Neurosurgical Causes of Pulsatile Tinnitus: Contemporary Update

Abstract

Traditionally in the domain of the otolaryngologist, pulsatile tinnitus (PT) has become increasingly relevant to neurosurgeons. PT may prove to be a harbinger of life-threatening pathology; however, often, it is a marker of a more benign process. Irrespectively, the neurosurgeon should be familiar with the many potential etiologies of this unique and challenging patient population. In this review, we discuss the myriad causes of PT, categorized by pulse-phase rhythmicity.

Letter: Neurosurgical Causes of Pulsatile Tinnitus: Contemporary Update

“…The authors reviewed the many causes of PT in their review article, divided into pulse-phase rhythmicity categories. 1 Here, we shall go over a few statements that, along with the study by Pingree et al, 1 should help readers better understand the neurosurgical etiology of PT.Different etiologies can induce PT. Hypervascular tumors such as glomus typmanicum or jugulare, as well as meningioma, 2 are neoplastic etiologies for PT.…”

Commentary: Neurosurgical Causes of Pulsatile Tinnitus: Contemporary Update

“…A uthors Pingree et al 1 have importantly reviewed the neurosurgical etiologies associated with pulsatile tinnitus (PT), a condition that has long been regarded as an otological domain, but is increasingly being recognized as pertinent to the neurosurgeon. The authors highlight the gap created by the advancing knowledge surrounding PT and the lack of historical classifications that fail to mirror this advancement.…”

“…1 Thus, they provide a review of neurosurgically treatable conditions associated with pulsatile tinnitus broken down by phase, categorized as arterial (systolic) and venous (diastolic). 1 PT makes up 4% of all tinnitus cases and is characterized as rhythmic and synchronous with the heartbeat. 2 Tinnitus-related changes in central nervous system activity are not restricted to auditory pathways; rather, they can include changes in networks of both auditory and nonauditory structures.…”

“…The authors highlight the gap created by the advancing knowledge surrounding PT and the lack of historical classifications that fail to mirror this advancement. 1 Thus, they provide a review of neurosurgically treatable conditions associated with pulsatile tinnitus broken down by phase, categorized as arterial (systolic) and venous (diastolic). 1 PT makes up 4% of all tinnitus cases and is characterized as rhythmic and synchronous with the heartbeat.…”

“…5 Nonvascular causes of PT include systemic or local high-flow states such as anemia, thyrotoxicosis, Paget disease, otosclerosis, superior semicircular bone dehiscence, Chiari syndrome, and tumors, namely paragangliomas and cholesteatomas. 1,4…”