Skip to main content

Advertisement

SpringerLink
Log in

The relationship between tinnitus and vascular anomalies on temporal bone CT scan: a retrospective case control study

  • Original Article
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

Introduction

Tinnitus is a common symptom in which etiology is unclear in a group of patients. Some of anatomic or vascular variations diagnosed on temporal bone computed tomography (CT) has been known to cause tinnitus particulary pulsatile form. Therefore significance of these anatomic variations has not been validated in patients with nonpulsatile tinnitus. The aim of this study is to ascertain several anatomic variations previously attributed to pulsatile tinnitus in nonpulsatile tinnitus patients. And secondly to assess the relationship between the amount of sigmoid sinus bulging and mastoid emissary vein (MEV), enlargement of those was not evaluated before in tinnitus patients.

Methods

Retrospectively, temporal bone CT scans of 70 patients with an existing complaint of tinnitus with unexplained etiology were enrolled. As a control group, 70 patients were selected from paranasal sinus CT scans without any otological or clinical findings.

Results

The type of tinnitus was subjective and nonpulsatile in the overall group. The diameters of enlarged MEV on the left side were significantly higher in the tinnitus group. Carotid canal dehiscence and high riding jugular bulb were significantly higher in the tinnitus patients. Petrous bone pneumatization was significantly lower in the tinnitus patients than in the control group.

Conclusions

In patients who complained of subjective nonpulsatile tinnitus with unknown etiology, some temporal bone vascular variations, including high riding jugular bulb, dehiscent carotid canal, left-sided MEV enlargement, and petrous bone pneumatization, seemed to have an association with tinnitus. Further studies comparing all these entities between pulsatile and nonpulsatile groups and healthy controls should be undertaken.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Davis A, El Rafaie A (2000) Epidemiology of tinnitus. In: Tyler RS (ed) Tinnitus hand book. Singular, Thompson Learning, San Diego, pp 1–23

    Google Scholar 

  2. Baguley D, McFerran D, Hall D (2013) Tinnitus. Lancet 382(9904):1600–1607

    Article  PubMed  Google Scholar 

  3. Nondahl DM, Cruickshanks KJ, Huang G-H et al (2011) Tinnitus and its risk factors in the Beaver Dam offspring study. Int J Audiol 50:313–320

    Article  PubMed  PubMed Central  Google Scholar 

  4. Madani G, Connor SE (2009) Imaging in pulsatile tinnitus. Clin Radiol 64:319–328

    Article  CAS  PubMed  Google Scholar 

  5. Zhao P, Lv H, Dong C, Niu Y, Xian J, Wang Z (2016) CT evaluation of sigmoid plate dehiscence causing pulsatile tinnitus. Eur Radiol 26(1):9–14

    Article  PubMed  Google Scholar 

  6. Grewal AK, Kim HY, Comstock RH, Berkowitz F, Kim HJ, Jay AK (2014) Clinical presentation and imaging findings in patients with pulsatile tinnitus and sigmoid sinus diverticulum/dehiscence. Otol Neurotol 35(1):16–21

    Article  PubMed  Google Scholar 

  7. Zhaohui L, Cheng D, Xiao W, Xiaoyi H, Pengfei Z, Han L, Qing L, Zhenchang W (2015) Association between idiopathic intracranial hypertension and sigmoid sinus dehiscence/diverticulum with pulsatile tinnitus: a retrospective imaging study. Neuroradiology (Epub ahead of print)

  8. Sözen E, Çelebi I, Uçal YO, Coşkun BU (2013) Is there a relationship between subjective pulsatile tinnitus and petrous bone pneumatization? J Craniofac Surg 24(2):461–463

    Article  PubMed  Google Scholar 

  9. Schuknecht HR (1993) Pathology of the ear, 2nd edn. Lea and Febiger, Philadelphia

    Google Scholar 

  10. Chauhan NS, Sharma YP, Bhagra T, Sud B (2011) Persistence of multiple emissary veins of posterior fossa with unusual origin of left petrosquamosal sinus from mastoid emissary. Surg Radiol Anat 33(9):827–831

    Article  PubMed  Google Scholar 

  11. Forte V, Turner A, Liu P (1989) Objective tinnitus associated with abnormal mastoid emissary vein. J Otolaryngol 18:232–235

