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Whoosh [hwoosh, hwoosh, woosh, woosh] noun 1. a loud, rushing noise, as of air or water: a great whoosh as the door opened. verb (used without object) 2. to move swiftly with a gushing or hissing noise: gusts of wind whooshing through the trees. verb (used with object) 3. to move (an object, a person, etc.) with a whooshing motion or sound: The storm whooshed the waves over the road. Also, woosh. Origin: 1840-1850; imit.

Pulsatile tinnitus is not tinnitus.
Pulsatile tinnitus is a rhythmical noise that is synchronous with the patient's heartbeat.

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Pulsatile Tinnitus & Children

Several people have written in with questions about how children with pulsatile tinnitus are affected, including how they may report the symptoms and what behaviors may help indicate that a child is experiencing tinnitus.  Also, some of you have pointed out that you developed tinnitus at such a young age and experienced the symptoms for so long, you didn't realize it was out of the ordinary until years later. 

Children with pulsatile tinnitus (and many other health conditions) often have difficulty describing their symptoms and expressing the way they feel.  After all, this is a challenge even for adult pulsatile tinnitus sufferers.  

There doesn't seem to be much (if any) information specifically focused on how to identify the youngest pulsatile tinnitus sufferers, however this page of questions and answers from The Oregon Tinnitus & Hyperacusis Treatment Clinic addresses tinnitus generally and includes some helpful tips that may help parents identify clues. 

Sat, January 30, 2010 | link          Comments

Poll Results: I Have Experienced _____ Depression In Association With My Pulsatile Tinnitus

48%  Major

36%  Minor

16%  No

25 Votes

Thanks for your vote!  Please participate in the latest Whooshers.com poll.  

Mon, January 25, 2010 | link          Comments

Lady Gaga Heartbeats In-Ear Headphones

On a lighter note, I did a double-take when I saw an ad for the new and (apparently) trendy

Lady Gaga's Heartbeats In-Ear Headphones

"...holistically designed to deliver the soundtrack of your life."

Oh, Ms. Gaga, if you only knew.

Fri, January 22, 2010 | link          Comments

Find A Neurotologist

If you are looking for a neurotologist in the United States, click here to access the 2009-2010 American Neurotology Society membership list by state (PDF file). 

This link will automatically download a PDF file to your downloads folder. 

See the American Neurotology Association for more information.  

Please write Whooshers@gmail.com if you have links to neurotologists outside the United States so we may share them with international Whooshers.

Wed, January 13, 2010 | link          Comments

You're Unremarkable. Don't Take It Personally.

A common frustration experienced by individuals with pulsatile tinnitus is that we endure tests to determine the cause of the PT, only to get results that come back "unremarkable."  One dear whoosher described her "unremarkable" experience on her blog.

The only thing worse than having a test that reveals something not recognizable by doctors (as described in this post a few days ago) is having a test that reveals nothing because it wasn't the right test to begin with and then having doctors who stop investigating the cause of your pulsatile tinnitus.  

Of course, an unremarkable result can be a great relief.  When my first tests came back unremarkable, I was relieved because I had convinced myself that my whoosh had to be caused by a giant brain tumor (even though the chances of this were slim).  Sound familiar?  So yes, I was relieved that the tests did not reveal my great fear.  But after a few minutes of relief, I was faced with: Okay, so now what?  What's causing my pulsatile tinnitus?  Will I ever find out?  

Truth be told, I was tired of tests. But I was even more tired of doctors who told me to "live with" pulsatile tinnitus without any explanation. My frustration motivated me to find doctors who were curious about the cause of my pulsatile tinnitus.

An article written in August 2000 by doctors Jane L. Weissman, MD and Barry E. Hirsch, MD for the medical journal Radiology explains that it is common for these tests to come back with no abnormal results.  The article addresses tinnitus and pulsatile tinnitus. 

