# Correlation between Temporomandibularibular Disorders and
## 1 Introduction  
The joint connecting the temporal bone and the mandible is known as the temporomandibular joint (TMJ), and it consists of two components separated by an articular disc [1]. The TMJ plays a fundamental role in facilitating various jaw movements, including propulsion, lateral motion, and opening and closing of the mouth [1]. Temporomandibular disorders (TMD) represent a group of musculoskeletal conditions that affect the masticatory muscles, the temporomandibular joint, and related structures [1]. These disorders manifest through symptoms such as pain in the temporomandibular joint area or nearby, audible joint noises during mandibular movements, alterations in mandibular kinematics (such as deviations in opening, closing, laterality, and protrusion), and other related issues [1]. Timitus, a condition characterized by the perception of sound without an externalsource, and TMD are two complex medical issues that can interact in significant ways. Tinnitus, also known as \"ringing in the ears\", represents a subjective symptom, while temporomandibular disorders involve the complex musculoskeletal system of the jaw and surrounding structures [2]. In a study on the relationship between TMD ontological symptoms, the data indicate that the prevalence of otologic symptoms (tinnitus, labyrinthitis, dizziness, loss of balance, and deafness) is 87% [3; 4]. Tinnitus is the most common symptom and it is associated with 25-65% of TMD cases according to the scientific literature [5; 6; 7; 8; 9; 10; 11]. Tinnitus can sometimes be associated with somatic issues, even in the absence of hearing loss. This condition is known as \"somatic tinnitus\" (ST) or somatosensory tinnitus [7; 12; 13]. Among the common causes of ST are TMJ and head and neck diseases [7; 12; 14; 15; 16; 17; 18]. In cases of ST, the patient experiences altered somatosensory input from the temporomandibular joint or cervical spine [19]. Some studies have explored the connections between the cochlear nuclei (CN) and the somatosensory system in the cervical or temporomandibular region, providing a physiological basis for ST [20; 21; 22]. Aftern fibers from the dorsal root ganglia or trigeminal ganglion convey cervical somatosensory or temporomandibular information to the brain and central auditory system. ST may be suspected when at least one of the following is present in the patient's medical history: (a) history of head or neck trauma; (b) tinnitus associated with dental, jaw, or cervical spine manipulation; (c) recurrent pain episodes in the head, neck, or shoulder girdle; (d) temporal coincidence of the appearance or increase of both pain and tinnitus; (e) tinnitus worsening during inadequate postures while resting, walking, working, or sleeping; and (f) intense bruxism episodes during the day or night [23]. [PERSON] et al. additionally suggested that tight myofascal trigger point bands in the deep masseter and lateral pterygoid muscles might be linked to middle ear injury [24]. Other authors claimed that the existence of this somatic modulation, as demonstrated by voluntary movements or particular resistance tests, is a key factor in the diagnosis of ST, if not the key factor [15; 25]. The best way to identify ST is unclear because there are no established guidelines for clinical evaluation [19]. TMDs can cause various symptoms related to the ears and auditory system due to the anatomical proximity of the TMJ to these structures [26; 27]. Sensations of closed ears and referred pain can be attributed to the malfunctioning of the Eustachian tube and tensor muscles [28; 29]. Additionally, both the tensor muscles of the tympanic and palatine veil are innervated by the trigeminal; therefore, deep pain affecting the structures of this nerve can cause ontological symptoms due to the brain stimulation [30; 31; 32; 33; 34; 35; 36]. It is unclear and still up for debate if craniomalibular problems and auditory symptoms relate to one another [37; 38; 39].