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Pulsatile Tinnitus: A Comprehensive Clinical Approach to Diagnosis and Management.

Sofía Pacheco-López1, Jose Pablo Martínez-Barbero2,3, Heriberto Busquier-Hernández2

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Summary

Pulsatile tinnitus (PT), a heartbeat-synchronous sound, requires accurate diagnosis. A new imaging protocol guides clinicians in managing PT, differentiating causes and ensuring appropriate patient care.

Keywords:
arteriovenous fistulaclinical approachidiopathic intracranial hypertensionpulsatile tinnitustinnitus

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Area of Science:

  • Otolaryngology
  • Neuroradiology
  • Cardiology

Background:

  • Pulsatile tinnitus (PT) affects 5-10% of tinnitus cases, presenting as heartbeat-synchronous sound.
  • PT can stem from vascular or non-vascular causes, necessitating accurate diagnosis due to potential serious implications.
  • Current diagnostic protocols lack standardization, creating a need for a refined approach.

Purpose of the Study:

  • To present an updated diagnostic and therapeutic management approach for pulsatile tinnitus.
  • To establish a standardized imaging diagnostic protocol for PT.
  • To guide clinicians in assessing and managing PT.

Main Methods:

  • Development of a new imaging diagnostic protocol by neuroradiologists, otologists, and otoneurologists.
  • Distinguishing diagnostic pathways for bilateral PT (ruling out systemic conditions) and unilateral PT (focused imaging for organic etiologies).

Main Results:

  • The proposed protocol aims to provide a comprehensive and specific imaging approach for PT evaluation.
  • It addresses the lack of consensus on standardized protocols for tinnitus diagnosis.
  • The protocol differentiates between systemic and localized causes based on PT laterality.

Conclusions:

  • A standardized imaging protocol is essential for the accurate diagnosis and management of pulsatile tinnitus.
  • The updated approach guides clinicians in evaluating PT, considering both vascular and non-vascular etiologies.
  • This protocol aids in identifying serious underlying conditions associated with PT.