Instead of stopping the investigation into the cause of an individual's pulsatile tinnitus, these doctors suggest (to other doctors, by the way; remember, this is a medical journal) that MORE testing be done after initial tests come back normal or "unremarkable," precisely because some causes of pulsatile tinnitus DO NOT SHOW UP on some tests.

Even better, the article lists some conditions and recommends the "best" imaging techniques to diagnose them.  It goes even further about certain conditions.  For example, these doctors suggest that benign intracranial hypertension, "often has no abnormal imaging findings."

Each case is different, but if you're at a dead end and your doctors do not think more tests are necessary, you may want to share this with them.  Even if that CT scan came back "unremarkable," you and your doctors may be able to find answers in other tests. 

Finally, I recognize that this journal article and the one in the last post contradict each other a little bit.  The previous article suggested that the answers (to some conditions) are often in the tests and that the issue is finding a doctor who knows what to look for.  This article suggests that if at first you get unremarkable results in a test, have further tests. 

I suppose the solution is somewhere in the middle.  

Source: "Imaging of Tinnitus: A Review," August 2000 Radiology, 216, 342-349. 

Mon, January 11, 2010 | link          Comments

Sigmoid Sinus Diverticulum: An(other) Identifiable (And Reparable) Cause Of Pulsatile Tinnitus

We know that there are many possible causes of PT.  Sigmoid Sinus Diverticulum, a condition not many doctors are aware of, is just one in a sea of possibilities.  This post is not so much about the symptoms of this condition.  Instead, I'm focusing on the story within the story here.  Bear with me...

Doctors who conducted the study below say the condition can be detected in a CTA/V (computed tomographic arteriography and venography) and that a “new surgical approach” can correct it.  This part of the abstract jumped out at me:

"Results: All patients electing surgical reconstruction had immediate and lasting resolution of the tinnitus."

Great news!  But the catch is, doctors who look at the CTA/V need to know what to look for.  Even the best doctors may not have this condition on their radar.  Apparently, it was first reported in medical journals only within the last few years.

Couple that with the fact that few doctors specialize in pulsatile tinnitus and voila!  Some validation for all the frustration in finding the cause of your whoosh.

Many of us have had a variety of tests that come back “unremarkable” or without anything that appears abnormal. This study, completed by doctors for doctors, indicates that in the case of this particular condition, the answers are often in the films of these tests; it’s just a matter of finding the right doctor who can recognize the problem.

I hear from many of you who tell me you've had tests over 1, 5, even 20 years, only to find out that the original tests revealed the cause of your whoosh.  Regular readers of Whooshers.com will remember that this was true, too, in the case of the whoosher with Chiari Malformation who told her story here. Years of suffering that didn't have to happen.  

Moral of the story: Don't give up if your tests come back "unremarkable." 

This abstract/summary below is for a study that explores diagnosis of sigmoid sinus diverticulum and surgery to correct it in select pusaltile tinnitus patients.

Otology & Neurotology - Abstract: Volume 28(1) January 2007 p 48-53 Sigmoid Sinus Diverticulum: A New Surgical Approach to the Correction of Pulsatile Tinnitus.

There aren't many resources about this condition in layman's terms (if you find one, please send it to us!), so ask your doctor for more information.  If s/he hasn't heard about it, provide them with the Web site above!

One patient describes her experience with sigmoid sinus diverticulum (symptoms/diagnosis/treatment) here.

Remember, this site is not a place to diagnose yourself or others.  We’re simply putting information out there –information that is already out there, but often difficult to find—to encourage you to continue seeking the cause of your PT, and to inform you as you have discussions with your doctors.

Have you been diagnosed with sigmoid sinus diverticulum?  If so we’d like to hear about your experience at whooshers@gmail.com, or post below in the comments section. 

Fri, January 8, 2010 | link          Comments

Poll Results: When I Press On My Neck On The Side Of The Pulsatile Tinnitus, The Whooshing ...

34%  subsides dramatically. 

