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Sound Measurements in Pulsatile Tinnitus: A Review in 171 Patients
Sander W J Ubbink1, Rutger Hofman1, Pim van Dijk1
1Departments of Otorhinolaryngology/Head & Neck Surgery.
Summary
External ear canal sound measurements can objectify pulsatile tinnitus (PT) in nearly half of diagnosed cases. This method helps rule out arterial pathologies like dural arteriovenous fistulas (DAVFs) when PT is not detected.
Area of Science:
- Otolaryngology
- Diagnostic Imaging
- Auditory Medicine
Background:
- Pulsatile tinnitus (PT) is a challenging condition to diagnose objectively.
- Identifying the underlying etiology of PT is crucial for effective management.
Purpose of the Study:
- To assess the diagnostic utility of external ear canal sound measurements for pulsatile tinnitus.
- To determine the effectiveness of sound recordings in objectifying PT compared to clinical findings and imaging.
Main Methods:
- Retrospective chart review of a prospective series of sound measurements.
- Analysis of data from 171 PT patients undergoing diagnostic workup between 2016 and 2023.
- Comparison of sound measurement detection rates across different pathologies (arterial, venous, nonvascular).
Main Results:
- An identifiable etiology for PT was found in 57% of patients via imaging.
- Sound measurements successfully objectified PT in 48% of patients with a diagnosed etiology.
- PT detection rates were higher for arterial pathologies (73%) and particularly dural arteriovenous fistulas (DAVFs) (100%) compared to venous (50%) or nonvascular (22%) causes.
- Sound measurements demonstrated greater sensitivity than auscultation for detecting bruits.
Conclusions:
- External ear canal sound recordings can objectify pulsatile tinnitus in a significant proportion of cases.
- Undetected PT via sound measurement may indicate a lower likelihood of arterial pathologies, especially DAVFs.
- Sound measurements, integrated with clinical evaluation and imaging, offer added diagnostic value for PT patients.
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