Prevalence and severity of Temporomandibular disorders among patients with Otological Manifestations attending Muhimbili National Hospital

Abstract

ABSTRACT Background: Temporomandibular disorders encompass the temporomandibular joint and stomatognathic muscular disorders. Temporomandibular disorders may have non-otological and otological symptoms mainly due to anatomical, embryological and functional commonness between the ear structures and the masticatory system. There is paucity of data especially in our locality regarding temporomandibular disorders and its manifestations especially the otic ones; thus necessitating determination of its prevalence and severity among patients with otological manifestations and eventually improve management of patients. Objective: This study aimed at determining the prevalence and severity of temporomandibular disorders among patients with otological manifestations attending Muhimbili National Hospital. Methodology: A total of 288 patients were enrolled in this cross-sectional study. A structured questionnaire (Fonseca) which had ten anamnestic questions was employed for data collection. The diagnosis was made by comparing the total score to the Fonseca anamnestic index severity categories as mild (20-40), moderate (45-65), and severe (70-100). Patients who had scores of 0-15 were regarded as having ‘No temporomandibular disorder’ . Other information such as demographics and clinical characteristics were collected. A logistic regression was used to investigate the relationship between number of otological manifestations and diagnosis of Temporomandibular disorder. Similarly, ordinal multinomial logistic regression was conducted to investigate the relationship between the number of otological manifestations and severity of temporomandibular disorders. Results: The prevalence of temporomandibular disorders was 61.46%. Out of 177 patients who had a diagnosis of temporomandibular disorder; 105 (59.32%) had mild temporomandibular disorder, 51(28.81%) had moderate temporomandibular disorder, and 21(11.86%) had severe temporomandibular disorder. In an adjusted analysis, there was a statistically significant relationship between a number of otological manifestations (Odds ratio=1.470, p-value=0.0066), parafunctional habit (Odds ratio=2.372,p-value= 0.0143) and the diagnosis of temporomandibular disorder. In ordinal multinomial logistic regression, being female (Odds ratio=0.514, p-value=0.0307) and the number of otological manifestations (Odds ratio=0.532, p= 0.001) was associated with severity of temporomandibular disorder. Conclusion and recommendation: Temporomandibular disorders were prevalent (61.46%) from our study. Majority; 105 (59.32%) of patients had mild temporomandibular disorder and few; 21(11.86%) had severe temporomandibular disorder and significant association was found between the number of otological manifestations; diagnosis and severity of temporomandibular disorders .Otorhinolaryngologists should be more vigilant and inquire about symptoms and signs of temporomandibular disorders in patients presenting at Otorhinolaryngology clinic.