Vecchiarelli, Kelly Amar, Arun Paul Emanuele, Donna Increasing awareness with recognition of pulsatile tinnitus for nurse practitioners in the primary care setting: A case study. Ligation of internal jugular veins is controversial in patients who have no absence of transverse and sigmoid sinus and identified as pulsatile tinnitus of venous origin. CT arteriography and venography are recommended preferentially. Vascular imaging is also necessary to exclude other pathological changes like dura arteriovenous fistula, sigmoid diverticulum and so on. It's assumed that a history of pulsatile tinnitus, alleviation of tinnitus when pressing jugular veins, tinnitus changing with head position or posture and no occupying lesion in temporal CT scan or cranial MRI are inadequate in diagnosing pulsatile tinnitus of venous origin. No one in our review complained of any complications. Three patients who got no immediate relief got no improvement at all. According to the long review (from one to five years postoperatively), two patients who acquired immediate effect got relief of tinnitus, four including complained of no relief and the seventh aggravated into roaring. Seven patients were inquired in this study and the other five lost to follow-up. Seven patients got relief of tinnitus in less than one week after the surgery, while the other 5 patients had no relief. We also reviewed associated articles in this report. We reevaluated the evidences of identifying pulsatile tinnitus of venous origin and reviewed the short-term and long-term postoperative effects and complications. A retrospective study was conducted on 12 patients who were diagnosed with pulsatile tinnitus of venous origin and treated with ligation of internal jugular veins. To discuss the diagnosis and management of pulsatile tinnitus of venous origin. Zhang, Yibo Wang, Wuqing Dai, Chunfu Chen, Liang Radiologic examination showed that the right sylvian vein protruded into the tympanum through the dehiscent anterior cortical plate of the tympanum. Audiometry and otoscopic examination findings were normal.
The frequency and intensity of the tinnitus were 125 Hz and 20 dB HL, respectively. The pulsatile tinnitus diminished with rotation of the head to the right side or by compression of the right cervical vascular structures. A 60-year-old woman presented with a 4-month history of objective persistent pulsatile tinnitus in the right ear with no other complaints. We herein report a newly described cause of venous pulsatile tinnitus: protrusion of an aberrant sylvian vein into the tympanum. Liu, Zhaohui Yu, Jingge Zhao, Pengfei Zhang, Hanjuan Wang, Qian Wang, Zhenchang Thorough history-taking and clinical examination are the basis for the efficient use of imaging studies to reveal the cause of pulsatile tinnitus.Īberrant sylvian vein: A newly described cause of pulsatile tinnitus. The clinical findings and imaging studies must always be evaluated together. Dural arteriovenous fistulae, inflammatory hyperemia, and intracranial hypertension were tied for fourth place (8% each).
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In our own series of patients, pulsatile tinnitus was most often due to highly vascularized tumors of the temporal bone (16%), followed by venous normal variants and anomalies (14%) and vascular stenoses (9%). Common venous causes are intracranial hypertension and, as predisposing factors, anomalies and normal variants of the basal veins and sinuses. Common causes at the arteriovenous junction include arteriovenous fistulae and highly vascularized skull base tumors. Typical arterial causes are arteriosclerosis, dissection, and fibromuscular dysplasia. Pulsatile tinnitus can be classified by its site of generation as arterial, arteriovenous, or venous. Pulsatile tinnitus requires both a functional organ of hearing and a genuine, physical source of sound, which can, under certain conditions, even be objectified by an examiner.
No prospective studies on this subject are available to date. Selective literature review and evaluation of our own series of patients. Nonetheless, uncertainty often arises in clinical practice about the findings to be sought and the strategy for work-up. Pulsatile tinnitus, unlike idiopathic tinnitus, usually has a specific, identifiable cause. Hofmann, Erich Behr, Robert Neumann-Haefelin, Tobias Schwager, Konrad Pulsatile tinnitus: imaging and differential diagnosis.
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