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Laryngorhinootologie 2002; 81(4): 268-275
DOI: 10.1055/s-2002-25324
Otologie
© Georg Thieme Verlag Stuttgart · New York

Das „Costen Syndrom” - welche Befunde lassen aus HNO-ärztlicher Sicht die Zusammenarbeit mit einem Zahnarzt sinnvoll erscheinen?

The „Costen Syndrome” - Which Symptoms Suggest that the Patient may Benefit from Dental Therapy?H.  Seedorf 1 , R.  Leuwer 2 , C.  Fenske 1 , H.  D.  Jüde 1
  • 1 Klinik und Poliklinik für Zahn-, Mund- und Kieferheilkunde. Abteilung für Zahnärztliche Prothetik (Prof. Dr. H. D. Jüde)
  • 2 Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde (Prof. Dr. U. Koch)
Further Information

Publication History

19. Juni 2001

3. August 2001

Publication Date:
24 April 2002 (online)

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Zusammenfassung

Hintergrund: In der Literatur wird seit den dreißiger Jahren ein Zusammenhang zwischen kraniomandibulären Dysfunktionen (CMD) und Otalgien bzw. Tinnitus diskutiert. Dieser Zusammenhang wird nach einem der frühesten und vehementesten Vertreter dieser These oft als „Costen Syndrom” bezeichnet. Ziel des vorliegenden Beitrages ist es, den derzeitigen Stand der Diskussion aus zahnärztlicher Sicht darzustellen.

Diagnose/Epidemiologie/Therapie: Eine allgemein gültige Definition für den Begriff CMD existiert nicht. Unterschiedlichen Autoren fassen eine Vielzahl verschiedener Befunde oder Diagnosen unter der Bezeichnung CMD zusammen. Ungeachtet einer hohen Prävalenz von CMD und starker Behandlungsnachfrage fehlt es an einer allgemein akzeptierten Standardtherapie.

Schlussfolgerungen: Das Fehlen klarer Definitionen und Standards ist das Haupthindernis bei der Beweisführung eines kausalen Zusammenhanges zwischen CMD und Otalgien bzw. Tinnitus. Dennoch wird bei Vorliegen einer Otalgie nach Ausschluss von Ursachen im HNO-ärztlichen Bereich im Einzelfall eine Abklärung durch einen Zahnarzt mit Erfahrung auf dem Gebiet der Funktionsdiagnostik als sinnvoll angesehen.

Abstract

Introduction: Since the thirties the hypothesis of a direct connection between temporomandibular disorders (TMD) and tinnitus/otalgia has been discussed. The thesis of this possible connection is often named after one of the earliest and most vehement supporters as „Costen Syndrome”. This review is aimed to elucidate the present state of the discussion from the Dentist's point of view.

Diagnosis/Epidemiology/Therapy of TMD: Diagnostic research criteria which define TMD are not standardized. Despite high prevalence and strong demand for treatment of TMD there is still a lack of a commonly accepted standard therapy and the potential benefit from a therapeutic point of view is still controversial.

TMD and Tinnitus/Otalgia: Concurrence of TMD and tinnitus by a common underlying cause is still unproven. By contrast a causal link between certain forms of TMD and otalgia is obvious.

Conclusion: A lack of clear definitions and standards for the diagnosis of TMD is the main hinderance to prove a causal relationship especially between TMD otalgia. However patients seeking care for otalgia with no identifiable otologic cause may benefit from dental therapy. Therefore future studies should focus on well defined subgroups of TMD to investigate a link between otalgia/tinnitus and TMD.

Schlüsselwörter

Otalgie - Tinnitus - Kraniomandibuläre Dysfunktion - CMD - TMD

Key words

Otalgia - Tinnitus - Temporomandibular-Joint-Disorder - CMD - TMD

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Dr. Hartwig Seedorf

Universitäts-Krankenhaus Eppendorf · Klinik- und Poliklinik für Zahn-, Mund- und Kieferkrankheiten · Abteilung für Zahnärztliche Prothetik

Martinistraße 52 · 20246 Hamburg ·

Email: seedorf@uke.uni-hamburg.de