27%  disappears completely!  

27%  remains the same. 

10%  subsides just a bit. 

1%   Other answer...

41 Votes

Thanks for voting!  Please vote in this week's new poll.  

Fri, January 8, 2010 | link          Comments

Medical Books, Articles & Journals About Pulsatile Tinnitus

Click HERE for a link to a selection of materials that mention pulsatile tinnitus.

Most of these are technical and not in lay terms, but you can read the abstracts (summaries/overviews) and discuss them with your doctor.  

Thu, January 7, 2010 | link          Comments

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Diagnosis and Treatment of Pulsatile Tinnitus, Dr. Maksim Shapiro, NYU Neurointerventional Radiology Section, NYU Langone Medical Center - neuroangio.org

Radiation Dose Chart - American Nuclear Society (ANS) Public Information Resources Page: Click here for an interactive dose chart for various medical diagnostic tests. A downloadable and printable version is also available on this page. Discuss with your doctors.

Find a Neurotologist: American Neurotological Society (ANS) Membership Roster

Find a Neurointervention Specialist: Society of Neurointerventional Surgery (SNIS)- Click on "Doctor Finder"

Find a Neuro-Ophthalmologist: The North American Neuro-Ophthalmology Society (NANOS)

Site: Neuroangio.org - Your neurovascular education and information resource. Patient Information.

UCSF Pulsatile Tinnitus Clinic

Article: "Pulsatile Tinnitus: Differential Diagnosis and Radiological Work-Up," Sjoert A. H. Pegge, Stefan C. A. Steens, Henricus P. M. Kunst, and Frederick J. A. Meijer, Department of Radiology and Nuclear Medicine, Radboud University Medical Center Nijmegen and Department of Otorhinolaryngology, Radboud University Medical Center Nijmegen, The Netherlands. (SEE TABLE 1).

Presentation: "Algorithm for Evaluation of Rhythmic Tinnitus," Douglas E Mattox, MD, Patricia Hudgins, MD, Jahrsdoerfer Lecture, University of Virginia, March 25, 2010. (This link is to the abstract/summary)

Presentation: "Imaging of the Patient with Tinnitus," Mary Beth Cunnane MD, Massachusetts Eye and Ear Infirmary, Dec 2013. (NEW! Mentions Pulsatile Tinnitus and Whooshers.com. Republished with Permission.)

Article: "Imaging in Pulsatile Tinnitus: Diagnostic Pearls and Potential Pitfalls," B. S. Purohit, R. Hermans, K. Op de beeck; 1SINGAPORE/SG, 2Leuven/BE, European Society of Radiology, 2014.

Article: "Imaging In Pulsatile Tinnitus : When Should It Ring A Bell?" G. Bathla1, V. Chong; 1singapore/SG, 2Singapore/SG, European Society of Radiology, 2012."

Article: "Pulsatile Tinnitus: Contemporary Assessment and Management," Aristides Sismanis, Current Opinion in Otolaryngology & Head & Neck Surgery: October 2011 - Volume 19 - Issue 5 - p 348357 doi: 10.1097/MOO.0b013e3283493fd8, Otology and neuro-otology: Edited by Myles L. Pensak.

NEW Article: "Emergence of Venous Stenosis as the Dominant Cause of Pulsatile Tinnitus," Eytan RazErez NossekDaniel Jethanamest, Vinayak Narayan, Aryan Ali, Vera Sharashidze, Tibor Becske, Peter K. Nelson, Maksim Shapiro, Originally published8 May 2022 https://doi.org/10.1161/SVIN.121.000154, American Heart Association Journal - Stroke: Vascular and Interventional Neurology. 2022;0:e000154

Article: "Temporal Bone: Vascular Tinnitus," William W.M. Lo and M. Marcel Maya, Vascular, pp.1361-1374, 2003.

