CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2022; 26(02): e233-e242
DOI: 10.1055/s-0041-1730429
Original Article

Effectiveness of Dry Needling in Bothersome Chronic Tinnitus in Patients with Myofascial Trigger Points

1   Otolaryngology Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
,
1   Otolaryngology Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
,
1   Otolaryngology Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
,
1   Otolaryngology Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
› Author Affiliations
Funding Coordenação de Aperfeiçoamento de Pessoal de Nível Superior Faculdade de Medicina da Universidade de São Paulo

Abstract

Introduction Therapeutic dry needling (DN) is effective in reducing the discomfort of chronic somatosensory tinnitus in patients with myofascial trigger points (MTP)s.

Objective To evaluate the efficacy of DN in chronic somatosensory tinnitus discomfort in patients with MTP.

Methods Placebo-controlled paired trial that included 16 patients with a diagnosis of somatosensory chronic tinnitus and with the presence of at least one active or latent MTP. Treatment was performed in two phases: (1) four sessions (one session per week for four consecutive weeks) of placebo DN and (2) four sessions of therapeutic DN with a gap (washout) of 15 days between these phases.

Results The Tinnitus Handicap Inventory (THI) variable and its emotional domain had a statistically significant reduction in therapeutic DN when compared with placebo DN (p = 0.024 and p = 0.011, respectively).

The tinnitus visual analogic scale (VAS) signaled a reduction in tinnitus discomfort when compared with moments before and after therapeutic DN (p < 0.05).

Conclusion The therapeutic DN technique for MTP in patients with chronic tinnitus of somatosensory origin proved effective in reducing symptom discomfort, as measured by the THI (total score) and its emotional domain when compared with placebo DN.



