PULSATILE TINNITUS ASSOCIATED WITH CONGENITAL CENTRAL-NERVOUS-SYSTEM MALFORMATIONS

Pulsatile tinnitus as a manifestation of congenital central nervous sy stem malformations has not been previously described. We present two p atients with type I Arnold-Chiari malformation and one patient with co ngenital stenosis of the sylvian aqueduct with pulsatile tinnitus. Pul satile tinnitus in these patients is believed to be secondary to incre ased intracranial pressure. Tinnitus subsided in one malformation. pat ient with Arnold-Chiari malformation after suboccipital decompression. The other two patients declined surgery. Audiologic and radiologic fi ndings are presented, and our diagnostic algorithm for pulsatile tinni tus is described. The pathophysiology of pulsatile tinnitus in these p atients is discussed. Otologists should be aware that pulsatile tinnit us can be a manifesting symptom in some patients with congenital centr al nervous system malformations.