Article: "Diagnostic Clues in Pulsatile Tinnitus (Somatosounds)," Carlos Herraiza and José Miguel Aparicioa, Unidad de Acúfenos; Instituto ORL Antolí-Candela, Madrid, Spain; Unidad de Otorrinolaringología, Fundación Hospital Alcorcón, Madrid, Spain; Otorrinolaringología, Hospital Quirón, Madrid, Spain, Acta Otorrinolaringol Esp. 2007;58(9):426-33. This is a link to the article abstract.

Article: "How I Struggled with (PULSATILE) Tinnitus," The Story of Actor Graham Cole, Daily Mail Online, January 10, 2007.

Article: "I Got Lifesaving OP for Whooshing Thanks to US Help," David Powell, Daily Post UK, DPW West, Feb 19, 2013.

Article: "Vital Signs: An Unwelcome Ringing," by Dr. Christopher Linstrom, Discover Magazine, April 2010. (About a cured patient with pulsatile tinnitus symptoms!)

Article: "Tinnitus Highlights Poor Doctor Patient Communication," Martin Young, MBChB, FCS(SA), Diagnosis and Treatment, KevinMd.Com, November 2010.

Article: "Pulsatile Tinnitus: Recent Advances in Diagnosis," Aristides Sismanis MD, Wendy R. K. Smoker, MD, The Laryngoscope, Volume 104, Issue 6, pages 681-688, June 1994. ABSTRACT (Summary)

Article: "Neuroradiologic Assessment of Pulsatile Tinnitus," Department of Otolaryngology Head and Neck Surgery Loyola University Medical Center, Maywood, IL: Dr Kircher and Dr Leonetti; Department of Otolaryngology-Head and Neck Surgery Henry Ford Health System, Detroit, MI: Dr Standring; Presented at the Annual Meeting of the American Academy of Otolaryngology-Head Neck Surgery, Chicago, IL. Sept. 22-24, 2008. (CLICKING THIS LINK WILL DOWNLOAD THE PDF FILE)

Article: "Imaging of Tinnitus: A Review," Jane L. Weissman, MD and Barry E. Hirsch, MD, Radiology, August 2000.

Article: "Imaging in Pulsatile Tinnitus," G. Madania and S.E.J. Connor, Clinical Radiology, Volume 64, Issue 3, Pages 319-328 (March 2009).

Article: "Imaging of the Patient With Tinnitus," Mary Beth Cunnane MD, Massachusetts Eye and Ear Infirmary, December 31, 2013. (NEW! Mentions Whooshers.com and PULSATILE tinnitus as well.)

Article: "Imaging of Pulsatile Tinnitus: A Review of 74 Patients," Guner Sonmez, C Cinar Basekim, Ersin Ozturk, Atilla Gungor, Esref Kizilkaya, Clinical Imaging, Volume 31, Issue 2, Pages 102-108 (March 2007). (This is an abstract/summary-you have to pay to see the article in its entirety)

Article: "Pulsatile Tinnitus: A Review of 84 Patients," Daniel Waldvogel, Heinrich P. Mattle, Matthias Sturzenegger and Gerhard Schroth, Journal of Neurology, Volume 245, Number 3, 137-142, DOI: 10.1007/s004150050193, November 12, 1997.

Article: "Role of Angiography in the Evaluation of Patients With Pulsatile Tinnitus," Edward J. Shin, MD; Anil K. Lalwani, MD; Christopher F. Dowd, MD, Laryngoscope 110: November 2000. (PDF FILE)

Article: "Angioplasty and Stenting for Intractable Pulsatile Tinnitus Caused by Dural Venous Sinus Stenosis: A Case Series Report," Li Baomin, Shi Yongbing, and Cao Xiangyu, Dept of Neurosurgery, Chinese PLA General Hospital, Beijing, Otol Neurotol. 35.366-370. Dec 2014.

