Cervical spine dysfunctions in patients with chronic subjective tinnitus.

OBJECTIVE

To assess, characterize, and quantify cervical spine dysfunction in patients with cervicogenic somatic tinnitus (CST) compared to patients suffering from other forms of chronic subjective non-pulsatile tinnitus.

STUDY

DESIGN

Cross-sectional study.

SETTING

Tertiary referral center.

PATIENTS: Consecutive adult patients suffering from chronic subjective non-pulsatile tinnitus were included.

EXCLUSION CRITERIA: Ménière's disease, middle ear pathology, intracranial pathology, cervical spine surgery, whiplash trauma, temporomandibular dysfunction.

INTERVENTION: Assessment comprises medical history, ENT examination with micro-otoscopy, audiometry, tinnitus assessment, temporomandibular and cervical spine investigation, and brain MRI. Patients were classified into CST and non-CST population. Cervical spine dysfunction was investigated using the Neck Bournemouth Questionnaire (NBQ) and clinical tests of the cervical spine, containing range of motion, pain provocation (adapted Spurling test, AST), and muscle tests (tenderness via trigger points, strength and endurance of deep neck flexors).

MAIN OUTCOME MEASURES: Between-group analysis was performed. The prevalence of cervical spine dysfunction was described for the total group and for CST and non-CST groups.

RESULTS

In total, 87 patients were included, of which 37 (43%) were diagnosed with CST. In comparison with the non-CST group, the CST group demonstrated a significantly higher prevalence of cervical spine dysfunction. In the CST group, 68% had a positive manual rotation test, 47% a positive AST, 49% a positive score on both, and 81% had positive trigger points. In the non-CST group, these percentages were 36, 18, 10, and 50%, respectively. Furthermore, 79% of the CST group had a positive NBQ versus 40% in the non-CST group. Significant differences between the both groups were found for all the aforementioned variables (all p < 0.005).

CONCLUSIONS

Although a higher prevalence of neck dysfunction was found in the CST group, neck dysfunction is often in non-CST patients.