Publication History

Received: 13 October 2020

Accepted: 03 March 2021

Article published online:
30 August 2021

© 2021. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 
  • References

  • 1 Jastreboff PJ. Phantom auditory perception (tinnitus): mechanisms of generation and perception. Neurosci Res 1990; 8 (04) 221-254
  • 2 Oiticica J, Bittar RS. Tinnitus prevalence in the city of São Paulo. Braz J Otorhinolaryngol 2015; 81 (02) 167-176
  • 3 Levine RA. Somatic (craniocervical) tinnitus and the dorsal cochlear nucleus hypothesis. Am J Otolaryngol 1999; 20 (06) 351-362
  • 4 Jousmäki V, Hari R. Parchment-skin illusion: sound-biased touch. Curr Biol 1998; 8 (06) R190
  • 5 Dehmel S, Cui YL, Shore SE. Cross-modal interactions of auditory and somatic inputs in the brainstem and midbrain and their imbalance in tinnitus and deafness. Am J Audiol 2008; 17 (02) S193-S209
  • 6 Manfredini D, Olivo M, Ferronato G, Marchese R, Martini A, Guarda-Nardini L. Prevalence of tinnitus in patients with different temporomandibular disorders symptoms. Int Tinnitus J 2015; 19 (02) 47-51
  • 7 Bressi F, Casale M, Papalia R. et al. Cervical spine disorders and its association with tinnitus: The “triple” hypothesis. Med Hypotheses 2017; 98: 2-4
  • 8 Travell JG, Simons DG, Simons LS. Travell & Simons' myofascial pain and dysfunction: the trigger point manual. Second edition. Philadelphia: Lippincott Williams & Wilkins; 1 vol.
  • 9 Yeng LT, Kaziyama HHS, Teixeira MJ. Myofascial painful syndrome. Rev Med 2001; 80 (n.spe1): 94-110
  • 10 Alvarez DJ, Rockwell PG. Trigger points: diagnosis and management. Am Fam Physician 2002; 65 (04) 653-660
  • 11 Travell JG, Simons LS, Simons DG. Dor e disfunção miofascial manual dos pontos-gatilho. 2 ed.. Porto Alegre: Artmed; 2005
  • 12 Ralli M, Salvi RJ, Greco A. et al. Characteristics of somatic tinnitus patients with and without hyperacusis. PLoS One 2017; a 12 (11) 1-15
  • 13 Sanchez TG, Rocha CB. Diagnosis and management of somatosensory tinnitus: review article. Clinics (São Paulo) 2011; 66 (06) 1089-1094
  • 14 Akamatsu FE, Yendo TM, Rhode C. et al. Anatomical Basis of the Myofascial Trigger Points of the Gluteus Maximus Muscle. Biomed Res Int 2017; 2017: 4821968 DOI: 10.1155/2017/4821968.
  • 15 Simpson LL. Molecular pharmacology of botulinum toxin and tetanus toxin. Annu Rev Pharmacol Toxicol 1986; 26: 427-453
  • 16 Imamura ST, Fischer AA, Imamura M. et al. Pain management using myofascial approach when other treatment failed. Phys Med Rehabil Clin N Am 1997; 8 (01) 179-196
  • 17 Björne A. Assessment of temporomandibular and cervical spine disorders in tinnitus patients. Prog Brain Res 2007; 166: 215-219 DOI: 10.1016/S0079-6123(07)66019-1.
  • 18 Herraiz C, Aparicio JM. [Diagnostic clues in pulsatile tinnitus (somatosounds)]. Acta Otorrinolaringol Esp 2007; 58 (09) 426-433
  • 19 Tachibana K, Ueki N, Uchida T, Koga H. Randomized Comparison of the Therapeutic Effect of Acupuncture, Massage, and Tachibana-Style-Method on Stiff Shoulders by Measuring Muscle Firmness, VAS, Pulse, and Blood Pressure. Evid Based Complement Alternat Med 2012; 2012: 989705 DOI: 10.1155/2012/989705.
  • 20 Wyant GM. Chronic pain syndromes and their treatment. II. Trigger points. Can Anaesth Soc J 1979; 26 (03) 216-219 DOI: 10.1007/BF03006985.
  • 21 Amanda B, Manuela M, Antonia M, Claudio M, Gregorio B. Posturography measures and efficacy of different physical treatments in somatic tinnitus. Int Tinnitus J 2010; 16 (01) 44-50
  • 22 Michiels S, Naessens S, Van de Heining P. et al. The effect of physical therapy treatment in patients with subjective tinnitus: a systematic review. Front Neurosci 2016; 10: 545
  • 23 Ong J, Claydon LS. The effect of dry needling for myofascial trigger points in the neck and shoulders: a systematic review and meta-analysis. J Bodyw Mov Ther 2014; 18 (03) 390-398
  • 24 Michiels S, Ganz Sanchez T, Oron Y. et al. Diagnostic Criteria for Somatosensory Tinnitus: A Delphi Process and Face-to-Face Meeting to Establish Consensus. Trends Hear 2018; 22: 2331216518796403 DOI: 10.1177/2331216518796403.
