What Is Pulsatile Tinnitus?

This post was written with Consensus AI Academic Search Engine – please read our Disclaimer at the end of this article. Pulsatile tinnitus is a type of tinnitus where the affected individual hears a rhythmic sound that often matches the beat of their heart. Unlike the more common form of tinnitus, which is characterized by a constant ringing or buzzing noise, pulsatile tinnitus is typically described as a whooshing or thumping sound. This condition can be both subjective, where only the patient can hear the noise, or objective, where the sound can also be detected by a physician using a stethoscope.

Causes and Associated Conditions

Pulsatile tinnitus can be caused by a variety of underlying conditions, many of which are related to vascular abnormalities. One study highlighted that atherosclerosis, a condition characterized by the thickening of the arterial walls, can lead to pulsatile tinnitus. The study used carotid Doppler ultrasound to evaluate patients and found that those with pulsatile tinnitus had significantly higher internal carotid artery intima-media thickness (IMT) and blood flow velocities compared to a control group1.

Another potential cause is the pneumatization of the petrous bone. Research has shown a significant relationship between subjective pulsatile tinnitus and the presence of pneumatization in the petrous bone, suggesting that this anatomical variation might contribute to the condition2. Additionally, tortuosity of the carotid and vertebral arteries has been associated with pulsatile tinnitus, indicating that structural abnormalities in the vascular system can play a role6.

Diagnostic Tools

Diagnosing pulsatile tinnitus often involves imaging studies to identify any vascular or structural abnormalities. Carotid Doppler ultrasound is a non-invasive and effective tool for evaluating the vascular structures in patients with pulsatile tinnitus. This method can measure parameters such as intima-media thickness, blood flow velocities, and arterial lumen diameters, providing valuable information for diagnosis1.

Computed tomography (CT) scans, particularly of the temporal bone, can also be useful. These scans can help identify pneumatization of the petrous bone, which has been linked to subjective pulsatile tinnitus2. Magnetic resonance angiography (MRA) is another imaging technique that can detect excessive tortuosity in the carotid and vertebral arteries, further aiding in the diagnosis6.

Conclusion

Pulsatile tinnitus is a unique form of tinnitus characterized by a rhythmic sound that often aligns with the heartbeat. It can be caused by various vascular and structural abnormalities, including atherosclerosis, petrous bone pneumatization, and arterial tortuosity. Diagnostic tools such as carotid Doppler ultrasound, CT scans, and MRA are essential for identifying the underlying causes and guiding appropriate management strategies. Understanding the diverse etiologies of pulsatile tinnitus is crucial for effective diagnosis and treatment.

Disclaimer

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