| 1. Krishnan A, Mattox DE, Fountain AJ, Hudgins PA. CT arteriography and venography in pulsatile tinnitus: preliminary results. AJNR Am J Neuroradiol. 2006;27(8):1635-1638. |
Observational-Dx |
16 patients |
To evaluate the utility of CTA/V in the imaging work-up of PT. |
Seven of the 16 patients had lesions on CTA/V that could account for their PT. Examples of pathologic conditions in the series included a significantly dominant venous system, a venous diverticulum with stricture, and a transverse sinus stenosis. |
4 |
| 2. National Institutes of Health. National Institute on Deafness and Other Communication Disorders (NIDCD). Quick Statistics. Available at: http://www.nidcd.nih.gov/health/statistics/Pages/quick.aspx. |
Review/Other-Dx |
N/A |
To present statics regarding deafness and other communication disorders. |
No results stated in abstract. |
4 |
| 3. Coelho CB, Santos R, Campara KF, Tyler R. Classification of Tinnitus: Multiple Causes with the Same Name. [Review]. Otolaryngol Clin North Am. 53(4):515-529, 2020 Aug. |
Review/Other-Dx |
N/A |
To review a broad range of approaches to understand and demarcate different tinnitus subtypes, which will be critical for exploring and finding cures for different subtypes. |
No results stated in the abstract. |
4 |
| 4. Abdalkader M, Nguyen TN, Norbash AM, et al. State of the Art: Venous Causes of Pulsatile Tinnitus and Diagnostic Considerations Guiding Endovascular Therapy. [Review]. Radiology. 300(1):2-16, 2021 07. |
Review/Other-Dx |
N/A |
To illustrate the venous causes of pulsatile tinnitus and demonstrates the associated endovascular treatment. |
No results stated in the abstract. |
4 |
| 5. Fife TD. Neuro-otology of Systemic Disease. In: Lewis SL, ed. Neurological Disorders due to Systemic Disease. 1st ed. Oxford, UK: Wiley-Blackwell Health Sciences; 2013:145-54. |
Review/Other-Dx |
N/A |
N/A |
Book chapter. |
4 |
| 6. Dalrymple SN, Lewis SH, Philman S. Tinnitus: Diagnosis and Management. [Review]. Am Fam Physician. 103(11):663-671, 2021 06 01. |
Review/Other-Dx |
N/A |
To discuss the diagnosis and management of Tinnitus. |
No results stated in the abstract. |
4 |
| 7. Tunkel DE, Bauer CA, Sun GH, et al. Clinical practice guideline: tinnitus. Otolaryngol Head Neck Surg 2014;151:S1-S40. |
Review/Other-Dx |
N/A |
To provide evidence-based recommendations for clinicians managing patients with tinnitus. |
No results stated in abstract. |
4 |
| 8. Sharma A, Kirsch CFE, Aulino JM, et al. ACR Appropriateness Criteria® Hearing Loss and/or Vertigo. J Am Coll Radiol 2018;15:S321-S31. |
Review/Other-Dx |
N/A |
Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for hearing loss and/or vertigo. |
No results stated in abstract. |
4 |
| 9. Shih RY, Burns J, Ajam AA, et al. ACR Appropriateness Criteria® Head Trauma: 2021 Update. J Am Coll Radiol 2021;18:S13-S36. |
Review/Other-Dx |
N/A |
Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for head trauma. |
No results stated in abstract. |
4 |
| 10. Ledbetter LN, Burns J, Shih RY, et al. ACR Appropriateness Criteria R Cerebrovascular Diseases-Aneurysm, Vascular Malformation, and Subarachnoid Hemorrhage. Journal of the American College of Radiology. 18(11S):S283-S304, 2021 11.J. Am. Coll. Radiol.. 18(11S):S283-S304, 2021 11. |
Review/Other-Dx |
N/A |
Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for cerebrovascular diseases-aneurysm, vascular malformation, and subarachnoid hemorrhage. |
No results stated in abstract. |
4 |
| 11. Kumar R, Rice S, Lingam RK. Detecting causes of pulsatile tinnitus on CT arteriography-venography: A pictorial review. [Review]. Eur J Radiol. 139:109722, 2021 Jun. |
Review/Other-Dx |
N/A |
To help in providing a comprehensive radiological evaluation, hence justifying the radiation dose and for patient assessment and prognostication. |
No results stated in the abstract. |
4 |
| 12. Mattox DE, Hudgins P. Algorithm for evaluation of pulsatile tinnitus. Acta Otolaryngol. 2008;128(4):427-431. |
Review/Other-Dx |
54 patients |
To evaluate the incidence of identifiable anomalies in patients with pulsatile tinnitus. |
Fifty-four patients were seen between January 2002 and June 2007 with the chief complaint of constant pulsatile tinnitus, excluding those with chemodectomas. On the basis of physical examination and imaging, 14 were considered arterial, 23 venous, and 15 were indeterminate in origin. Among patients with venous tinnitus, sigmoid sinus diverticulum was the most common finding. Among patients with arterial tinnitus, carotid atherosclerotic disease was the most common. One patient had erosion of the cochlea by the carotid artery. Non-vascular entities identified include superior semicircular canal dehiscence and benign intracranial hypertension. |
4 |
| 13. Hofmeier B, Wolpert S, Aldamer ES, et al. Reduced sound-evoked and resting-state BOLD fMRI connectivity in tinnitus. Neuroimage (Amst). 20:637-649, 2018. |
Observational-Dx |
N/A |
To perform a comprehensive study of mild hearing-impaired participants with and without tinnitus, excluding participants with co-occurrences of hyperacusis |
No results stated in the abstract. |
4 |
| 14. Yakunina N, Kim SS, Nam EC. BOLD fMRI effects of transcutaneous vagus nerve stimulation in patients with chronic tinnitus. PLoS ONE. 13(11):e0207281, 2018. |
Review/Other-Dx |
36 patients |
To explore the effects of Transcutaneous VNS (tVNS) on brain activity in patients with tinnitus. |
The locus coeruleus and nucleus of the solitary tract in the brainstem were activated in response to stimulation of both locations compared with the sham stimulation. The cochlear nuclei were also activated, which was not observed in healthy subjects with normal hearing. Multiple auditory and limbic structures, as well as other brain areas associated with generation and perception of tinnitus, were deactivated by tVNS, particularly the parahippocampal gyrus, which was recently speculated to cause tinnitus in hearing-impaired patients. |
4 |
| 15. Amukotuwa SA, Marks MP, Zaharchuk G, Calamante F, Bammer R, Fischbein N. Arterial Spin-Labeling Improves Detection of Intracranial Dural Arteriovenous Fistulas with MRI. AJNR Am J Neuroradiol. 39(4):669-677, 2018 Apr. |
Observational-Dx |
39 patients |
To assess the accuracy and added value of 3D pseudocontinuous arterial spin-labeling MR imaging for the detection of these lesions. |
Identification of the venous arterial spin-labeling signal had a high sensitivity (94%) and specificity (88%) for the presence a dural arteriovenous fistula. Receiver operating characteristic analysis showed significant improvement in diagnostic performance with the addition of pseudocontinuous arterial spin-labeling in comparison with structural MR imaging (?area under the receiver operating characteristic curve = 0.179) and a trend toward significant improvement in comparison with structural MR imaging with time-of-flight MRA (?area under the receiver operating characteristic curve = 0.043). Interobserver agreement for the presence of a dural arteriovenous fistula improved substantially and was almost perfect with the addition of pseudocontinuous arterial spin-labeling (? = 0.92). |
2 |
| 16. Farb RI, Agid R, Willinsky RA, Johnstone DM, Terbrugge KG. Cranial dural arteriovenous fistula: diagnosis and classification with time-resolved MR angiography at 3T. AJNR Am J Neuroradiol. 30(8):1546-51, 2009 Sep. |
Review/Other-Dx |
40 patients |
To report our experience of using a commercially available form of time-resolved MR angiography (trMRA) at 3T for the diagnosis and classification of a cranial DAVF compared with the reference standard of digital subtraction angiography (DSA). |
Forty patients were identified who had undergone DSA and trMRA for evaluation of DAVF, yielding a total of 42 cases. On DSA, the results of 7 cases were normal, 15 cases were performed for surveillance of a previously cured fistula, and a new fistula (14) or persistent (6) fistula was found in 20 cases. Of these 20 fistulas, on DSA, 13 were Borden I, 2 were Borden II, and 5 were Borden III. In 93% (39/42) of DAVF cases, the 3 readers were unanimous and correct in their independent interpretation of the trMRA, correctly identifying (or excluding) all fistulas and accurately classifying them when encountered. |
4 |
| 17. Grossberg JA, Howard BM, Saindane AM. The use of contrast-enhanced, time-resolved magnetic resonance angiography in cerebrovascular pathology. [Review]. Neurosurgical Focus. 47(6):E3, 2019 12 01. |
Review/Other-Dx |
N/A |
To discuss the use of contrast-enhanced, time-resolved magnetic resonance angiography in cerebrovascular pathology. |
No results stated in the abstract. |
4 |
| 18. Nishimura S, Hirai T, Sasao A, et al. Evaluation of dural arteriovenous fistulas with 4D contrast-enhanced MR angiography at 3T. AJNR Am J Neuroradiol. 31(1):80-5, 2010 Jan. |
Observational-Dx |
18 consecutive patients |
To test the hypothesis that 4D-CE-MRA at 3T enables the same characterization of intracranial DAVFs as DSA. |
At DSA, 8 fistulas were located at the transverse sigmoid sinus; 8, at the cavernous sinus; and 2, at the sinus adjacent to the foramen magnum. Interobserver agreement was fair for the main arterial feeders (kappa = 0.59), excellent for the fistula site (kappa = 0.91), and good for venous drainage (kappa = 0.86). Intermodality agreement was moderate for the main arterial feeders (kappa = 0.68) and excellent for the fistula site (kappa = 1.0) and venous drainage (kappa = 1.0). |
2 |
| 19. Schoeff S, Nicholas B, Mukherjee S, Kesser BW. Imaging prevalence of sigmoid sinus dehiscence among patients with and without pulsatile tinnitus. Otolaryngol Head Neck Surg. 150(5):841-6, 2014 May. |
Review/Other-Dx |
194 patients |
To define the radiographic prevalence of sigmoid sinus diverticulum or dehiscence (SSDD) in patients with and without pulsatile tinnitus (PT). |
