Somatic Modulation of Tinnitus: A Review and Some Open Questions

Abstract

 Tinnitus modulation by movements of the temporomandibular joint, head and neck musculo
skeletal structures and the eye can be found in one to two thirds of tinnitus sufferers; unfortu
nately this condition is often overlooked by otolaryngologists. Although somatic modulation 
has been initially hypothesized as a fundamental characteristic of tinnitus, there is increasing 
evidence of a tight connection with disorders of non-auditory regions. The structure that mostly 
modulates tinnitus is the temporomandibular joint, which mainly causes an increase in tinnitus 
loudness, followed by head and neck movements that may result in an increase or decrease of 
loudness and eye movements (gaze-evoked tinnitus). Besides loudness, somatic movements 
can also modulate tinnitus pitch and localization. Somatosensory tinnitus is a relatively new 
f
 inding that leaves several open questions: are there individual predisposing factors to somatic 
modulation? How strong is the association between the capability to somatically modulate tin
nitus and an underlying non-auditory disorder? Why patients that have concomitant hyperacu
sis also have higher chances of tinnitus modulation? Further basic science and clinical research 
is required to address these and many other questions about somatosensory tinnitus.