Investigação tomográfica da fissura petrotimpânica em pacientes com disfunção temporomandibular e sintomas otológicos

Abstract

Temporomandibular disorder (TMD) is a multifactorial condition often associated with otologic manifestations, possibly due to the anatomical communication between the temporomandibular joint (TMJ) and the ear through the petrotympanic fissure (PTF). The present study aimed to correlate the morphological aspects of the PTF, observed in cone beam computed tomography images, with otologic symptoms and morphological changes of the mandibular condyle in individuals with and without TMD. This was a retrospective observational cross-sectional study that evaluated 242 TMJ from 121 participants, 49 with TMD and 72 without TMD and otological symptoms (control group). The images were analyzed by two calibrated examiners, considering three morphological types of PTF: Type 1, characterized as a wide passage throughout its entire length; Type 2, with a wide entrance that progressively narrows; and Type 3, with a narrower outlet into the tympanic cavity. Different patterns of condylar changes, such as flattening, sclerosis, osteophyte, erosion, and subchondral cyst, were also evaluated. Otologic symptoms included otalgia, ear pressure, tinnitus, hearing loss, and aural fullness. The results showed no significant association between the PTF types and otologic symptoms. There were also no significant differences in the morphological changes of the condylar processes between the TMD and control groups. In the control group, Type 1 was more prevalent in women and Type 3 in men. We concluded that the morphological variations of the PTF may be related to individual anatomical characteristics, but they did not demonstrate a direct association with the evaluated otologic symptoms in patients with TMD.