Within the PT group, SSDD was identified in 24% of ears (9/37) and 23% of patients (7/30); all SSDD patients were female (P = .024). Patients with SSDD were significantly younger (P = .037). SSDD more frequently caused objective tinnitus (P = .016). There was no difference in average BMI between those with and those without SSDD. In the non-PT group, SSDD was identified in 2 (both female) of 164 patients (1.2%; 0.6% of ears). The difference in SSDD prevalence between groups was significant (P < .0001). |
4 |
| 20. Waldvogel D, Mattle HP, Sturzenegger M, Schroth G. Pulsatile tinnitus--a review of 84 patients. J Neurol. 245(3):137-42, 1998 Mar. |
Review/Other-Dx |
84 patients |
To discuss the review of Pulsatile Tinnitus in 84 patients. |
In order to understand its clinical spectrum and management better we analysed the files of 84 patients seen at our institution over a 10-year period. Noninvasive techniques (ultrasound, computed tomography, magnetic resonance imaging) and angiography were employed as investigations tailored to the individual patient. A vascular disorder [i.e. arteriovenous fistula, dissection of the internal carotid artery (ICA), fibromuscular dysplasia, aneurysm of the ICA and sinus thrombosis] was found in 36 patients (42%), most commonly a dural arteriovenous fistula or a carotid-cavernous sinus fistula. In 26 patients with a vascular abnormality, pulsatile tinnitus was the presenting symptom. In 12 patients (14%), nonvascular disorders such as glomus tumour or intracranial hypertension with a variety of causes explained the tinnitus. We conclude that patients with pulsatile tinnitus should be investigated with noninvasive techniques. If these are negative or to clarify abnormal findings of noninvasive techniques selective angiography is needed for diagnosis and to guide treatment. |
4 |
| 21. Dong C, Zhao PF, Yang JG, Liu ZH, Wang ZC. Incidence of vascular anomalies and variants associated with unilateral venous pulsatile tinnitus in 242 patients based on dual-phase contrast-enhanced computed tomography. Chin Med J. 128(5):581-5, 2015 Mar 05. |
Observational-Dx |
242 patients |
To evaluate the incidence of various vascular anomalies and variants on the PT side and determined whether these lesions occurred as multiple or single entities. |
(1) A total 170 patients (170/242) had more than one anomaly or variant on the symptomatic side, and 58 patients (58/242) had a single lesion on tomography. (2) There was a statistically significant difference in the incidence of dehiscent sigmoid plate (P = 0.000), lateral sinus stenosis (P = 0.014), high jugular bulb (P = 0.000), sigmoid sinus diverticulum (P = 0.000), jugular bulb diverticulum (P = 0.000), dehiscent jugular bulb (P = 0.000), and a large emissary vein (P = 0.006) between the symptomatic and asymptomatic sides. (3) Dehiscent sigmoid plate (86.4%) was the most frequent lesion on the symptomatic side, followed by lateral sinus stenosis (55.8%), high jugular bulb (47.1%), sigmoid sinus diverticulum (34.3%), jugular bulb diverticulum (13.6%), dehiscent jugular bulb (13.6%), large emissary vein (4.1%), sinus thrombosis (1.2%), and petrosquamosal sinus (0.8%). |
2 |
| 22. Nicholson P, Brinjikji W, Radovanovic I, et al. Venous sinus stenting for idiopathic intracranial hypertension: a systematic review and meta-analysis. J Neurointerv Surg. 11(4):380-385, 2019 Apr. |
Meta-analysis |
20 articles (474 patients) |
To provide an updated systematic review and meta-analysis of the use of venous stenting in these patients, examining clinical outcomes. |
Twenty articles from 18 different centers were included. In a total of 474 patients. 418 were female (88%). The mean age of the patients was 35, while the mean body mass index (BMI) was 35 kg/m2. Median follow-up was 18 months. The overall rate of improvement in papilloedema was 93.7% (95% CI 90.5% to 96.9%), while the overall rate of improvement or resolution of headache was 79.6% (95% CI 73.3% to 85.9%). Pulsatile tinnitus resolved in 90.3% (95% CI 83.8% to 96.70%), while the overall rate of recurrence of IIH symptoms after stenting was 9.8% (95% CI 6.7% to 13%). The rate of major complications was 1.9% (95% CI 0.07% to 3.1%). |
Good |
| 23. Sonmez G, Basekim CC, Ozturk E, Gungor A, Kizilkaya E. Imaging of pulsatile tinnitus: a review of 74 patients. Clin Imaging. 2007;31(2):102-108. |
Review/Other-Dx |
74 patients |
To assess the effectiveness of imaging modalities in detecting the underlying pathologies in patients with pulsatile tinnitus. |
The underlying pathology of tinnitus was detected in 50 patients (67.6%), and 24 patients were normal with radiologic studies. The most common cause was high jugular bulbus (21%) followed by atherosclerosis, dehiscent jugular bulbus, aneurysm of internal carotid artery, dural arteriovenous fistula, aberrant internal carotid artery, jugular diverticulum, and glomus tumor. |
4 |
| 24. Zhao P, Wang Z, Xian J, Yan F, Liu Z. Persistent petrosquamosal sinus in adults: qualitative imaging evaluation on high-resolution CT venography. Acta Radiol. 2014;55(2):225-230. |
Observational-Dx |
532 patients |
To analyze the characteristics of PSS on high-resolution CT venography (HRCTV) in order to improve imaging diagnostic accuracy as well as to assist clinical management. |
The average diameter of the PSS was 1.4 mm. Twenty-nine TBs (74%) had PSS origin from the dorsolateral surface of the transverse sinus before its junction with the superior petrosal sinus (Position A); three TBs (8%) had PSS origin from the ventroinferior surface of the transverse sinus after or before the junction (Position B or C); seven TBs (18%) had PSS without definite origin (Position D). Eighteen TBs (46%) had PSS course in a lateral bony canal/groove (lateral canal type); 15 TBs (38%) had PSS course in petrosquamosal fissure (PSF) (PSF type); six TBs (15%) had PSS course in both (lateral canal/PSF type). For other imaging findings, a branch entering the cranial part of PSS was identified in 10 TBs (26%); a vascular mass was formed in five TBs (13%); focal defect of bony wall was observed in seven TBs (18%). A postglenoid foramen (PGF) was detected in 25 TBs (64%). |
3 |
| 25. Grewal AK, Kim HY, Comstock RH 3rd, Berkowitz F, Kim HJ, Jay AK. Clinical presentation and imaging findings in patients with pulsatile tinnitus and sigmoid sinus diverticulum/dehiscence. Otol Neurotol. 35(1):16-21, 2014 Jan. |
Review/Other-Dx |
261 patients |
To understand the clinical and imaging features of patients with PT due to SSDD. |
Cohort 1: 35 cases of SSDD were identified (18%); 10 (29%) true diverticula; and 25 (71%) dehiscence. Sixty-six percent were right sided. Twelve patients had PT (34%). Patients with SSDD are more likely to have PT (p = 0.003). A significant association between right SSDD and PT was found (p = 0.001). Cohort 2: 15 out of 61 patients had PT and CT-confirmed SSDD. All were female subjects; average age was 45 years (26-73 yr). Radiologic evaluation revealed 10 SSDD cases on the right (66.7%), 2 on the left (13.3%%), and 3 bilateral (20%). Sensorineural hearing loss was seen in 8 (53%), aural fullness in 12 (80%). Average BMI was 32.2 (21.0-59.82), and 4 (26%) had audible mastoid bruits. |
4 |
| 26. Harvey RS, Hertzano R, Kelman SE, Eisenman DJ. Pulse-synchronous tinnitus and sigmoid sinus wall anomalies: descriptive epidemiology and the idiopathic intracranial hypertension patient population. Otol Neurotol 2014;35:7-15. |
Review/Other-Dx |
13 patients |
To describe the clinical features of a population of patients with sinus wall anomalies (SWA) and pulse-synchronous tinnitus (PST). |
hirteen patients presented with sigmoid sinus diverticulum (39.4%) and 20 (60.6%) with sinus wall dehiscence. Thirty ears were successfully treated with surgery (responders), and 3 were not (nonresponders). Responders' mean age was 38 years, with 26 female patients (92.9%) and 2 male (7.1%). BMI of responders compared with nonresponders did not differ significantly (35.5 versus 33.4 kg/m2, p = 0.08). BMI of responders was elevated compared with an asymptomatic control group (35.5 versus 27.4 kg/m2, p < 0.0001). BMI of responders did not differ significantly compared with a cohort of patients with spontaneous CSF otorrhea and temporal bone encephaloceles (35.5 versus 40.7 kg/m2, p = 0.17). |
4 |
| 27. Liu Z, Chen C, Wang Z, et al. Sigmoid sinus diverticulum and pulsatile tinnitus: analysis of CT scans from 15 cases. Acta Radiol. 54(7):812-6, 2013 Sep. |
Observational-Dx |
15 patients |
To examine the computed tomography (CT) characteristics of sigmoid sinus diverticulum accompanied with PT. |
Sigmoid sinus diverticulum was located on the same side of PT in 15 patients. Diverticula originated at the superior curve of the sigmoid sinus in 11 patients and the descending segment of the sigmoid sinus in four patients. Sigmoid sinus diverticula focally eroded into the adjacent mastoid air cells in 12 patients and mastoid cortex in three patients. Among eight patients with unilateral dominant brain venous systems, the diverticula were seen on the dominant side in seven patients and non-dominant side in one patient. In contrast, the other seven patients showed co-dominant brain venous systems, with three presenting diverticula on the right side and four on the left. More notably, dehiscent sigmoid plate on the PT side was demonstrated in all patients. In addition, temporal bone hyper-pneumatization was found in nine patients, good and moderate pneumatization in three patients, respectively. |
4 |
| 28. Madani G, Connor SE. Imaging in pulsatile tinnitus. [Review] [33 refs]. Clin Radiol. 64(3):319-28, 2009 Mar. |
Review/Other-Dx |
N/A |
To discuss imaging in pulsatile tinnitus. |
No results stated in the abstract |
4 |
| 29. Narvid J, Do HM, Blevins NH, Fischbein NJ. CT angiography as a screening tool for dural arteriovenous fistula in patients with pulsatile tinnitus: feasibility and test characteristics. AJNR Am J Neuroradiol. 2011;32(3):446-453. |
Observational-Dx |
7 patients |
