Clinical utility of imaging for pulsatile tinnitus

Area of Science:

• Otolaryngology
• Radiology
• Vascular Medicine

Background:

• Pulsatile tinnitus affects millions, but the frequency of urgent imaging findings is unknown.
• Current guidelines for imaging workup lack consensus.
• Diagnostic algorithms exist but have strict patient criteria.

Purpose of the Study:

• To determine the prevalence of time-sensitive imaging findings in pulsatile tinnitus patients.
• To assess the association between imaging findings and patient outcomes.

Main Methods:

• Retrospective study of 100 randomly sampled patients with pulsatile tinnitus.
• Data collected from a single healthcare system (1/1/2014-12/31/2023).
• Analysis of electronic health records and imaging reports.

Main Results:

• 93% of patients had true pulsatile tinnitus; 6.5% had time-sensitive findings (e.g., pseudoaneurysm, fistula).
• Imaging findings were associated with receiving treatment (p < 0.01).
• No association was found between imaging findings and symptom resolution (p = 0.74).

Conclusions:

• Imaging can identify critical findings in a subset of pulsatile tinnitus cases.
• Imaging does not appear to significantly influence treatment toward symptom resolution.
• Further research may clarify optimal imaging strategies for pulsatile tinnitus.