Diagnostic Criteria for Somatosensory Tinnitus: A Delphi Process and Face-to-Face Meeting to Establish Consensus.
Sarah Michiels, Tanit Ganz Sanchez, Yahav Oron and 14 others
PMID 30213235WHAT IT FOUND
Experts agreed that tinnitus can change with head, neck, jaw, eye movements, somatic maneuvers, or trigger-point pressure.
They also included simultaneous pain onset or worsening, trauma history, posture effects, variable pitch/loudness/location, and unexplained unilateral tinnitus. These are expert recommendations, not tested interventions.
Key findings
01The consensus list treats tinnitus modulation by head, neck, jaw, eye movements, somatic maneuvers, or trigger-point pressure as strongly suggestive, but somatosensory tinnitus can exist without modulation.
02Included tinnitus characteristics were simultaneous onset or aggravation with neck or jaw pain, preceding head or neck trauma, increase during bad postures, variable pitch/loudness/location, and unilateral tinnitus not accounted for by the audiogram.
03Included accompanying symptoms were frequent head, neck or shoulder pain; temporomandibular disorders; pressure-tender myofascial trigger points; increased suboccipital or cervical extensor muscle tension; teeth clenching or bruxism; and dental diseases.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for SLPs
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What it does not show
The Delphi panel was small: 15 experts agreed to participate, and 14 completed Round 2. Only six experts attended the face-to-face consensus meeting, and several panelists had other engagements. The systematic review screening and data extraction were done by one author. The study reports expert consensus, not patient outcomes, diagnostic accuracy, or tested treatment effects. The paper warns that somatic maneuvers alone can lead to overdiagnosis and that neck or jaw pain can co-occur with tinnitus without a causal relation. The text says there was no financing for the study, while the funding declaration names Fonds voor wetenschappelijk onderzoek Vlaanderen.
Declared interests
The funding declaration names Fonds voor wetenschappelijk onderzoek Vlaanderen. The text also says there was no financing for the study. No author conflict declarations are supplied.
The easy way to misread this
Do not read the consensus list as a validated diagnostic test or as evidence that any treatment reduces tinnitus. It is expert agreement on suggestive features, and the paper says somatosensory tinnitus can exist even when tinnitus cannot be modulated.