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Pulsatile tinnitus: contemporary assessment and management

Sismanis, Aristidesa,b

Current Opinion in Otolaryngology & Head & Neck Surgery: October 2011 - Volume 19 - Issue 5 - p 348–357
doi: 10.1097/MOO.0b013e3283493fd8
Otology and neuro-otology: Edited by Myles L. Pensak

Purpose of review: Pulsatile tinnitus is an uncommon otologic symptom, which often presents a diagnostic and management dilemma to the otolaryngologist. The majority of patients with pulsatile tinnitus have a treatable cause. Failure to establish correct diagnosis may have disastrous consequences, because a potentially life-threatening, underlying disorder may be present. The purpose of this review is to familiarize the otolaryngologist with the most common causes, evaluation, and management of pulsatile tinnitus.

Recent findings: The pathophysiology, classification, various causes, evaluation, and management of the most common causes of pulsatile tinnitus are presented in this review.

Summary: Pulsatile tinnitus deserves a thorough evaluation and, in the majority of cases, there is a treatable underlying cause. The possibility of a life-threatening cause needs to be ruled out in every patient with pulsatile tinnitus. The otolaryngologist should be familiar with the evaluation and management of this symptom.

aDepartment of Otorhinolaryngology – Head and Neck Surgery, University of Athens

bA’ ORL Clinic, Ippokration Hospital, Athens, Greece

Correspondence to Aristides Sismanis, MD, FACS, Professor of Otorhinolaryngology – Head and Neck Surgery, University of Athens, Athens, Greece E-mail:

© 2011 Lippincott Williams & Wilkins, Inc.