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Algorithm for evaluation of pulsatile tinnitus.

Douglas E Mattox1, Patricia Hudgins

  • 1Department of Otolaryngology - Head & Neck Surgery, Emory University School of Medicine, Atlanta, GA 30322, USA. douglas.mattox@emory.edu

Acta Oto-Laryngologica
|March 28, 2008
PubMed
Summary

Pulsatile tinnitus evaluation often reveals underlying vascular or non-vascular anomalies. Careful physical examination and imaging are crucial for diagnosing the cause of pulsatile tinnitus.

Area of Science:

  • Otolaryngology
  • Radiology
  • Vascular Surgery

Background:

  • Pulsatile tinnitus is a complex condition requiring thorough investigation.
  • Identifying the source of pulsatile tinnitus is essential for effective management.

Purpose of the Study:

  • To determine the frequency of identifiable abnormalities in patients presenting with pulsatile tinnitus.
  • To correlate clinical findings with imaging results in pulsatile tinnitus cases.

Main Methods:

  • Retrospective chart review of 54 patients with pulsatile tinnitus.
  • Evaluation included physical examination and CT angiography.
  • Outcome measured was the incidence of abnormalities on imaging.

Main Results:

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  • 14 arterial, 23 venous, and 15 indeterminate causes identified.
  • Common venous finding: sigmoid sinus diverticulum.
  • Common arterial finding: carotid atherosclerotic disease.
  • Other findings: semicircular canal dehiscence, benign intracranial hypertension.

    • Conclusions:

    • Pulsatile tinnitus necessitates comprehensive physical examination.
    • Selected imaging techniques are vital for identifying the origin of symptoms.
    • A significant proportion of pulsatile tinnitus cases have identifiable vascular or non-vascular origins.