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ACR Appropriateness Criteria^® Tinnitus.

, Marcus M Kessler¹, Marwan Moussa²

¹Principal Author, AllegiantMD, Tampa, Florida.

Journal of the American College of Radiology : JACR

|November 6, 2017

Summary

Tinnitus, the perception of sound without an external source, requires careful evaluation. Imaging is typically reserved for pulsatile tinnitus or cases with neurological symptoms, not for nonpulsatile tinnitus alone.

Keywords:

AUC Appropriate Use Criteria Appropriateness Criteria CT MRI Nonpulsatile tinnitus Objective tinnitus Pulsatile tinnitus Subjective tinnitus Tinnitus Unilateral tinnitus

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Area of Science:

Neurology
Radiology
Otolaryngology

Background:

Tinnitus is the perception of sound without an external source.
It can be a benign symptom or indicate a serious central nervous system disorder.
Disabling tinnitus necessitates a thorough diagnostic approach.

Purpose of the Study:

To outline the appropriate use of imaging in tinnitus evaluation.
To guide clinicians based on American College of Radiology Appropriateness Criteria.
To differentiate between tinnitus requiring further investigation and that which does not.

Main Methods:

Review of evidence-based guidelines from the American College of Radiology.
Analysis of medical literature on tinnitus and diagnostic imaging.
Application of established methodologies for rating imaging appropriateness.

Main Results:

History and physical examination are paramount for determining imaging needs.
CT and MRI are indicated for pulsatile tinnitus to rule out vascular issues.
Imaging is generally not recommended for subjective, nonpulsatile tinnitus without other neurological deficits.

Conclusions:

Imaging decisions for tinnitus should be guided by specific clinical factors, not solely by the presence of tinnitus.
ACR Appropriateness Criteria provide evidence-based recommendations for imaging in tinnitus.
Expert opinion may be used when evidence is limited.