Local anaesthetic surgical treatment of severe objective pulsatile tinnitus: a useful technique

Abstract

Objective pulsatile tinnitus is a rare condition with an often dramatic presentation. We present the case of a 70-year-old woman who presented with over two years' history of unilateral distressing objective pulsatile tinnitus. Carotid arteriography revealed a highly tortuous internal carotid artery. Computed tomography of the ipsilateral temporal bones showed a large jugular bulb. Internal jugular vein ligation under local anaesthetic yielded immediate resolution of her symptoms.Tinnitus (also called tinnitus aurium) is derived from the Latin word tinnire, meaning to ring. It refers to the perception of sound in the absence of any corresponding external sound. Pulsatile tinnitus (PT) is often caused by a change in blood flow in or around the ear or a change in the awareness of that blood flow.

Degree of Sigmoid Sinus Compression and the Symptom Relief Using Magnetic Resonance Angiography in Venous Pulsating Tinnitus

“…Persistent venous PT would have serious impact on the quality of the patients' daily life. Clinicians [ 4 , 5 , 6 ] had tried to bring relief from PT through ligating jugular vein in the neck, but it would trigger florid pseudotumor cerebri that might be accompanied by severe headaches, progressive visual loss, and other disturbing neurologic symptoms [ 4 ], especially when it comes to stenosis or atresia of the contralateral system. With the technology advancement, magnetic resonance venography (MRV) has been applied to study the intracranial venous morphology and drainage situation, and venous malformations referred to as aneurysms or diverticula of transverse-sigmoid sinus or arteriovenous fistula (AVF) have been diagnosed and treated in the existing literatures [ 7 , 8 , 9 ].…”