To determine the sensitivity and specificity of CTA compared with cerebral angiography for DAVF in patients presenting with PT. |
The presence of arterial feeders showed good test characteristics for screening, with a sensitivity of 86% (95% CI, 42-99) and a specificity of 100% (95% CI, 52-100). A shaggy sinus or tentorium was highly specific: sensitivity of 42% (95% CI, 11-79) and specificity of 100% (95% CI, 56-100). The presence of transcalvarial venous channels demonstrated a poor sensitivity of 29% (95% CI, 5-70) but a high specificity 86% (95% CI, 42-99). CT attenuation of the jugular veins showed statistically significant asymmetry in the DAVF group versus the control group (P < .05). |
2 |
| 30. Ellenstein A, Yusuf N, Hallett M. Middle ear myoclonus: two informative cases and a systematic discussion of myogenic tinnitus. Tremor Other Hyperkinet Mov (N Y) 2013;3. |
Review/Other-Dx |
N/A |
To systematically evaluate the different mechanisms and movement disorder phenomena that could lead to a diagnosis of middle ear myoclonus (MEM). |
From a functional neuroanatomic perspective, we explain how tensor tympani MEM is best explained as a form of peritubal myogenic tinnitus, similar to the related disorder of essential palatal tremor. From a pathogenic perspective, we discuss how MEM symptomatology may reflect different mechanical and neurologic processes. We emphasize the diagnostic imperative to recognize when myogenic tinnitus is consistent with a psychogenic origin. |
4 |
| 31. Fox GN, Baer MT. Palatal myoclonus and tinnitus in children. West J Med 1991;154:98-102. |
Review/Other-Dx |
1 patient |
To review palatal myoclonus and tinnitus in children. |
No results stated in abstract. |
4 |
| 32. Park SN, Bae SC, Lee GH, et al. Clinical characteristics and therapeutic response of objective tinnitus due to middle ear myoclonus: a large case series. Laryngoscope 2013;123:2516-20. |
Observational-Tx |
58 patients |
To evaluate the clinical characteristics and therapeutic response of tinnitus due to middle ear myoclonus (MEM) and to suggest appropriate diagnostic methods. |
Patients had a mean age of 29.8 years (range, 6-70 years), 20.7% (n = 12) were <10 years old, 39.7% (n = 23) were <20 years old, 74.1% (n = 43) were <40 years old, and 5.2% (n = 3) were >/=60 years old. Remembered stressful events or noise exposure were associated with the onset of MEM in 51.8% (n = 30) and 27.6% (n = 16) of patients, respectively. The most frequent nature of the tinnitus was a crackling sound. MEM associated with forceful eyelid closure was observed in 15% of patients. Impedance audiogram and otoendoscopic examinations of the tympanic membrane were helpful tools for diagnosing MEM. With medical therapy, more than 75% of patients exhibited complete or partial remission of their tinnitus. Patients with intractable MEM who underwent sectioning of the middle ear tendons had very good outcomes. |
2 |
| 33. Sinclair CF, Gurey LE, Blitzer A. Palatal myoclonus: algorithm for management with botulinum toxin based on clinical disease characteristics. Laryngoscope 2014;124:1164-9. |
Observational-Dx |
15 patients |
To review the clinical characteristics and management of patients with palatal myoclonus and devise an algorithm for treatment with botulinum toxin based on presenting symptoms, clinical examination findings, and involved muscle groups. |
Patients were more commonly female (60.0% vs. 40.0%) with average age at onset of 35.6 years. In 40.0% of patients, the myoclonus began after a viral upper respiratory tract infection. Two-thirds of patients had been previously treated unsuccessfully with oral medications. Predominant presenting symptoms included clicking tinnitus (46.7%), nonaudible awareness of palatal movements +/- rhinolalia (20.0%), or both (33.3%). Clinical examination revealed co-incident involvement of pharyngeal musculature in 53.3%. Palatal site for initial botulinum toxin injection depended on the predominant presenting symptom: for tinnitus, 2.5 U were injected transorally into the tensor veli palatini muscle at the level of the pterygoid hamulus/lateral soft palate; for palatal movements, the injection was placed medially on either side of the uvula. Dose and location of subsequent injections were tailored depending on response to the toxin and location of subsequent observed maximal muscular contractions. |
4 |
| 34. Wu V, Cooke B, Eitutis S, Simpson MTW, Beyea JA. Approach to tinnitus management. [Review]. Can Fam Physician. 64(7):491-495, 2018 07. |
Review/Other-Dx |
N/A |
To provide family physicians with an evidence-based and practical approach to managing patients with tinnitus. |
Tinnitus affects more than 40% of Canadians at least once in their lifetimes, most commonly older adults. Tinnitus is the perception of sound without external stimulation. It can greatly affect a patient's physical and psychological quality of life. Clinical history taking is directed at eliciting whether symptoms have a pulsatile or nonpulsatile quality, whether symptoms are unilateral or bilateral, and whether there is associated hearing loss. For tinnitus that is pulsatile or unilateral, referral to an otolaryngologist is recommended, as these qualities might be associated with more serious underlying conditions. Most patients with tinnitus can be managed with reassurance, conservative measures, and hearing aids if substantial hearing loss exists. |
4 |
| 35. In 't Veld M, Fronczek R, de Laat JA, Kunst HPM, Meijer FJA, Willems PWA. The Incidence of Cranial Arteriovenous Shunts in Patients With Pulsatile Tinnitus: A Prospective Observational Study. Otol Neurotol. 39(5):648-653, 2018 06. |
Observational-Dx |
50 patients |
To determine the incidence of arteriovenous shunts, i.e., arteriovenous malformations (AVMs) or dural arteriovenous fistulas (dAVFs), in patients referred for catheter angiography (digital subtraction angiography [DSA]). Furthermore, to assess which clinical features were predictive for the presence of such a lesion. |
Fifty patients were included in the final analyses. While no AVMs were found, a dAVF was found in 12 cases (24%). Three of these demonstrated cortical venous reflux, thus requiring treatment due to the risk of hemorrhage. In three cases (6%), DSA demonstrated a non-arteriovenous-shunt abnormality, likely causing the tinnitus. The odds of having a dAVF were significantly raised by unilaterality, objective bruit, and the ability to influence the tinnitus with compression. Unilaterality even had a negative predictive value of 1 and, if used as selection criterion, would have raised dAVF prevalence from 24 to 32%. |
2 |
| 36. Remley KB, Coit WE, Harnsberger HR, Smoker WR, Jacobs JM, McIff EB. Pulsatile tinnitus and the vascular tympanic membrane: CT, MR, and angiographic findings. Radiology 1990;174:383-9. |
Review/Other-Dx |
107 |
To identify the frequency and types of lesions, to construct an imaging algorithm utilizing basic historical and physical examination information, and to define the role of MR imaging in the diagnostic evaluation. |
Of the 100 patients with pulsatile tinnitus, 25 had objective tinnitus. A vascular tympanic membrane was present in 37 cases (35%). Normal vascular variants were present in 23 patients (21%). Twenty-seven patients (25%) had acquired vascular lesions. Temporal bone tumors were found in 33 patients (31%). No abnormality was identified in 21 cases (20%). |
4 |
| 37. Pelkonen O, Tikkakoski T, Luotonen J, Sotaniemi K. Pulsatile tinnitus as a symptom of cervicocephalic arterial dissection. J Laryngol Otol. 2004;118(3):193-198. |
Review/Other-Dx |
136 consecutive patients |
To investigate pulsatile tinnitus as a presenting symptom in cervicocephalic arterial dissection (CCAD). |
Of the 136 consecutive patients with confirmed CCAD, 16 presented with pulsatile tinnitus. On admission 10 patients presented with subjective tinnitus and five with objective tinnitus, tinnitus being the only presenting symptom in one case. In one further case with bilateral ICA dissection (ICAD) subjective tinnitus appeared three months after the initial symptoms of arterial dissection, despite a contralateral cervical bruit being evident on admission. Thirteen patients presented with headache or neck pain. Ischaemic symptoms were detected in six and Horner's syndrome in four patients. Vertigo and dysgeusia were reported in two patients each. Arterial dissection involved unilateral ICA in 11, bilateral ICA in two, unilateral vertebral artery (VA) in two and bilateral ICA and bilateral VA in one patient. In angiography the most common finding was irregular stenosis, and the majority of these abnormalities normalized during follow-up. To avoid delay in diagnosis a high index of suspicion and early angiography (digital subtraction or magnetic resonance angiography) are warranted. |
4 |
| 38. von Babo M, De Marchis GM, Sarikaya H, et al. Differences and similarities between spontaneous dissections of the internal carotid artery and the vertebral artery. Stroke. 2013;44(6):1537-1542. |
Observational-Dx |
970 patients |
To compare potential risk factors, clinical symptoms, diagnostic delay, and 3-month outcome between spontaneous internal carotid artery dissection (sICAD) and spontaneous vertebral artery dissection (sVAD). |
Patients with sICAD were older (46.3 +/- 9.6 versus 42.0 +/- 10.2 years; P<0.001), more often men (62.7% versus 53.0%; P=0.004), and presented more frequently with tinnitus (10.9% versus 3.4%; P<0.001) and more severe ischemic strokes (median National Institutes of Health Stroke Scale, 10 +/- 7.1 versus 5 +/- 5.9; P<0.001). Patients with sVAD had more often bilateral dissections (15.2% versus 7.6%; P<0.001) and were more often smokers (36.0% versus 28.7%; P=0.007). Thunderclap headache (9.2% versus 3.6%; P=0.001) and neck pain were more common (65.8% versus 33.5%; P<0.001) in sVAD. Subarachnoid hemorrhage (6.0% versus 0.6%; P<0.001) and ischemic stroke (69.5% versus 52.2%; P<0.001) were more frequent in sVAD. After multivariate analysis, sex difference lost its significance (P=0.21), and all other variables remained significant. Time to diagnosis was similar in sICAD and sVAD and improved between 2001 and 2012 compared with the previous 10-year period (8.0 +/- 10.5 days versus 10.7 +/- 13.2 days; P=0.004). In sVAD, favorable outcome 3 months after ischemic stroke (modified Rankin Scale, 0-2: 88.8% versus 58.4%; P<0.001), recurrent transient ischemic attack (4.8% versus 1.1%; P=0.001), and recurrent ischemic stroke (2.8% versus 0.7%; P=0.02) within 3 months were more frequent. |
