrado em Otorrinolaringologia) – Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2023.