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

Abstract

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.

CT evaluation of sigmoid plate dehiscence causing pulsatile tinnitus

“…A transverse sinus with focal reduction of the luminal diameter by 50 % or more on the axial images was considered stenosed. A mastoid emissary vein diameter more than 4.0 millimetres was seen as abnormal [6]. HJBs and mastoid emissary veins were detected on axial HRCTV section.…”

“…After surgical reconstruction, it can be totally eliminated. SPD without SSD is currently reported as the most common cause of PT on CTA/V, with an incidence of 23 % (7/30) to 40 % (12/30) [6,8]. However, SPD without SSD had not been reported as a cause of PT until 2011, when Eisenman DJ first stated that PT with SPD could be treated successfully after simply covering the SPD with substitutes [10].…”

“…Unlike non-PT, PT can usually be found with potential causes [1]. CT arteriography/venography (CTA/V) is mostly recommended for PT patients with normal otoscopic findings, which allows assessment of arterial, venous and neoplastic causes with a single examination [2][3][4][5][6].…”

Association between the extent of sigmoid sinus dehiscence and an occurrence of pulsatile tinnitus: a retrospective imaging study

“…HRCTV was recently recommended for PT patients as it can demonstrate the status of venous sinuses and temporal bones simultaneously in one study and reduce the radiation dose. 8,15 Additionally, the potential bias produced by the opacification of the sigmoid sinus with contrast in the PT group, which may hinder visualisation of a thin bone cannot be overlooked in the current study. An appropriate window width and level combining with multiplanar reconstruction technique could reduce the impact of it to some extent.…”

“…7,15 In the present study, all of the highresolution images were reconstructed with a bone algorithm and multiplanar reconstruction images were generated to demonstrate the details of the SSD and ensure the accuracy of the measurements. Data from the present study showed that the prevalence of SSD in non-PT patients (43/ 539) was higher than that reported by Schoeff et al (2/164).…”