3 |
| 39. Sismanis A. Pulsatile tinnitus. Otolaryngol Clin North Am. 2003;36(2):389-402, viii. |
Review/Other-Dx |
N/A |
To describe the different classifications of tinnitus and the approaches used to diagnose them. |
No results stated in abstract. |
4 |
| 40. Hillman TA, Kertesz TR, Hadley K, Shelton C. Reversible peripheral vestibulopathy: the treatment of superior canal dehiscence. Otolaryngol Head Neck Surg. 2006;134(3):431-436. |
Observational-Tx |
30 patients |
To review cases of SCD found at our institution and report their presentation, workup, and response to therapy. |
Thirty patients were identified with SCD. Patients presented with chronic disequilibrium (63%), Tullio's phenomenon (41%), pressure evoked vertigo (44%), hearing loss (30%), and pulsatile tinnitus (7%). ENG performed early in our series revealed abnormal nystagmus with sound presentation, Valsalva, or tympanogram; however, history and CT examination alone was used to identify this condition in most of our patients. Twenty-seven of the 30 patients had some symptoms related to SCD; the other 3 were found to have incidental SCD on CT examination. Of these patients, 14 had severe enough symptoms to warrant operative intervention. All, but one had resolution of their symptoms after completion of intervention. |
3 |
| 41. Jacky Chen CH, Nguyen T, Udawatta M, et al. Clinical Assessment of Patients with Bilateral Superior Semicircular Canal Dehiscence. World Neurosurg. 126:e1549-e1552, 2019 Jun. |
Review/Other-Dx |
99 patients |
To distinguish the differences in symptoms, treatment options, and outcomes between patients with unilateral and bilateral superior semicircular canal dehiscence (SSCD). |
A total of 99 patients with SSCD had been treated at our institution from March 2011 to May 2017. Of these 99 patients, 41 (41.4%) had a diagnosis of bilateral SSCD. Of the 41 patients with bilateral SSCD, 27 (65.9%) were women, and the mean age was 53.6 ± 10.9 years (range, 31.7-73.9). The most common presenting symptom was tinnitus (n = 33; 80.4%) and dizziness (n = 33; 80.4%). Previous trauma to the head correlated with a bilateral SSCD presentation (P = 0.04). Trends were reported between female sex and bilateral SSCD [r(35) = 0.32379; P = 0.0506]. Postoperatively, trends were also found, with greater rates of dizziness in patients with bilateral SSCD compared with those with unilateral SSCD (odds ratio, 3.81; P = 0.0659), and less improvement in dizziness (odds ratio, 0.186; P = 0.0627). No other significant differences were found between the symptoms or clinical outcomes and improvements between the bilateral and unilateral cohorts. |
4 |
| 42. Kline NL, Angster K, Archer E, et al. Association of pulse synchronous tinnitus and sigmoid sinus wall abnormalities in patients with idiopathic intracranial hypertension. Am J Otolaryngol. 41(6):102675, 2020 Nov - Dec. |
Observational-Dx |
22 patients |
To assess the incidence of SSWAs in patients with IIH and PT, and to determine if there is an association between SSWAs and PT in this population. |
22 subjects were enrolled and 14 subsequently underwent CT. The incidence of SSWAs was significantly higher in subjects with PT than without (70% vs. 0%, p = 0.02). Mean age, BMI and opening pressures did not differ between those with and without SSWAs or PT. |
2 |
| 43. Li X, Qiu X, Ding H, et al. Effects of different morphologic abnormalities on hemodynamics in patients with venous pulsatile tinnitus: A four-dimensional flow magnetic resonance imaging study. J Magn Reson Imaging. 53(6):1744-1751, 2021 06. |
Observational-Dx |
44 patients |
To evaluate the effects of sigmoid sinus wall dehiscence (SSWD), transverse sinus stenosis (TSS), and sigmoid sinus diverticulum (SSD) on the hemodynamics of transverse-sigmoid sinus in venous PT patients. |
Blood flow patterns were independently assessed by three neuroradiologists. One-way analysis of variance or Kruskal-Wallis test was also used. On the symptomatic side, all patients had SSWD, 33 patients had TSS, and 22 patients had SSD. Compared with healthy controls, patients with TSS, without TSS, with SSD, and without SSD all showed higher Vmax (all p < 0.050), Vavg (all p < 0.050), and Flowavg (all p < 0.050). Patients with TSS showed higher Vmax (p < 0.050) and Vavg (p < 0.050) than those without TSS, and no significant difference in Flowavg was found between the two groups (p = 0.408). No significant differences in Vmax , Vavg , and Flowavg were found between patients with and without SSD (all p = 1.000). Jet-like flow in the stenosis and downstream of the stenosis was observed in all patients with TSS. Vortex in SSD was observed in 15 patients with SSD (68%). High blood velocity and flow may be characteristic markers of venous PT. SSWD may be a necessary condition for venous PT. TSS may further increase the blood velocity and form a jet-like flow. SSD may be related to vortex formation but had no significant effect on blood velocity and flow. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY STAGE: 3. |
2 |
| 44. Lao Z, Sha Y, Chen B, Dai CF, Huang WH, Cheng YS. Labyrinthine sequestrum: four case studies. Otolaryngol Head Neck Surg. 147(3):535-7, 2012 Sep. |
Review/Other-Tx |
4 patients |
To present 4 case studies of patients with labyrinthine sequestrum. |
Imaging studies showed an osteolytic soft mass with calcified debris in the inner ear, and the bony labyrinth was eroded partly or completely by granulation mass, with loss of bony morphology. Further pathological examination was coincident with inflammatory granulation tissue with some calcification or osseous tissue. The disease process is attributed to chronic osteomyelitis due to the presence of osteonecrosis. Prompt CT and MRI examinations and optimal therapeutic management facilitate definitive diagnosis and protect against fatal complications. |
4 |
| 45. Cho IK, Jung JY, Yoo DS, Suh MW. 3-Dimensional reconstruction of the venous system in patients suffering from pulsatile tinnitus. Acta Otolaryngol. 2012;132(3):285-289. |
Observational-Dx |
11 patients and 12 normal control ears |
To compare, through 3D-reformatted images of the intracranial venous system, the volume, cross-sectional area, and caliber changes in patients with PT and normal controls. |
The L/S ratio was significantly increased in the PT group (5.01), compared with the control group (3.42). When the threshold value of the L/S ratio was assessed by the ROC method, 4.75 seemed to be the significant dissecting point. The sensitivity of this method was 0.64 and the specificity was 0.83. |
3 |
| 46. Cunnane MB. Imaging of Tinnitus. [Review]. Neuroimaging Clin N Am. 29(1):49-56, 2019 Feb. |
Review/Other-Dx |
N/A |
To discuss the imaging of Tinnitus. |
No results stated in the abstract. |
4 |
| 47. Mundada P, Singh A, Lingam RK. CT arteriography and venography in the evaluation of Pulsatile tinnitus with normal otoscopic examination. Laryngoscope. 125(4):979-84, 2015 Apr. |
Observational-Dx |
30 patients |
To assess the ability of computed tomography arteriography and venography (CT A/V) to detect various findings that suggest a potential cause of pulsatile tinnitus and to examine the association between these findings and the side of pulsatile tinnitus. |
One or more findings that are known to cause pulsatile tinnitus were detected on the symptomatic side in 30 patients; on the asymptomatic side in 3 patients, one patient with bilateral pulsatile tinnitus showed a potential cause of symptoms only on one side, and in one patient no potential cause could be identified. There is a significant association seen between the side of pulsatile tinnitus and various potential causes of pulsatile tinnitus detected (P < 0.001), between the side of pulsatile tinnitus and various potential venous cause detected (P < 0.001), and between the side of pulsatile tinnitus and the side of dominant venous system (P = 0.02). |
2 |
| 48. Christie A, Teasdale E. A comparative review of multidetector CT angiography and MRI in the diagnosis of jugular foramen lesions. Clin Radiol. 65(3):213-7, 2010 Mar. |
Observational-Dx |
15 patients |
To compare the efficiency of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the diagnosis of jugular foramen lesions. |
Pathology reported six glomus jugulare tumours and five neuromas, which were all correctly diagnosed using MDCT. A confident diagnosis was also made in the remaining four cases based on the pattern of enhancement. Only glomus tumours enhanced in the arterial phase. Overall, MRI was used to make a confident diagnosis in eight patients. One showed no enhancement and was correctly diagnosed as a neuroma, and seven demonstrated the tumour flow voids characteristic of a glomus tumour. The remaining seven cases all showed a similar enhancement pattern and could not be confidently differentiated between a neuroma or a glomus tumour. MDCT angiography enabled a confident assessment of the jugular vein in all cases, but MRI was inconclusive in a third of cases. Also, in the nine cases of glomus tumour diagnosed using MDCT, an enlarged feeding artery was identified in eight patients. |
4 |
| 49. Bathla G, Hegde A, Nagpal P, Agarwal A. Imaging in Pulsatile Tinnitus: Case Based Review. J Clin Imaging Sci. 10:84, 2020. |
Review/Other-Dx |
N/A |
To review the common causes of pulsatile tinnitus (PT), along with emphasis on key imaging findings. |
No results stated in the abstract. |
4 |
