Arteriovenöse Durafistel als seltene Ursache für einen pulssynchronen Tinnitus

Abstract

Pulse-synchronized tinnitus aurium is commonly caused by vascular processes within the area of the temporal bone. With a microphone or a stethoscope in the external ear or on the mastoid perceptible noises can be heard by the physician. The most important differential diagnoses of an objective tinnitus are paraganglioma of the glomus jugulare or the glomus tympanicum, vascular stenosis, arteriovenouse malformations, aneurysms and atypic findings of the bulbus venae jugularis interna of the temporal bone. In case of a pulse-synchronized tinnitus purposeful use of neuroradiological diagnostic can lead to a correct diagnosis. The indication for invasive intervention of dural fistulas depends on the number and the hemodynamic relevance of these fistulas and on individual suffering of the patient. Even if it does not succeed, all to embolize AV-short-circuits, it is possible to reduce the intensity of the tinnitus in order to continue with conservative therapy.

Low-Frequency Air–Bone Gap and Pulsatile Tinnitus Due to a Dural Arteriovenous Fistula: Considerations upon Possible Pathomechanisms and Literature Review

“…While PT is widely considered a typical manifestation of DAVFs [40], the association between AVM and other otologic manifestations such as vertigo, otalgia and chronic otitis media with effusion represent anecdotal findings [41][42][43]. Similarly, AVMs presenting with HL have rarely been reported in the literature.…”

Inner Ear Conductive Hearing Loss and Unilateral Pulsatile Tinnitus Associated with a Dural Arteriovenous Fistula: Case Based Review and Analysis of Relationship between Intracranial Vascular Abnormalities and Inner Ear Fluids

“…While the presence of a PT linked to DAVFs is not a rare occurrence [ 22 – 24 ], the association of PT, CHL, and DAVFs is a very rare condition. We made a review of literature, through systematic searches in PubMed (National Center for Biotechnology Information of US National Library of Medicine) by these key words: dural arteriovenous fistula, DAVF, and hearing loss.…”

“…Recent literature suggests that an alteration of venous cerebral circulation, like in consequence of bilateral transverse sinus stenosis (BTSS) [ 27 ] or DAVF [ 22 – 24 ], might be the underlying mechanism of PT, independently of presence or absence of elevated values of intracranial pressure [ 27 ]. Vascular abnormalities (i.e., BTSS and DAVF) could alter the frail balance between intracranial and labyrinthine fluids with consequences on labyrinth hydromechanics, causing otologic symptoms [ 28 – 30 ].…”