  • 25 Dommertholt J, Fernandes-de-las-Peñas C. Trigger point dry needling: an evidenced and clinical-based approach. Churchill Livingstone: Elsevier; 2013: 304
  • 26 Hong CZ. Lidocaine injection versus dry needling to myofascial trigger point. The importance of the local twitch response. Am J Phys Med Rehabil 1994; 73 (04) 256-263
  • 27 Baldry P. Superficial versus deep dry needling. Acupunct Med 2002; 20 (2-3): 78-81
  • 28 Kirkwood BR, Sterne JAC. Essential medical statistics. Cidade: Blackwell Science; 2006: 502
  • 29 Folmer RL, Griest SE. Chronic tinnitus resulting from head or neck injuries. Laryngoscope 2003; 113 (05) 821-827
  • 30 Sanchez TG, Bento RF, Miniti A, Camara J. Tinnitus: some characteristics and epidemiology. Clinical experience from Clinics Hospital of São Paulo University. Revista Bras Otorrino. 1997; 63 (03) 229-235
  • 31 Paula Erika Alves F, Cunha F, Onishi ET, Branco-Barreiro FC, Ganança FF. [Tinnitus Handicap Inventory: cross-cultural adaptation to Brazilian Portuguese]. Pro Fono 2005; 17 (03) 303-310
  • 32 Newman CW, Sandridge SA, Jacobson GP. Psychometric adequacy of the Tinnitus Handicap Inventory (THI) for evaluating treatment outcome. J Am Acad Audiol 1998; 9 (02) 153-160
  • 33 Zeman F, Koller M, Figueiredo R. et al. Tinnitus handicap inventory for evaluating treatment effects: which changes are clinically relevant?. Otolaryngol Head Neck Surg 2011; 145 (02) 282-287
  • 34 Duckert LG, Rees TS. Placebo effect in tinnitus management. Otolaryngol Head Neck Surg 1984; 92 (06) 697-699
  • 35 Theodoroff SM, Kaltenbach JA. The role of the brainstem in generating and modulating tinnitus. Am J Audiol 2019; 28 (1S): 225-238
  • 36 Pierce KJ, Kallogjeri D, Piccirillo JF, Garcia KS, Nicklaus JE, Burton H. Effects of severe bothersome tinnitus on cognitive function measured with standardized tests. J Clin Exp Neuropsychol 2012; 34 (02) 126-134
  • 37 Simonetti P, Oiticica J. Tinnitus neural mechanisms and structural changes in the brain: the contribution of neuroimaging research. International Archives of Otorhinolaryngology 2015; 19 (03) 259-265
  • 38 Kraus KS, Canlon B. Neuronal connectivity and interactions between the auditory and limbic systems. Effects of noise and tinnitus. Hear Res 2012; 288 (1-2): 34-46
  • 39 Klinge C, Röder B, Büchel C. Increased amygdala activation to emotional auditory stimuli in the blind. Brain 2010; 133 (Pt 6): 1729-1736
  • 40 Drago F, Nardo L, Rampello L, Raffaele R. Vestibular compensation in aged rats with unilateral labyrinthectomy treated with dopaminergic drugs. Pharmacol Res 1996; 33 (02) 135-140
  • 41 Tegg-Quinn S, Bennett RJ, Eikelboom RH, Baguley DM. The impact of tinnitus upon cognition in adults: A systematic review. Int J Audiol 2016; 55 (10) 533-540
  • 42 Tang Z-Q, Trussell LO. Serotonergic regulation of excitability of principal cells of the dorsal cochlear nucleus. J Neurosci 2015; 35 (11) 4540-4551
  • 43 Thompson AM, Thompson GC, Britton BH. Serotoninergic innervation of stapedial and tensor tympani motoneurons. Brain Res 1998; 787 (01) 175-178.
  • 44 Lee SK, Chung H, Chung JH, Yeo SG, Park MS, Byun JY. Effectiveness of transcutaneous electrical stimulation for chronic tinnitus. Acta Otolaryngol 2014; 134 (02) 159-167
  • 45 Unell L, Ström D, Ekman K, Johansson A, Arnrup K, Carlsson GE. A 3-year study of patients with tinnitus and jaw muscle tenderness. Cranio 2019; 37 (05) 304-309 DOI: 10.1080/08869634.2018.1430097.
  • 46 Montazeri K, Mahmoudian S, Razaghi Z, Farhadi M. Alterations in auditory electrophysiological responses associated with temporary suppression of tinnitus induced by low-level laser therapy: a before-after case series. J Lasers Med Sci 2017; 8 (1, Suppl 1): S38-S45
  • 47 Michiels S, Ganz SanchezT, Oron Y, Gilles A, Haider HF, Erlandsson S, Bechter K, Vielsmeier V, Biesinger E, Nam EC, Oiticica J, de Medeiros ÍRT, Bezerra RochaC, Langguth B, Van de Heyning P, De Hertogh W, Hall DA. Diagnostic criteria for somatosensory tinnitus: a Delphi process and face-to-face meeting to establish consensus. Trends Hear 2018; 22: 2331216518796403 DOI: 10.1177/2331216518796403.