Vascular abnormalities - a true cause of pulsatile tinnitus?

Area of Science:

• Otolaryngology
• Neurology
• Radiology

Background:

• Pulsatile tinnitus can indicate underlying vascular pathology.
• Many identified vascular pathologies may be incidental findings unrelated to tinnitus.

Purpose of the Study:

• To investigate whether vascular pathologies found in patients with pulsatile tinnitus are true causes or incidental findings.

Main Methods:

• Retrospective analysis of imaging results from 272 patients with pulsatile tinnitus.
• Evaluation for clinically relevant pathologies and correlation with symptom laterality.

Main Results:

• 88% of patients had normal scans; 6% had insignificant incidental findings.
• 7% had findings needing intervention, but 42% of these did not correlate with the symptomatic side.
• Rates of intracranial aneurysm and arteriovenous malformation were similar to general populations.

Conclusions:

• Vascular abnormalities in pulsatile tinnitus patients may often be incidental, not causative.
• Findings suggest a need to re-evaluate the diagnostic approach for pulsatile tinnitus.
• The effectiveness of new National Institute for Health and Care Excellence guidelines warrants investigation.