Causes of Pulsatile Tinnitus
Causes of Pulsatile Tinnitus
Pulsatile Tinnitus:
Vascular anomalies:
- Glomus tumor
- Carotid stenosis
- Congenital arteriovenous malformation
- Aneurysms of the intratemporal portion of the internal carotid
- Prominent jugular bulb
- Benign intracranial hypertension
Other causes of Pulsatile Tinnitus
- Paget’s Disease
- Dysfunction of heart valves
- High cardiac output states (hyperthyroidism, anemia, fever)
- Multiple Sclerosis
- Arnold-Chiari
Nonpulsatile tinnitus:
Objective:
- Tumors of the skull base and temporal bone.
- Eustachian tube open
- Palatal myoclonus
- Spasm idiopathic stapedial muscle
- Prominent jugular bulb
Subjective: In this case, rather than a differential diagnosis must speak of etiological associations: 90% of patients with otologic problems, 33% related vascular disease, 10% is associated with drug use and 5-10% with neurological disease.
Otologic factors:
- Chronic acoustic trauma or sudden
- Otosclerosis
- Presbycusis
- Earwax
- Meniere’s Syndrome
- Acoustic neuroma
- Barotrauma
- Perforated eardrum
Vascular factors:
- Sudden deafness (labyrinthine stroke)
- Hypertension
- Vasculitis
- Atherosclerosis
Factors Hematologic:
- Anemia
- Polycythemia vera
Drugs:
- NSAIDs (mostly aspirin, ibuprofen and naproxen)
- Antibiotics: Aminoglycosides, Erythromycin, Doxycycline, Minocycline
- Diuretics: Furosemide and ethacrynic acid
- Gynecology and heavy metals: cisplatin, mercury, lead
Topical agents otologic: antiseptics, antibiotics and anti-inflammatory
Neurological factors:
- TEC. Whiplash
- Multiple Sclerosis
- Migraine with aura hearing
- Meningitis
- Temporal lobe seizures
- Dental problems and disorders of the temporomandibular joint
Metabolic factors:
- Hyper-or hypothyroidism
- Deficiencies of vitamin A, B12 and zinc
- Hyperlipidemia
Psychological factors: It is not uncommon in patients with tinnitus detect pathology based depressive or anxious. Diagnosis is important because specific treatment of these can significantly improve tinnitus. Also, up to 25% of patients who present with this symptom may develop depressive symptoms.
