CBCT and Audiological Analysis of the TMJ-Tinnitus Relationship

NCT07460193 | Not Yet Recruiting

• 1 other identifier: 2026/02-45
• Study Type: observational
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to investigate the relationship between Temporomandibular Disorders (TMD) and subjective tinnitus at both morphological and functional levels. Current literature suggests that somatosensory inputs from the temporomandibular joint (TMJ) and masticatory muscles can modulate auditory pathways, a phenomenon known as Somatosensory Tinnitus. However, the specific role of TMJ bone morphology and critical neighboring structures, such as the Petrotympanic Fissure (PTF), in this interaction remains unclear. In this clinical study, patients with tinnitus will undergo a comprehensive evaluation including Cone Beam Computed Tomography (CBCT) to quantitatively analyze condylar morphology and osteoarthritic changes. Additionally, audiological tests will be performed to assess the functional state of the auditory system. This multidisciplinary approach aims to clarify the biological link between TMD and tinnitus, potentially improving diagnostic protocols and highlighting the importance of TMJ stabilization in tinnitus management.

Conditions

Tinnitus; Temporomandibular Joint Disorders; Somatosensory Tinnitus; Osteoarthritis, Temporomandibular Joint

Keywords

Tinnitus; Temporomandibular Joint Disorders; Cone-Beam Computed Tomography; Audiometry

Outcome Measures

Primary Outcomes (1)

• Frequency of Petrotympanic Fissure (PTF) Morphological Types

  The morphology of the PTF will be categorized into three types according to the Sato et al. classification: Type 1 (Open), Type 2 (Partially Open), and Type 3 (Closed) using CBCT imaging.

  Baseline (at the time of the single CBCT scan during the initial clinical visit).

Secondary Outcomes (3)

• Presence of Osteoarthritic Changes in the Mandibular Condyle

  Baseline.

• Pure Tone Thresholds

  Baseline

• Maximum Pain-Free Mouth Opening

  Baseline.

Study Arms (2)

TMD with Tinnitus (Case Group)

Patients diagnosed with Temporomandibular Disorders (TMD) based on clinical examination and history, who also report co-existing subjective tinnitus. This group will be evaluated for both TMJ morphological changes (via CBCT) and audiological status.

Diagnostic Test: Cone Beam Computed Tomography (CBCT); Diagnostic Test: Audiological Assessment; Other: Clinical TMJ Examination

TMD without Tinnitus (Control Group)

Patients diagnosed with Temporomandibular Disorders (TMD) but who do not experience any form of tinnitus (subjective or objective). This group serves as a control to compare the specific TMJ morphological variations and audiological findings associated with the presence of tinnitus.

Diagnostic Test: Cone Beam Computed Tomography (CBCT); Diagnostic Test: Audiological Assessment; Other: Clinical TMJ Examination

Interventions

Cone Beam Computed Tomography (CBCT) DIAGNOSTIC_TEST

High-resolution 3D imaging of the temporomandibular joint (TMJ) using the Instrumentarium OP300 Dental unit. The procedure involves evaluating condylar morphology, osteoarthritic changes (flattening, resorption, osteophytes), and the anatomical structure of the Petrotympanic Fissure (PTF) based on the Sato et al. classification.

TMD with Tinnitus (Case Group); TMD without Tinnitus (Control Group)

Audiological Assessment DIAGNOSTIC_TEST

A comprehensive evaluation of the auditory system to determine hearing thresholds and the functional status of the ear. This includes pure tone audiometry and specific tests to characterize the frequency and intensity of tinnitus in the patient group.

TMD with Tinnitus (Case Group); TMD without Tinnitus (Control Group)

Clinical TMJ Examination OTHER

Systematic physical examination of the masticatory muscles and the TMJ. This includes bilateral palpation for pain and tenderness, assessment of mandibular range of motion (maximal mouth opening, lateral and protrusive movements), and recording of joint sounds (clicking or crepitation).

TMD with Tinnitus (Case Group); TMD without Tinnitus (Control Group)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients who applied to the Otorhinolaryngology clinic with tinnitus complaints and were subsequently diagnosed with TMD in the Dentomaxillofacial Radiology clinic

You may qualify if:

• Patients aged 18 years and older.
• Patients presenting with otological symptoms such as tinnitus and ear pain.
• Patients diagnosed with Temporomandibular Disorders (TMD) based on clinical and radiographic examination.
• Patients who have been referred for CBCT imaging as part of their routine diagnostic process for TMD.
• Willingness to provide written informed consent to participate in the study.

You may not qualify if:

• Presence of objective tinnitus (e.g., vascular or muscular origin).
• History of chronic otitis media or other middle ear pathologies that could cause hearing loss or tinnitus.
• Previous history of temporomandibular joint surgery or major maxillofacial trauma.
• Presence of systemic metabolic bone diseases or inflammatory rheumatic diseases (e.g., Rheumatoid Arthritis).
• History of malignancy in the head and neck region.
• Pregnancy (due to CBCT imaging contraindication).
• Neurological or psychological disorders that would prevent cooperation during clinical and audiological examinations.

Sponsors & Collaborators

• Kutahya Health Sciences University: lead

Study Sites (1)

Kütahya Health Sciences University

Kütahya, Kütahya, 43020, Turkey (Türkiye)

Location

Related Publications (3)

• Cakur B, Yasa Y. Correlation Between Tinnitus and Petrotympanic Fissure Status Among Patients With Temporomandibular Joint Dysfunction. J Oral Maxillofac Surg. 2016 Jan;74(1):47-52. doi: 10.1016/j.joms.2015.07.020. Epub 2015 Jul 31.

  PMID: 26279489 RESULT

• Buergers R, Kleinjung T, Behr M, Vielsmeier V. Is there a link between tinnitus and temporomandibular disorders? J Prosthet Dent. 2014 Mar;111(3):222-7. doi: 10.1016/j.prosdent.2013.10.001. Epub 2013 Nov 25.

  PMID: 24286640 RESULT

• Sato I, Arai H, Asaumi R, Imura K, Kawai T, Yosue T. Classifications of tunnel-like structure of human petrotympanic fissure by cone beam CT. Surg Radiol Anat. 2008 Jun;30(4):323-6. doi: 10.1007/s00276-008-0327-4. Epub 2008 Feb 21.

  PMID: 18288438 RESULT

MeSH Terms

Conditions

Tinnitus; Temporomandibular Joint Disorders; Osteoarthritis

Interventions

Cone-Beam Computed Tomography

Condition Hierarchy (Ancestors)

Hearing Disorders; Ear Diseases; Otorhinolaryngologic Diseases; Sensation Disorders; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Craniomandibular Disorders; Mandibular Diseases; Jaw Diseases; Musculoskeletal Diseases; Joint Diseases; Muscular Diseases; Stomatognathic Diseases; Arthritis; Rheumatic Diseases

Intervention Hierarchy (Ancestors)

Tomography, X-Ray Computed; Tomography, X-Ray; Radiography; Diagnostic Imaging; Diagnostic Techniques and Procedures; Diagnosis; Tomography

Central Study Contacts

EDA İZGİ, Asst. Prof.

CONTACT

+905543578814; eda.ucbas@ksbu.edu.tr

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Asst. Prof.

Study Record Dates

• First Submitted: February 20, 2026
• First Posted: March 10, 2026
• Study Start: April 1, 2026
• Primary Completion: May 1, 2026
• Study Completion: July 1, 2026
• Last Updated: March 10, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)