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Pulsatile tinnitus: contemporary assessment and management

Sismanis, Aristidesa,b

Current Opinion in Otolaryngology & Head and 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.