| 50. Hewes D, Morales R, Raghavan P, Eisenman DJ. Pattern and severity of transverse sinus stenosis in patients with pulsatile tinnitus associated with sigmoid sinus wall anomalies. Laryngoscope. 130(4):1028-1033, 2020 04. |
Observational-Dx |
36 patients |
To describe the location and severity of transverse sinus stenosis (TSS) in a consecutive series of patients with intraoperatively confirmed sigmoid sinus wall abnormalities (SSWA). |
Twenty-six of 36 subjects had adequate imaging data. The majority of subjects had some degree of bilateral TSS, and the majority of stenoses involved the distal transverse sinus. Subjects with diverticulum were significantly more likely than those with dehiscence to have ipsilateral distal TSS (16 of 16 vs. 4 of 10, P = 0.009). The mean minimum transverse sinus diameter, stenosis severity grade, and overall posterior venous sinus outflow were significantly worse in the subjects as compared to normal controls (P = 0.002), although not as severe as the comparable values in historical controls with IIH (P < 0.003). |
2 |
| 51. Eisenman DJ, Raghavan P, Hertzano R, Morales R. Evaluation and treatment of pulsatile tinnitus associated with sigmoid sinus wall anomalies. Laryngoscope. 128 Suppl 2:S1-S13, 2018 10. |
Observational-Dx |
40 patients |
To describe clinical and radiographic features of sigmoid sinus wall anomalies (SSWA) associated with pulsatile tinnitus (PT) and determine factors predictive of response to surgery. |
Twenty-three ears had isolated sigmoid sinus dehiscence, and 17 had diverticulum. The rates of transverse sinus stenosis (TSS) and empty sella, 66% and 32% respectively, were significantly higher than in historical controls (P = 0.02 and 0.001). Thirty-six out of 40 subjects (90%) had complete resolution of their PT following surgery, including all those with a diverticulum. For subjects with dehiscence alone without diverticulum, a favorable response to surgery was strongly associated with the presence of TSS (P = 0.01) and empty sella (P = 0.02). |
2 |
| 52. Ettyreddy AR, Shew MA, Durakovic N, et al. Prevalence, Surgical Management, and Audiologic Impact of Sigmoid Sinus Dehiscence Causing Pulsatile Tinnitus. Otol Neurotol. 42(1):82-91, 2021 01. |
Observational-Dx |
19 patients |
To evaluate the prevalence, surgical management, and audiologic impact of pulsatile tinnitus caused by sigmoid sinus dehiscence. |
Nineteen patients (89.4% women) had surgery for suspected sigmoid sinus dehiscence. The mean dehiscence size was 6.1 mm (range, 1-10.7 mm). Eight patients had concurrent sigmoid sinus diverticulum and one patient also had jugular bulb dehiscence. Only two patients (10.5%) had the defect identified by radiology. Low-frequency pure-tone average, measured at frequencies of 250 and 500 Hz, showed a significant median improvement of 8.8 dB following resurfacing (18.8 dB versus 10.0 dB, p = 0.02). The majority of patients had complete resolution of pulsatile tinnitus (16/19, 84.2%). Of those without complete resolution, two patients had partial response and one patient had no improvement. There were no significant complications. Of 41 consecutively tracked patients with a pulsatile tinnitus chief complaint, sigmoid pathology represented 32% of cases. |
2 |
| 53. Liu Z, He X, Du R, Wang G, Gong S, Wang Z. Hemodynamic Changes in the Sigmoid Sinus of Patients With Pulsatile Tinnitus Induced by Sigmoid Sinus Wall Anomalies. Otol Neurotol. 41(2):e163-e167, 2020 02. |
Observational-Dx |
15 patients |
To investigate the hemodynamic changes of pulsatile tinnitus (PT) patients induced by sigmoid sinus wall anomalies (SSWA). |
APV at PT side of patients was 13.4 ± 3.3 cm/s, which was significantly slower than that at corresponding side of controls (15.8 ± 2.6 cm/s). PNV and RF at PT side of patients were 21.0 ± 15.4 cm/s and 2.4% respectively, which were significantly higher than those values at corresponding side of controls (both of them were 0). HR, CSA, PPV, APFV/beat, APFV/min, AFV/beat, AFV/min, ANV, ANFV/beat, and ANFV/min were 69.8 ± 9.4 beat/min, 48.4 ± 17 mm, 31.4 ± 5.9 cm/s, 5.4 ± 1.8 ml/beat, 373.9 ± 117.7 ml/min, 5.1 ± 2.0 ml/beat, 352.0 ± 134.6 ml/min, 2 (0-4.9) cm/s, 1 (0-2.7) ml/beat, and 4.1 (0-141.3) ml/min at PT side of patients, and 67.4 ± 7.8 beat/min, 38.2 ± 18 mm, 29.9 ± 3.9 cm/s, 5.3 ± 2.0 ml/beat, 350.3 ± 125.3 ml/min, 5.1 ± 1.9 ml/beat, 340.5 ± 117.9 ml/min, 0 (0-2.1) cm/s, 0 (0-0.8) ml/beat, and 0 (0-55.4) ml/min at corresponding side of controls. These hemodynamics were not significantly different between groups. |
2 |
| 54. Wang AC, Nelson AN, Pino C, Svider PF, Hong RS, Chan E. Management of Sigmoid Sinus Associated Pulsatile Tinnitus: A Systematic Review of the Literature. [Review]. Otol Neurotol. 38(10):1390-1396, 2017 12. |
Review/Other-Dx |
139 patients |
To perform a systematic review exploring surgical and endovascular intervention of PT caused by sigmoid sinus anomalies. |
Of 139 patients, 90.4% were female. Mean age was 39.0 years. Diagnosis was sigmoid sinus diverticulum/aneurysm in 47.5% of patients, sigmoid sinus dehiscence in 35.3% of patients, and both in 17.3%. Sigmoid sinus wall reconstruction/resurfacing (SSW R/R) was used in 91.4% and endovascular procedures in 7.9% of patients. Postoperative recurrence was 3.5% (mean follow-up 21.1 m). Although there was no association between resolution rate and age or sex, right-sided PT resolved at a higher rate. For every increase in body mass index by 1 kg/m, the odds of PT resolution increased 9.2%. |
4 |
| 55. Wang D, Zhao Y, Tong B. Treatment of pulsatile tinnitus caused by anomalies of the sigmoid sinus wall via combined internal and external sigmoid sinus wall reconstruction with 3D temporal bone CT guidance. Eur Arch Otorhinolaryngol. 277(9):2439-2445, 2020 Sep. |
Observational-Dx |
11 patients |
To present analysis aims to describe a surgical approach wherein pulsatile tinnitus (PT) arising due to sigmoid sinus wall anomalies (SSWA) can be treated via combination internal and external sigmoid sinus wall reconstruction. To evaluate the utility of temporal bone 3D-CT imaging during both the pre- and post-operative assessments of all treated patients. |
SSWA in the 3D-CT imaging from these patients were all distinct. In 10/11 patients, PT fully resolved following reconstruction of the sinus wall. The remaining patients exhibited significant improvements in symptoms postoperatively, with PT fully resolving within a 1-month follow-up period. No patients suffered any major complications. |
2 |
| 56. Zhao P, Ding H, Lv H, et al. CT venography correlate of transverse sinus stenosis and venous transstenotic pressure gradient in unilateral pulsatile tinnitus patients with sigmoid sinus wall anomalies. Eur Radiol. 31(5):2896-2902, 2021 May. |
Observational-Dx |
57 patients |
To investigate the correlation between transverse sinus stenosis (TSS) and transstenotic pressure gradient (TPG) in unilateral pulsatile tinnitus (PT) patients with sigmoid sinus wall anomalies (SSWA). |
The mean value of ipsilesional TPG was 7.61 ± 0.52 mmHg. The degree and length of ipsilesional TSS were positively correlated with TPG (p < 0.001, p' < 0.001), respectively. TPG was significantly larger in patients with contralateral transverse sinus dysplasia than those without (p = 0.023) and significantly smaller in patients with ipsilesional sigmoid sinus diverticulum than those with isolated dehiscence (p = 0.001). No statistical difference in TPG was shown between ipsilesional TSSs of different shapes or locations (p > 0.05). No correlation was noted between the degree of ipsilesional transverse sinus outflow laterality and TPG (p = 0.051). Stepwise linear regression indicated that the degree (ß = 9.207, 95% CI = 3.558-14.856), length (ß = 0.122, 95% CI = 0.025-0.220) of ipsilesional TSS, and contralateral transverse sinus dysplasia (ß = 1.875, 95% CI = 0.220-3.530) were significantly correlated with TPG (R2 = 0.471). |
2 |
| 57. Lenck S, Labeyrie MA, Vallee F, et al. Stent Placement for Disabling Pulsatile Tinnitus Caused by a Lateral Sinus Stenosis: A Retrospective Study. Oper Neurosurg (Hagerstown). 13(5):560-565, 2017 10 01. |
Observational-Dx |
14 patients |
To describe the clinical, radiological, and manometric characteristics of patients treated for disabling PT by lateral sinus stenosis. Assessment of the efficacy of stenting for this indication. |
Fourteen patients were included in our study. All of them were women. The median age at the onset of symptoms was 39.0 (21.0) years. The median body mass index was 28.5 (7.0) kg/m 2 . Stenting of the lateral sinus led to the disappearance of PT without recurrence in 13 patients. In one patient, stenting did not modify the noise. In this case, another cause of PT was diagnosed after stent placement. |
2 |
| 58. Deuschl C, Goricke S, Gramsch C, et al. Value of DSA in the diagnostic workup of pulsatile tinnitus. PLoS One 2015;10:e0117814. |
Observational-Dx |
54 patients |
To evaluate the diagnostic impact of DSA in the diagnostic workup of patients with PT in comparison to MRI alone. |
37 of the 54 patients revealed a pathology explaining PT on MRI, which was detected by the readers in 100% and proofed by means of DSA. 24 dAVF, four paraganglioma, two AVM and seven more pathologies were described. All patients without pathology on MRI did also not show any pathology in DSA. |
3 |
| 59. Noguchi K, Melhem ER, Kanazawa T, Kubo M, Kuwayama N, Seto H. Intracranial dural arteriovenous fistulas: evaluation with combined 3D time-of-flight MR angiography and MR digital subtraction angiography. AJR Am J Roentgenol 2004;182:183-90. |
Observational-Dx |
17 MR angiograms in 15 patients and 35 MR angiograms in 35 controls |
To compare the diagnostic utility of 3D time-of-flight (TOF) MR angiography and MR digital subtraction angiography in patients with angiographically proven moderate- to high-flow intracranial dural arteriovenous fistula. |
