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Analysis of Etiology, Diagnosis, and Treatment Strategy and Efficacy of Pulsatile Tinnitus Caused by Abnormal Vascular Anatomy

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Abstract

Objective

To investigate the etiology, clinical characteristics, diagnosis, and treatment strategies and efficacy of pulsatile tinnitus (PT) caused by vascular anatomy abnormality.

Methods

The clinical data of 45 patients with PT in our hospital from 2012 to 2019 were collected and retrospectively analyzed.

Results

All 45 patients had vascular anatomical abnormalities. The patients were divided into 10 categories according to the different locations of vascular abnormalities: sigmoid sinus diverticulum (SSD), sigmoid sinus wall dehiscence (SSWD), SSWD with high jugular bulb, pure dilated mastoid emissary vein, aberrant internal carotid artery (ICA) in the middle ear, transverse-sigmoid sinus (TSS) transition stenosis, TSS transition stenosis with SSD, persistent occipital sinus stenosis, petrous segment stenosis of ICA, and dural arteriovenous fistula. All patients complained of PT synchronous with heartbeat rhythm. Endovascular interventional therapy and extravascular open surgery were used according to the location of the vascular lesions. Tinnitus disappeared in 41 patients, was significantly relieved in 3 patients, and was unchanged in 1 patient postoperatively. Except for one patient with transient headache postoperatively, no obvious complications occurred.

Conclusion

PT caused by vascular anatomy abnormalities can be identified by detailed medical history and physical and imaging examination. PT can be relieved or even completely alleviated after appropriate surgical treatments.

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References

  1. Sismanis A. Pulsatile tinnitus. A 15-year experience. Am J Otol, 1998,19(4):472–477

    CAS  PubMed  Google Scholar 

  2. Hofmann E, Behr R, Neumann-Haefelin T, et al. Pulsatile tinnitus: imaging and differential diagnosis. Dtsch Arztebl Int, 2013,110(26):451–458

    PubMed  PubMed Central  Google Scholar 

  3. Yeo WX, Xu SH, Tan TY, et al. Surgical management of pulsatile tinnitus secondary to jugular bulb or sigmoid sinus diverticulum with review of literature. Am J Otolaryngol, 2018,39(2):247–252

    Article  CAS  PubMed  Google Scholar 

  4. Kurata A, Miyasaka Y, Oka H, et al. Spontaneous carotid cavernous fistulas with special reference to the influence of estradiol decrease. Neurol Res, 1999,21(7):631–639

    Article  CAS  PubMed  Google Scholar 

  5. Terelak-Borys B, Skonieczna K, Grabska-Liberek I. Ocular ischemic syndrome - a systematic review. Med Sci Monit, 2012,18(8):RA138–RA144

    Article  PubMed  PubMed Central  Google Scholar 

  6. Hou K, Li G, Luan T, et al. Endovascular treatment of the cavernous sinus dural arteriovenous fistula: current status and considerations. Int J Med Sci, 2020,17(8):1121–1130

    Article  PubMed  PubMed Central  Google Scholar 

  7. Liu S, Wang GP, Zeng R, et al. Research advances in surgical treatments of sigmoid sinus associated pulsatile tinnitus. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi (Chinese), 2020,55(1):63–67

    CAS  Google Scholar 

  8. Li B, Liang Y, Cao X, et al. Image anatomic characteristics and clinical diagnosis and treatment of cerebral venous sinus stenosis. Zhonghua Yi Xue Za Zhi (Chinese), 2015,95(43):3505–3508

    Google Scholar 

  9. Louis RG Jr, Loukas M, Wartmann CT, et al. Clinical anatomy of the mastoid and occipital emissary veins in a large series. Surg Radiol Anat, 2009,31(2):139–144

    Article  PubMed  Google Scholar 

  10. Kim LKP, Ahn CS, Fernandes AEL. Mastoid emissary vein: anatomy and clinical relevance in plastic & reconstructive surgery. J Plast Reconstr Aesthet Surg, 2014,67(6):775–780

    Article  PubMed  Google Scholar 

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

    Article  PubMed  PubMed Central  Google Scholar 

  12. Van Damme JP, Heylen G, Gilain C, et al. Pulsatile tinnitus associated with dehiscent internal carotid artery: An irremediable condition? Auris Nasus Larynx, 2017,44(5):612–615

    Article  PubMed  Google Scholar 

  13. Barnett HJ, Taylor DW, Eliasziw M, et al. Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis. North Am Symptomatic Carotid Endarterectomy Trial Collaborators. N Engl J Med, 1998,339(20):1415–1425

    Article  CAS  PubMed  Google Scholar 

  14. Kiyosue H, Hori Y, Okahara M, et al. Treatment of intracranial dural arteriovenous fistulas: current strategies based on location and hemodynamics, and alternative techniques of transcatheter embolization. Radiographics, 2004,24(6):1637–1653

    Article  PubMed  Google Scholar 

  15. Hou K, Li G, Luan T, et al. Endovascular treatment of the cavernous sinus dural arteriovenous fistula: current status and considerations. Int J Med Sci, 2020,17(8):1121–1130

    Article  PubMed  PubMed Central  Google Scholar 

  16. Meneghelli P, Pasqualin A, Lanterna LA, et al. Surgical treatment of anterior cranial fossa dural arterio-venous fistulas (DAVFs): a two-centre experience. Acta Neurochir (Wien), 2017,159(5):823–830

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Otolaryngology, Ningbo First Hospital, Ningbo, 315000, China

    Sha Lv, Jia-tian Yuan, Qi-wei Xie, Shi-xiong Tang & Yao-wen Wang

Authors
  1. Sha Lv
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  2. Jia-tian Yuan
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  3. Qi-wei Xie
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  4. Shi-xiong Tang
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  5. Yao-wen Wang
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Corresponding author

Correspondence to Yao-wen Wang.

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The authors have declared no conflicts of interest for this article.

Additional information

This project was supported by the Medical Science and Technology Project of Zhejiang Province (No. 2019KY584) and Traditional Chinese Medicine Science and Technology Project of Zhejiang Province (No. 2023ZL648).

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Lv, S., Yuan, Jt., Xie, Qw. et al. Analysis of Etiology, Diagnosis, and Treatment Strategy and Efficacy of Pulsatile Tinnitus Caused by Abnormal Vascular Anatomy. CURR MED SCI 43, 173–183 (2023). https://doi.org/10.1007/s11596-022-2691-4

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  • DOI: https://doi.org/10.1007/s11596-022-2691-4

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