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Pulsatile tinnitus. A 15-year experience

A Sismanis¹

¹Department of Otolaryngology-Head and Neck Surgery, Medical College of Virginia/Virginia Commonwealth University, Richmond 23298-0146, USA.

The American Journal of Otology

|July 14, 1998

Summary

This study details a 15-year evaluation of pulsatile tinnitus patients. Most cases had treatable causes like benign intracranial hypertension, highlighting the importance of thorough examination.

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Area of Science:

Neurology
Otolaryngology
Vascular Surgery

Background:

Pulsatile tinnitus is a complex auditory symptom requiring systematic investigation.
Understanding the diverse etiologies is crucial for effective management.

Purpose of the Study:

To present a 15-year experience in the systematic evaluation and treatment of pulsatile tinnitus.
To identify common causes and diagnostic approaches for pulsatile tinnitus.

Main Methods:

A cohort of 145 patients with pulsatile tinnitus evaluated between 1981 and 1996.
Individualized diagnostic protocols including imaging, ultrasonography, and cerebrospinal fluid pressure measurement.
Treatment strategies were tailored to the identified underlying etiology.

Main Results:

Benign intracranial hypertension (56 patients) was the most frequent diagnosis.
Atherosclerotic carotid artery disease (24 patients) and glomus tumors (17 patients) were also significant findings.
A specific diagnosis remained elusive in 13 patients.

Conclusions:

A comprehensive patient history and physical examination are paramount for evaluating pulsatile tinnitus.
Individualized diagnostic workups, potentially including imaging and lumbar puncture, are essential.
The majority of patients with pulsatile tinnitus present with a treatable underlying condition.

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