In patients with dural arteriovenous fistula, source images of 3D TOF MR angiography showed two abnormal findings: multiple high-intensity curvilinear or nodular structures adjacent to the sinus wall and high-intensity areas in the venous sinus. Findings of multiple high-intensity structures adjacent to the sinus wall were observed in all cases of dural arteriovenous fistula. Findings of high-intensity areas in the venous sinus were observed in 13 of 17 cases of dural arteriovenous fistula. Findings of multiple high-intensity structures adjacent to the sinus wall were not observed in any control subjects. Findings of high-intensity areas within the venous sinus were observed in five of 35 control subjects. Findings of MR digital subtraction angiography showed early filling of the venous sinus, suggestive of dural arteriovenous fistula, in 13 of 15 patients with dural arteriovenous fistula. Sensitivity and specificity of multiple high-intensity structures adjacent to the sinus wall, high-intensity areas in the venous sinus, and early filling of the venous sinus were 100% and 100%, 76% and 86%, and 87% and 100%, respectively. Although 3D TOF MR angiography failed to show the findings of retrograde cortical venous drainage and venous sinus occlusion, MR digital subtraction angiography clearly showed both findings in all five subjects. |
2 |
| 60. Chadha NK, Weiner GM. Vascular loops causing otological symptoms: a systematic review and meta-analysis. Clin Otolaryngol 2008;33:5-11. |
Meta-analysis |
5 studies |
To determine evidence for a relationship between vascular loops in contact with the vestibulocochlear nerve (CN VIII) and otological symptoms. |
Five case-control studies included. A statistically significant association was demonstrated for the prevalence of vascular loops in contact with CN VIII, with unilateral sensorineural hearing loss: pooled odds ratio (OR) 2.0 [95% confidence interval (CI): 1.5-2.6]. No association was demonstrated for non-pulsatile tinnitus. A highly significant association with vascular loops was shown in subjects having pulsatile tinnitus, with pooled OR: 78.8 (95% CI: 10.9-821.8). |
M |
| 61. Guevara N, Deveze A, Buza V, Laffont B, Magnan J. Microvascular decompression of cochlear nerve for tinnitus incapacity: pre-surgical data, surgical analyses and long-term follow-up of 15 patients. Eur Arch Otorhinolaryngol. 2008;265(4):397-401. |
Review/Other-Dx |
15 patients |
To select a homogeneous group of patients suffering from incapacitating tinnitus who underwent endoscopy-assisted microvascular decompressionthrough a retrosigmoid keyhole approach. |
During the surgery, a vascular compression was found on every patient. In a long-term follow-up, 53.3% (8 cases) of our tinnitus cases improved and 20% (3 cases) of them were completely cured. The ABR returned to normal in all patients who had good clinical results (diminished or disappeared tinnitus). When a vertebral artery loop (5 cases) was concerned we obtained 80% of good clinical results. No one showed amelioration or sudden aggravation of their hearing. Three cases required surgical correction of cerebrospinal fluid leak and one case developed spontaneously regressive swallowing problems. Such microvascular decompression surgery of the cochlear nerve appears to be successful in treating incapaciting tinnitus in particular when a vertebral artery loop is observed. Therefore, in such a case, one might recommend neurovascular decompression surgery, keeping in mind that the complications of this surgery should be minimized by a careful closure of the retrosigmoid approach. In order to ensure a better selection of patient more accurate cochlear nerve monitoring and functional MRI should be a promising assessment. |
4 |
| 62. Nowe V, De Ridder D, Van de Heyning PH, et al. Does the location of a vascular loop in the cerebellopontine angle explain pulsatile and non-pulsatile tinnitus? Eur Radiol. 2004;14(12):2282-2289. |
Observational-Dx |
47 patients |
To investigate patients with unexplained pulsatile and non-pulsatile tinnitus by means of MR imaging of the cerebellopontine angle (CPA) and to correlate the clinical subtype of tinnitus with the location of a blood vessel (in the internal auditory canal or at the cisternal part of the VIIIth cranial nerve). |
High-resolution T2-weighted CISS images of the CPA demonstrate a significantly higher number of vascular loops in the internal auditory canal in patients with pulsatile tinnitus. Virtual endoscopy of the CPA provides a non-invasive view of the anatomical relationships between nerves and blood vessels and can be of use to demonstrate vascular contacts with the cisternal part of the VIIIth cranial nerve in patients with non-pulsatile tinnitus. Our findings indicate that in some patients with non-pulsatile tinnitus, the location of the blood vessel impinging on the cisternal segment of the VIIIth cranial nerve can be correlated with the clinical subtype of tinnitus (high pitch and low pitch). Furthermore, we found a correlation between the clinical presentation of tinnitus (high pitch and low pitch) and the perceptive hearing loss in patients with non-pulsatile tinnitus. |
3 |
| 63. Levine SB, Snow JB Jr. Pulsatile tinnitus. [Review] [38 refs]. Laryngoscope. 97(4):401-6, 1987 Apr. |
Review/Other-Dx |
N/A |
To discuss Pulsatile tinnitus. |
No results stated in the abstract. |
4 |
| 64. Weissman JL, Hirsch BE. Imaging of tinnitus: a review. [Review] [49 refs]. Radiology. 216(2):342-9, 2000 Aug. |
Review/Other-Dx |
N/A |
To discuss the review of imaging of tinnitus. |
No results stated in the abstract. |
4 |
| 65. Li Y, Chen H, He L, et al. Hemodynamic assessments of venous pulsatile tinnitus using 4D-flow MRI. Neurology. 91(6):e586-e593, 2018 08 07. |
Observational-Dx |
21 patients |
To use 4D-flow MRI to characterize hemodynamics of transverse and sigmoid sinus in venous pulsatile tinnitus (PT) patients and to investigate their differences vs healthy controls. |
There were hemodynamic differences between PT patients and healthy controls. Compared with the control group, the PT group showed significantly higher Vtp_avg, Vtp_max, Vavg, Vmax, and Flowavg, and slightly higher PI. For the assessment of flow pattern, inter-reader reproducibility was excellent (? = 1.00). Vortex or turbulence was observed in PT patients with good sensitivity (86.4%) and specificity (90.9%). Drainage dominance was more frequently observed in patients (15/21, 71.4%) than healthy controls (4/11, 36.4%). |
2 |
| 66. Farid M, Alawamry A, Zaitoun MMA, Bessar AA, Darwish EAF. Relentless pulsatile tinnitus secondary to dural sinovenous stenosis: is endovascular sinus stenting the answer?. Clin Radiol. 76(7):526-531, 2021 07. |
Observational-Dx |
17 patients |
To assess the efficacy of endovascular venous sinus stenting (EVSS) in treating pulsatile tinnitus (PT) caused by dural venous sinus stenosis (DVSS), and to determine whether it is an adequate remedy in cases with concurrent venous anomalies. |
Except for one patient who continued to complain of PT, all of the patients, including two with concomitant sinus diverticula, described complete resolution of the tinnitus immediately following stenting. The post-stenting PG was significantly lower than the pre-stenting PG (p<0.0001). No procedure related complications occurred and no recurrence was recorded during the follow-up period. |
2 |
| 67. Sundararajan SH, Ramos AD, Kishore V, et al. Dural Venous Sinus Stenosis: Why Distinguishing Intrinsic-versus-Extrinsic Stenosis Matters. AJNR Am J Neuroradiol. 42(2):288-296, 2021 01. |
Observational-Dx |
158 patients |
To review preprocedural imaging of patients with symptomatic idiopathic intracranial hypertension and pulsatile tinnitus, classify the stenosis, and assess a trend between stenosis type and clinical presentation while reviewing the frequencies of other frequently seen imaging findings in these conditions. |
Most patients with idiopathic intracranial hypertension (75 of 115 sinuses, 65%) had extrinsic stenosis, and most patients with pulsatile tinnitus (37 of 45 sinuses, 82%) had intrinsic stenosis. Marked optic nerve tortuosity was more common in idiopathic intracranial hypertension. Cephaloceles were rare in both cohorts, with an increased trend toward the presence in idiopathic intracranial hypertension. Empty sellas were more common in idiopathic intracranial hypertension. Cerebellar tonsils were similarly located at the foramen magnum level in both cohorts. Saccular venous aneurysms were more common in pulsatile tinnitus. Internal jugular bulb diverticula were similarly common in both cohorts. |
2 |
| 68. Gedikli O, Kemal O, Yildirim U, et al. Is there an association between the parameters of arterial stiffness and tinnitus?. Acta Otolaryngol (Stockh). 140(2):128-132, 2020 Feb. |
Observational-Dx |
98 patients |
To investigate the relationship between arterial stiffness and tinnitus using the central pulse-wave analysis method. |
No statistically significant difference was determined between Groups in respect of age, smoking and hypertension (p > .05). Statistically significantly higher Central Pulse Pressure (CPP) values and pulse wave velocity were higher in Group 1 compared to the control group (p < .005). No statistical variation was detected in terms of the augmentation index (18.5 ± 11.3 vs 16.7 ± 10.3, p = .543). |
2 |
| 69. Yeh SJ, Tsai LK, Jeng JS. Clinical and carotid ultrasonographic features of intracranial dural arteriovenous fistulas in patients with and without Pulsatile Tinnitus. J Neuroimaging. 2010;20(4):354-358. |
Observational-Dx |
67 patients |
To characterize the clinical and ultrasonographic features of DAVF in patients with pulsatile tinnitus. |
Pulsatile tinnitus was highly associated with the location and feeding arteries of DAVF (P < .001). The sensitivity of resistive index (RI; Norm, >.72) and end diastolic velocity (EDV; Norm, <21 cm/sec) of external carotid artery (ECA) in CDS study for diagnosing DAVF in patients with pulsatile tinnitus was 95% and 92%, respectively. Changes of RI and EDV of ECA also correlated with the changes of tinnitus status. |
