CT arteriography and venography in the evaluation of Pulsatile tinnitus with normal otoscopic examination.

Abstract

Our retrospective study aims to assess the ability of computed tomography arteriography and venography (CT A/V) to detect various findings that suggest a potential cause of pulsatile tinnitus and to examine the association between these findings and the side of pulsatile tinnitus. A retrospective review of CT arteriography and venography of 32 patients with established pulsatile tinnitus and normal otoscopic examination was performed. The scans were performed using a 64-slice multidetector scanner and were reviewed to look for findings that are known to cause pulsatile tinnitus. One or more findings that are known to cause pulsatile tinnitus were detected on the symptomatic side in 30 patients; on the asymptomatic side in 3 patients, one patient with bilateral pulsatile tinnitus showed a potential cause of symptoms only on one side, and in one patient no potential cause could be identified. There is a significant association seen between the side of pulsatile tinnitus and various potential causes of pulsatile tinnitus detected (P < 0.001), between the side of pulsatile tinnitus and various potential venous cause detected (P < 0.001), and between the side of pulsatile tinnitus and the side of dominant venous system (P = 0.02). CT arteriography and venography is a useful tool in detecting many described potential causes of pulsatile tinnitus. Significant association is demonstrated between the side of pulsatile tinnitus and the potential causes of pulsatile tinnitus detected by CT arteriography and venography when the otoscopic examination is normal.