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September 1959

Costen's Syndrome: A Reinterpretation

AMA Arch Otolaryngol. 1959;70(3):309-314. doi:10.1001/archotol.1959.00730040317004

Costen's syndrome is the term applied to a symptom-complex described by J. B. Costen in 1934.1 The symptoms can be summarized as follows:

  1. Otological symptoms: loss of hearing, stuffiness in the ears, and tinnitus aurium.

  2. Head and neck pain: pain in and about the ears, headaches in the vertex and occipital regions, and pain typical of "sinus disease."

  3. Miscellaneous symptoms: vertigo, tenderness of the temporomandibular joint to palpation, burning sensations in the tongue and throat, and a metallic taste.

Costen claimed1-6 that the symptoms forming his syndrome were produced by overclosure of the mandible and that "opening the bite" would clear up these symptoms. Costen's syndrome has been debated as a single entity standing or falling by the correctness of every one of its symptoms, by the validity of the etiology given by Costen, and by the success of its treatment by "opening the bite."

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