    CAS  PubMed  Google Scholar 

  12. Lambert PR, Cantrell RW (1986) Objective tinnitus in association with an abnormal posterior condylar emissary vein. Am J Otol 7:204–207

    CAS  PubMed  Google Scholar 

  13. Lee SH, Kim SS, Sung KY, Nam EC (2013) Pulsatile tinnitus caused by a dilated mastoid emissary vein. J Korean Med Sci 28(4):628–630

    Article  PubMed  PubMed Central  Google Scholar 

  14. Lo WWM, Solti-Bohman LG, McElveen JT (1985) Aberrant carotid artery: radiologic diagnosis with emphasis on high-resolution computed tomography. RadioGraphics 5:985–993

    Article  CAS  PubMed  Google Scholar 

  15. Dietz RR, Davis WL, Harnsberger HR, JacobsJM Blatter DD (1994) MR imaging and MR angiography in the evaluation of pulsatile tinnitus. Am J Neuroradiol 15:879–889

    CAS  PubMed  Google Scholar 

  16. Eisenman DJ (2011) Sinus wall reconstruction for sigmoid sinus diverticulum and dehiscence: a standardized surgical procedure for a range of radiographic findings. Otol Neurotol 32(7):1116–1119

    Article  PubMed  Google Scholar 

  17. Pekçevik Y, Pekçevik R (2014) Why should we report posterior fossa emissary veins? Diagn Interv Radiol 20(1):78–81

    PubMed  Google Scholar 

  18. Krishnan A, Mattox DE, Fountain AJ et al (2006) CT arteriography and venography in pulsatile tinnitus: preliminary results. AJNR Am J Neuroradiol 27:1635–1683

    CAS  PubMed  Google Scholar 

  19. Remley KB, Coit WE, Harnsberger HR et al (1990) Pulsatile tinnitus and the vascular tympanic membrane: CT, MR, and angiographic findings. Radiology 174:383–389

    Article  CAS  PubMed  Google Scholar 

  20. Sonmez G, Basekim CC, Ozturk E et al (2007) Imaging of pulsatile tinnitus: a review of 74 patients. Clin Imaging 31:102–108

    Article  PubMed  Google Scholar 

  21. Henriksen SD, KindtMW Pedersen CB et al (2000) Pseudoaneurysm of lateral internal carotid artery in the middle ear. Int J Pediatr Otorhinolaryngol 52(2):163–167

    Article  CAS  PubMed  Google Scholar 

  22. Jen A, Sanelli PC, Banthia V et al (2004) Relationship of petrous temporal bone pneumatization to the eustachian tube lumen. Laryngoscope 114(4):656–660

    Article  PubMed  Google Scholar 

  23. Virapongse C, Sarwar M, Bhimani S et al (1985) Computed tomography of temporal bone pneumatization: 1. Normal pattern and morphology. Am J Roentgenol 145(3):473–481

    Article  CAS  Google Scholar 

  24. Schoeff S, Nicholas B, Mukherjee S, Kesser BW (2014) Imaging prevalence of sigmoid sinus dehiscence among patients with and without pulsatile tinnitus. Otolaryngol Head Neck Surg 150(5):841–846

    Article  PubMed  Google Scholar 

  25. Gologorsky Y, Meyer SA, Post AF, Winn HR, Patel AB, Bederson JBD (2009) Novel surgical treatment of a transverse-sigmoid sinus aneurysm presenting as pulsatile tinnitus: technical case report. Neurosurgery 64(2):E393–E394 (discussion E394)

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The article is not supported by any organizations.

Author information

Authors and Affiliations

  1. School of Medicine, Sutcuimam University, Kahramanmaras, Turkey

    Betul Kizildag, Nagihan Bilal, Nursel Yurttutan, Mehmet Akif Sarica, Gulay Gungor & Murat Baykara

Authors
  1. Betul Kizildag
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nagihan Bilal
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nursel Yurttutan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mehmet Akif Sarica
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gulay Gungor
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Murat Baykara
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Betul Kizildag.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kizildag, B., Bilal, N., Yurttutan, N. et al. The relationship between tinnitus and vascular anomalies on temporal bone CT scan: a retrospective case control study. Surg Radiol Anat 38, 835–841 (2016). https://doi.org/10.1007/s00276-016-1629-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-016-1629-6

Keywords

Search

Navigation