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Vascular abnormalities – a true cause of pulsatile tinnitus?

Published online by Cambridge University Press:  27 January 2022

H Walters Open the ORCID record for H Walters [Opens in a new window] ,
N Chung  and
P Arullendran
H Walters*
Affiliation:
ENT Department, Sunderland Royal Hospital, UK
N Chung
Affiliation:
Newcastle University Medical School, Newcastle upon Tyne, UK
P Arullendran
Affiliation:
ENT Department, Sunderland Royal Hospital, UK
*
Author for correspondence: Mr Holt Walters, ENT Department, Sunderland Royal Hospital, Kayll Road, Sunderland SR4 7TP, UK E-mail: holt.walters@nhs.net
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Abstract

Objective

Pulsatile tinnitus can be a symptom of vascular pathology. However, many of these pathologies present as incidental findings on scanning for unrelated symptoms. This study investigated whether the pathologies attributed to pulsatile tinnitus could instead be considered incidental findings.

Methods

This retrospective study evaluated imaging results of 272 pulsatile tinnitus cases for clinically relevant pathologies, and examined correlations between the site of symptoms and the imaging findings.

Results

Of 272 patients, 238 (88 per cent) had normal scans, 17 (6 per cent) had clinically insignificant incidental findings, and 18 (7 per cent) had findings requiring further investigation or intervention; regarding these latter 18 patients, findings for 8 patients (42 per cent) did not correlate with the symptomatic side. The rates of intracranial aneurysm and arteriovenous malformation in the pulsatile tinnitus group were comparable to those in normal populations.

Conclusion

The comparable rates of vascular abnormalities within the symptomatic pulsatile tinnitus group, plus clinically relevant findings contralateral to symptoms, suggest that vascular pathologies could be incidental findings rather than causes of pulsatile tinnitus. Evaluation is recommended of the effectiveness of the new National Institute for Health and Care Excellence guidelines for pulsatile tinnitus investigation.

Keywords

TinnitusGlomus TympanicumIntracranial AneurysmArteriovenous MalformationsArteriovenous Fistula

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 2 , February 2023 , pp. 138 - 142
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Mr H Walters takes responsibility for the integrity of the content of the paper

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