3 |
| 70. Bierry G, Riehm S, Marcellin L, Stierle JL, Veillon F. Middle ear adenomatous tumor: a not so rare glomus tympanicum-mimicking lesion. J Neuroradiol. 37(2):116-21, 2010 May. |
Review/Other-Dx |
N/A |
To present several radiologic and clinical findings that will help the radiologist to discriminate MEAT from GT. |
MEAT and GT appeared as tissular lesion with significant enhancement on CT and MR. A vascular blush was present on angiography in all cases of GT and absent from all cases of MEAT. A close relationship between the tumor and the Jacobson's nerve or its branches was identified in all cases of GT. Pulsatile tinnitus was present in all patients with GT and absent in all patients with MEAT. |
4 |
| 71. Lewis S, Chowdhury E, Stockdale D, Kennedy V, Guideline Committee. Assessment and management of tinnitus: summary of NICE guidance. BMJ. 368:m976, 2020 Mar 31. |
Review/Other-Dx |
N/A |
To discuss the assessment and management of tinnitus |
No results stated in the abstract. |
4 |
| 72. Chari DA, Limb CJ. Tinnitus. [Review]. Med Clin North Am. 102(6):1081-1093, 2018 Nov. |
Review/Other-Dx |
N/A |
To discuss the review of the comprehensive history, physical examination, and audiogram of Tinnitus. |
No results stated in the abstract. |
4 |
| 73. Lee CF, Lin MC, Lin HT, Lin CL, Wang TC, Kao CH. Increased risk of tinnitus in patients with temporomandibular disorder: a retrospective population-based cohort study. Eur Arch Otorhinolaryngol 2016;273:203-8. |
Review/Other-Dx |
37,925 patients |
To determine whether there is an increased risk of tinnitus in patients with temporomandibular joint (TMJ). |
A higher proportion of TMJ disorder patients suffered from hearing loss (5.30 vs. 2.11 %), and degenerative and vascular ear disorders (0.20 vs. 0.08 %) compared with the control patients. The crude hazard ratio (HR) of tinnitus in the TMJ disorder cohort was 2.73-fold higher than that in the control patients, with an adjusted HR of 2.62 (95 % CI = 2.29-3.00). The comorbidity-specific TMJ disorder cohort to the control patients' adjusted HR of tinnitus was higher for patients without comorbidity (adjusted HR = 2.75, 95 % CI = 2.39-3.17). We also observed a 3.22-fold significantly higher relative risk of developing tinnitus within the 3-year follow-up period (95 % CI = 2.67-3.89). |
4 |
| 74. Funnell JP, Craven CL, Thompson SD, et al. Pulsatile versus non-pulsatile tinnitus in idiopathic intracranial hypertension. Acta Neurochir (Wien). 160(10):2025-2029, 2018 10. |
Observational-Dx |
59 patients |
To determine tinnitus symptom response after dural venous sinus stenting (DVSS) or CSF diversion with a shunt, in patients with both pulsatile (PT) and non-pulsatile tinnitus (NPT). |
We identified 59 patients with IIH (56 F:3 M), mean age 32.5 ± 9.49 years, 14 of whom suffered from tinnitus. Of these 14, seven reported PT and seven reported NPT. Patients with tinnitus had a mean 24-h ICP and PA of 9.09 ± 5.25 mmHg and 6.05 ± 1.07 mmHg respectively. All 7 patients with PT showed symptom improvement or resolution after DVSS (n = 4), secondary DVSS (n = 2) or shunting (n = 1). In contrast, of the 7 with NPT, only 1 improved post intervention (DVSS), despite 2 patients having shunts and 5 having DVSS. |
2 |
| 75. Ocak E, Kocaoz D, Acar B, Topcuoglu M. Radiological Evaluation of Inner Ear with Computed Tomography in Patients with Unilateral Non-Pulsatile Tinnitus. J. int. adv. otol.. 14(2):273-277, 2018 Aug. |
Observational-Dx |
115 patients |
To investigate the possible relationship between tinnitus and certain bony inner ear structures using computed tomography (CT). |
The mean BCNC width was significantly narrower in G1 and G2 than in the control group (G3) (p<0.001). For patients in G2, BCNC width was significantly narrower in ears with tinnitus (p<0.001) than in ears without tinnitus. The mean IAC diameter at PAI was also narrower in the G1 patients (p=0.007) compared with the other groups. |
2 |
| 76. Willinsky RA. Tinnitus: imaging algorithms. Can Assoc Radiol J 1992;43:93-9. |
Review/Other-Dx |
N/A |
To review imaging algorithms based on symptoms and signs. |
For patients with nonpulsatile tinnitus and a normal drum, magnetic resonance imaging is preferred if a retrocochlear lesion is suspected, whereas high-resolution computed tomography (HRCT) is recommended if a cochlear abnormality is likely. If a chronic inflammation in the middle ear is suspected, HRCT is the study of choice to differentiate cholesteatoma from chronic otitis media. If the bruit is objective and the tympanic membrane normal, selective cerebral angiography should be the initial investigation, because most such patients have an acquired vascular abnormality, usually a dural arteriovenous fistula. If there is pulsatile tinnitus and a retrotympanic mass, HRCT should be the first examination because this technique allows differentiation of a vascular variation, such as an aberrant carotid artery or jugular dehiscence, from a paraganglioma. |
4 |
| 77. Gimsing S. Vestibular schwannoma: when to look for it? J Laryngol Otol. 2010;124(3):258-264. |
Observational-Dx |
199 vestibular schwannoma patients and 225 non-tumour patients |
To compare audiometric parameters in patients with vestibular schwannoma and in those with asymmetric hearing loss from other causes; and to assess proposed screening criteria by comparing published protocols. |
Vestibular schwannoma and non-tumour patients with little or no hearing loss in the unaffected ear were inseparable; however, vestibular schwannoma patients with hearing loss in the unaffected ear had greater audiometric asymmetry, compared with non-tumour patients with the same pattern of hearing loss. The sensitivity of screening protocols varied from 73 to 100 per cent; parallelism was observed between sensitivity and screening rate. |
3 |
| 78. Cao W, Hou Z, Wang F, Jiang Q, Shen W, Yang S. Larger tumor size and female gender suggest better tinnitus prognosis after surgical treatment in vestibular schwannoma patients with tinnitus. Acta Otolaryngol (Stockh). 140(5):373-377, 2020 May. |
Observational-Dx |
298 patients |
To investigate the tinnitus maintenance mechanism from the view of tinnitus change after surgical treatment in vestibular schwannoma (VS) patients |
Among 298 VS cases, 201 of them had tinnitus symptom (67.4%). No statistical difference in the surgical approach was found between the tinnitus poor outcome and good outcome groups (p = .14), and statistical difference was found in gender (p = .04) and tumor size (p = .01) between the two groups. Binary logistic regression analysis revealed that gender (odds ratio [OR], 2.12; 95% CI, 1.10-4.08 [p = .03]) and tumor size (OR, 2.22; 95% CI, 1.16-4.24 [p = .02]) emerged as a significant and independent factor associated with the good outcome of tinnitus |
2 |
| 79. Jiang ZY, Kutz JW, Jr., Roland PS, Isaacson B. Intracochlear schwannomas confined to the otic capsule. Otol Neurotol. 2011;32(7):1175-1179. |
Review/Other-Dx |
10 cases |
To determine the natural history and management for patients with intracochlear schwannomas. |
Hearing loss was present in all 10 patients at their initial presentation. Tinnitus was present in 50% of patients, and vertigo was present in 30% of patients. No patient presented with aural fullness or facial weakness. The pattern of hearing loss seemed to correlate with the location of the lesion within the cochlea. Of the 9 patients that had follow-up MRIs, 3 patients showed tumor growth. Two of the 10 patients underwent surgical excision for intractable vertigo that resulted in resolution of symptoms |
4 |
| 80. Springborg JB, Poulsgaard L, Thomsen J. Nonvestibular schwannoma tumors in the cerebellopontine angle: a structured approach and management guidelines. Skull Base 2008;18:217-27. |
Review/Other-Dx |
N/A |
To provide a structured approach to the diagnosis of nonvestibular schwannoma cerebellopontine angle (CPA) lesions and also management guidelines. |
No results listed in abstract. |
4 |
| 81. Choi KJ, Sajisevi MB, Kahmke RR, Kaylie DM. Incidence of Retrocochlear Pathology Found on MRI in Patients With Non-Pulsatile Tinnitus. Otol Neurotol. 36(10):1730-4, 2015 Dec. |
Observational-Dx |
218 patients |
To identify the incidence of retrocochlear pathology on MRI in patients with non-pulsatile tinnitus. |
Of the 218 patients who met inclusion criteria, 198 (91.3%) had unremarkable MRIs. Six patients (2.7%) had MRI findings that accounted for their tinnitus. Of these patients, five had unilateral tinnitus with asymmetric hearing loss because of acoustic neuroma found on MRI. One patient presented with bilateral tinnitus with asymmetric hearing loss and was found to have a right acoustic neuroma. Twenty (9.2%) patients had bilateral or unilateral tinnitus without hearing loss, all with unremarkable MRIs. Fourteen patients (6.4%) had incidental findings including two acoustic neuromas that were identified contralateral to the side of presenting tinnitus. |
4 |
| 82. Arai M, Takada T, Nozue M. Orthostatic tinnitus: an otological presentation of spontaneous intracranial hypotension. Auris Nasus Larynx 2003;30:85-7. |
Observational-Dx |
1 patient |
To report a case of spontaneous intracranial hypotension with orthostatic tinnitus. |
Cranial MRI with gadolinium infusion showed diffuse enhancement of the dura mater. Radionuclide cisternography demonstrated CSF leaks at the upper and lower thoracic levels. Epidural blood patches at these leak sites alleviated the orthostatic headache, however, orthostatic tinnitus and muffled hearing persisted. Initial audiometry was unremarkable; repeat audiometry performed 6 weeks later demonstrated low-frequency hearing loss in the right ear. Continuous epidural saline infusion for 3 consecutive days was performed; auditory symptoms disappeared 4 weeks thereafter. |
4 |
