Imaging Study in Pulsatile Tinnitus: A Case Report
Introduction: Pulsatile tinnitus is a rare condition and has its origins in arterial and venous structures in the head and neck. Malformations, tumors, and anatomical variations are well known causes of pulsatile tinnitus. However, a radiological investigation is necessary in order to identify the s...
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| Published in: | International Archives of Otorhinolaryngology Vol. 18; no. S 01 |
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| Main Authors: | , , , |
| Format: | Conference Proceeding Journal Article |
| Language: | English |
| Published: |
04-09-2014
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| Online Access: | Get full text |
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| Summary: | Introduction:
Pulsatile tinnitus is a rare condition and has its origins in arterial and venous structures in the head and neck. Malformations, tumors, and anatomical variations are well known causes of pulsatile tinnitus. However, a radiological investigation is necessary in order to identify the specific etiology.
Objectives:
The objective of this study is to present a case of unilateral pulsatile tinnitus, with an otoscopic alteration suggesting vascular etiology, not detected in usual imaging studies.
Resumed Report:
A 43-year-old female patient (A. T. S.) presented with a left unilateral hearing loss and pulsatile tinnitus, for 2 years, to the otolaryngology department, without any periods of remission. A physical examination revealed a reddish lesion bulging out of the anterior superior quadrant of the left tympanic membrane, no cranial nerves deficit was detected. Audiometry showed a left conductive hearing loss. As for imaging examinations, it was initially requested a temporal bone computed tomography (CT), showing a complete opacification of the left mastoid cells, and a soft tissue density material in mastoid antrum, "aditus ad antrum," and Prussak space, bulging the tympanic membrane. The remaining structures were preserved. For better detailing, a magnetic resonance angiography (MRA) was performed, both considered normal. Finally, a cerebral arteriography revealed an arterial "blush" flowing from a branch of the petrous segment of the internal carotid artery, overlapping the temporal bone.
Conclusion:
Although, CT and MRA are widely used for the investigation of vascular lesions of the temporal bone, sometimes it is necessary to use more invasive tests for a proper diagnosis.
Keywords:
Pulsatile tinnitus, vascular abnormalities. |
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| ISSN: | 1809-9777 1809-4864 |
| DOI: | 10.1055/s-0034-1388813 |