Pulsatile tinnitus - A 15-year experience

Purpose: This study aimed to report the author's 15-year experience with th e systematic evaluation and treatment of patients with pulsatile tinnitus. Methods:Between August 1981 and August 1996, 145 patients with pulsatile ti nnitus were evaluated. The diagnostic protocol was individualized according to the clinical findings and included appropriate radiologic testing, ultr asonography studies, and lumbar puncture with cerebrospinal fluid pressure measurement. Treatment was directed toward the etiology of the tinnitus. Results: Benign intracranial hypertension syndrome (pseudotumor cerebri) wa s the most common diagnosis (56 patients), followed by atherosclerotic caro tid artery disease (24 patients) and glomus tumors (17 patients). In 13 pat ients, no specific diagnosis could be reached. Conclusions: Thorough history and physical examination are the two most imp ortant factors in evaluating patients with pulsatile tinnitus. Evaluation s hould be individualized and may include radiologic testing, ultrasonography studies, and lumbar puncture with cerebrospinal fluid pressure measurement s. The majority of patients have a treatable underlying etiology.