| 83. Isildak H, Albayram S, Isildak H, Spontaneous intracranial hypotension syndrome accompanied by bilateral hearing loss and venous engorgement in the internal acoustic canal and positional change of audiography. Journal of Craniofacial Surgery. 21(1):165-7, 2010 Jan. |
Review/Other-Dx |
1 patient |
To describe spontaneous intracranial hypotension (SIH) as a curable reason of hearing loss, tinnitus, and vertigo. |
Spontaneous intracranial hypotension, which may cause Meniere syndrome-like symptoms, is a curable reason of hearing loss, tinnitus, and vertigo. In addition, the fluctuation of the hearing loss with positional changes supports the use of positional audiometry when evaluating hearing loss-related SIH. Venous engorgement in the internal acoustic canal may be related to the symptoms. |
4 |
| 84. Loureiro RM, Sumi DV, Lemos MD, et al. The role of magnetic resonance imaging in Meniere disease: the current state of endolymphatic hydrops evaluation. Einstein. 17(1):eMD4743, 2019 Feb 25. |
Review/Other-Dx |
N/A |
To discuss the role of magnetic resonance imaging in Meniere disease: the current state of endolymphatic hydrops evaluation. |
No results stated in the abstract. |
4 |
| 85. Paskoniene A, Baltagalviene R, Lengvenis G, et al. The Importance of the Temporal Bone 3T MR Imaging in the Diagnosis of Meniere's Disease. Otol Neurotol. 41(2):235-241, 2020 02. |
Observational-Dx |
105 patients |
To evaluate endolymphatic hydrops using the 3T temporal bone magnetic resonance imaging (MRI), performed according to the chosen protocol, and determine whether it could be applied as an objective diagnostic tool for Menière's disease |
78.1% of subjects had abnormal MRI findings other than hydrops, and it was more than 90% (50/55) of patients in the definite MD group (p < 0.001). Changes in caloric test were observed in 63.8% of subjects in general, and in 76.4% of patients with a definite Menière's disease. The side of the endolymphatic hydrops observed on MR imaging corresponded to the clinical diagnosis of the Menière's disease based on the results of audiometry (p < 0.001) and unilateral weakness (p < 0.001). Endolymphatic hydrops on MRI and directional preponderance in caloric test were two independent predictors of the definite Menière's disease. |
2 |
| 86. Patel VA, Oberman BS, Zacharia TT, Isildak H. Magnetic resonance imaging findings in Meniere's disease. J Laryngol Otol. 131(7):602-607, 2017 Jul. |
Observational-Dx |
78 patients |
To identify and evaluate cranial magnetic resonance imaging findings associated with Ménière's disease. |
Lack of visualisation of the left and right vestibular aqueducts was identified as statistically significant amongst Ménière's disease patients (left, p = 0.0001, odds ratio = 0.02; right, p = 0.0004, odds ratio = 0.03). Both vestibular aqueducts were of abnormal size in the Ménière's disease group, albeit with left-sided significance (left, p = 0.008, odds ratio = 10.91; right, p = 0.49, odds ratio = 2.47). |
2 |
| 87. Perez-Carpena P, Lopez-Escamez JA. Current Understanding and Clinical Management of Meniere's Disease: A Systematic Review. Semin Neurol. 40(1):138-150, 2020 Feb. |
Review/Other-Dx |
N/A |
To conduct a systematic review on MD to update current knowledge, focusing on its mechanisms, diagnosis, comorbidities, and practical management. |
No results stated in the abstract |
4 |
| 88. Pyykko I, Zou J, Poe D, Nakashima T, Naganawa S. Magnetic resonance imaging of the inner ear in Meniere's disease. [Review]. Otolaryngol Clin North Am. 43(5):1059-80, 2010 Oct. |
Review/Other-Dx |
N/A |
A critical review of the recent advancements in the inner ear MRI technology, contrast agent application and the correlated ototoxicity study, and the uptake dynamics of GdC in the inner ear. |
GdC causes inflammation of the mucosa of the middle ear, but there are no reports or evidence of toxicity-related changes in vivo either in animals or in humans. Intravenously administered GdC reached the guinea pig cochlea about 10 minutes after administration and loaded the scala tympani and scala vestibuli with the peak at 60 minutes. However, the perilymphatic loading peak was 80 to 100 minutes in mice after intravenous administration of GdC. In healthy animals the scala media did not load GdC. In mice in which GdC was administered topically onto the round window, loading of the cochlea peaked at 4 hours, at which time it reached the apex. The initial portions of the organ to be filled were the basal turn of the cochlea and vestibule. In animal models with endolymphatic hydrops (EH), bulging of the Reissner's membrane was observed as deficit of GdC in the scala vestibuli. Histologically the degree of bulging correlated with the MR images. In animals with immune reaction-induced EH, MRI showed that EH could be limited to restricted regions of the inner ear, and in the same inner ear both EH and leakage of GdC into the scala media were visualized. More than 100 inner ear MRI scans have been performed to date in humans. Loading of GdC followed the pattern seen in animals, but the time frame was different. In intravenous delivery of double-dose GdC, the inner ear compartments were visualized after 4 hours. The uptake pattern of GdC in the perilymph of humans between 2 hours and 7 hours after local delivery needs to be clarified. In almost all patients with probable or suspected Meniere's disease, EH was verified. Specific algorithms with a 12-pole coil using fluid attenuation inversion recovery sequences are recommended for initial imaging in humans. |
4 |
| 89. Liudahl AA, Davis AB, Liudahl DS, Maley J, Policeni B, Hansen MR. Diagnosis of small vestibular schwannomas using constructive interference steady state sequence. Laryngoscope. 128(9):2128-2132, 2018 09. |
Observational-Dx |
N/A |
To evaluate the diagnostic accuracy of constructive interference steady state (CISS) sequencing compared to gadolinium-enhanced T1 (GdT1) magnetic resonance imaging (MRI) to screen for small vestibular schwannomas (VSs), and to assess the overall diagnostic confidence of neuroradiologists in their ability to accurately diagnose or rule out VSs using constructive interference steady state (CISS) imaging compared to a GdT1 MRI STUDY DESIGN |
The majority of the lesions were in the lateral internal auditory canal, with eight intralabyrinthine tumors. The overall sensitivity of CISS for both readers was 93.5%. All tumor locations had high sensitivities except for the intralabyrinthine location (62.3%). Four of the eight total intralabyrinthine lesions were missed by at least one reader. Each reader was highly confident in diagnosing VSs with CISS, which approximated that of GdT1 MRI. |
4 |
| 90. Chole RA, Parker WS. Tinnitus and vertigo in patients with temporomandibular disorder. Arch Otolaryngol Head Neck Surg 1992;118:817-21. |
Review/Other-Dx |
1032 patients |
To observe tinnitus and vertigo in patients with temporomandibular disorder |
No results listed in abstract. |
4 |
| 91. Park RJ, Moon JD. Prevalence and risk factors of tinnitus: the Korean National Health and Nutrition Examination Survey 2010-2011, a cross-sectional study. Clin Otolaryngol 2014;39:89-94. |
Review/Other-Dx |
10,061 individuals |
To examine the association between tinnitus and several potential risk factors in Korean population. |
Of the 10,061 participants ranging from 20 to 97 years old, the overall prevalence of any tinnitus was 21.4% and annoying tinnitus was 7.3%. In a multivariable logistic regression model, the following factors were associated with having tinnitus: occupational noise exposure [any tinnitus, odd ratio (OR) = 1.34; annoying tinnitus, OR = 1.47], non-occupational noise exposure (any tinnitus, OR = 1.48; annoying tinnitus, OR = 2.02), hearing impairment (any tinnitus, OR = 2.27; annoying tinnitus, OR = 3.61), chronic otitis media (any tinnitus, OR = 1.53; annoying tinnitus, OR = 1.36), chronic rhinosinusitis (any tinnitus, OR = 1.38; annoying tinnitus, OR = 1.38), temporomandibular disorder (any tinnitus, OR = 1.69; annoying tinnitus, OR = 1.90), depression (any tinnitus, OR = 1.44; annoying tinnitus, OR = 1.70), and higher stress level (any tinnitus, OR = 1.28; annoying tinnitus, OR = 1.76). |
4 |
| 92. Chemali Z, Nehme R, Fricchione G. Sensory neurologic disorders: Tinnitus. [Review]. Handb. clin. neurol.. 165:365-381, 2019. |
Review/Other-Dx |
N/A |
To discuss the Sensory neurologic disorders in Tinnitus. |
No results stated in the abstract. |
4 |
| 93. Oosterloo BC, Croll PH, de Jong RJB, Ikram MK, Goedegebure A. Prevalence of Tinnitus in an Aging Population and Its Relation to Age and Hearing Loss. Otolaryngol Head Neck Surg. 164(4):859-868, 2021 04. |
Observational-Dx |
6098 patients |
To investigate the prevalence of tinnitus among a general aging population, across age strata and hearing status. |
Tinnitus was prevalent in 21.4% (n = 1304). Prevalent tinnitus was evenly distributed over 5-year age groups. Participants with hearing impairment were more likely to have tinnitus (odds ratio, 2.27; 95% CI, 1.92-2.69) as compared with those without hearing impairment. The median THI-s score was 4 (interquartile range, 0-10), indicating a slight handicap, and 14.6% of the participants reported a moderate or severe handicap (THI-s =16). |
2 |
| 94. Shapiro SB, Noij KS, Naples JG, Samy RN. Hearing Loss and Tinnitus. [Review]. Med Clin North Am. 105(5):799-811, 2021 Sep. |
Review/Other-Dx |
N/A |
To explain the diagnostic workup of hearing loss and tinnitus, review the pathophysiology of the most common causes, and describe the treatments available |
No results stated in the abstract |
4 |
| 95. American College of Radiology. ACR Appropriateness Criteria® Radiation Dose Assessment Introduction. Available at: https://www.acr.org/-/media/ACR/Files/Appropriateness-Criteria/RadiationDoseAssessmentIntro.pdf. |
Review/Other-Dx |
N/A |
To provide evidence-based guidelines on exposure of patients to ionizing radiation. |
No abstract available. |
4 |