Article: "CT Angiography as a Screening Tool for Dural Arteriovenous Fistula in Patients with Pulsatile Tinnitus: Feasibility and Test Characteristics," J. Narvid, H.M. Do, N.H. Blevins and N.J. Fishbein, American Journal of Neuroradiology 32:446-453, March 2011.

Article: "Brain Dural Arteriovenous Fistula (BDAVF)," Patient Information, www.NeuroAngio.org

Article: "Usefulness of C-Arm Cone-Beam Computed Tomography in Endovascular Treatment of Traumatic Carotid Cavernous Fistulas: A Technical Case Report," Sato, Kenichi MD, PhD; Matsumoto, Yasushi MD; Kondo, Ryushi MD, PhD; Tominaga, Teiji MD, PhD, Neurosurgery: August 2010 - Volume 67 - Issue 2 - p 467470.

Article (Abstract): "A Convenient Sonographic Technique for Diagnosis of Pulsatile Tinnitus Induced by a High Jugular Bulb," The American Institute of Ultrasound in Medicine, Minoru Nakagawa, MD, Norimitsu Miyachi, MLT and Kenjiro Fujiwara, MD, Department of Neurosurgery (M.N., K.F.) and Clinical Laboratory (N.M.), Kosei General Hospital, Hiroshima, Japan, J Ultrasound Med 27:139-140 0278-4297, 2008.

Article: "Surgical Treatment of the High Jugular Bulb in Patients with Ménières Disease and Pulsatile Tinnitus," V. Couloigner, A. Bozorg Grayeli, D. Bouccara, N. Julien and O. Sterkers, European Archives of Oto-Rhino-Laryngology Volume 256, Number 5, 224-229, DOI: 10.1007/s004050050146 (ABSTRACT)

Article: "Brain AVM," (arteriovenous malformation), MayoClinic.com

Article: "Chiari Malformation," MayoClinic.com

Article: "Ménière's Disease," National Institute on Deafness and Other Communication Disorders (NIDCD)

Article: "TMJ Disorders," MayoClinic.com

Article: "Anemia," American Society of Hematology, Hemotology.org

Article: "Pseudotumor Cerebri," (also called Benign Intracranial Hypertension) MayoClinic.com

Article: "Pulse-Synchronous Tinnitus," The Intracranial Hypertension Research Foundation

Article: "Coarctation of the Aorta," MayoClinic.com

Article: "Man Cured of Hearing His Eyeballs Move," www.bbc.co.uk, July 27, 2011. Superior Canal Dehiscence Syndrome (SCDS)

Article: "Diagnosis and Cure of Venous Hum Tinnitus," Laryngoscope, Chandler JR, 93(7):892-5, July 1983.

Article: (Abstract) "Sinus Wall Reconstruction for Sigmoid Sinus Diverticulum and Dehiscence: A Standardized Surgical Procedure for a Range of Radiographic Findings," Dr. DJ Eisenman, Department of Otorhinolaryngology - Head & Neck Surgery, University of Maryland School of Medicine, Baltimore, Maryland; Otology Neurotology, 32(7):1116-9; September 2011.

Article: (Abstract) "Awake Embolization of Sigmoid Sinus Diverticulum Causing Pulsatile Tinnitus: Simultaneous Confirmative Diagnosis and Treatment," Park YH, Kwon HJ, Department of Otolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Republic of Korea, Interv Neuroradiol. 2011 Sep;17(3):376-9. Epub 2011 Oct 17. (NEW!)

Article: "A New Therapeutic Procedure for Treatment of Objective Venous Pulsatile Tinnitus," Sanchez TG, Murao M, Medeiros HRT, Kii M, Bento RF, Caldas JG, et al. Int Tinnitus J. 2002;8(1):54-57.

Article: "Glomus Tympanicum," The New England Journal of Medicine, Volume 362:e66, Number 22, June 3, 2010.

Article: "Resolution of Pulsatile Tinnitus Following an Upper Mediastinal Lymph Node Resection," Wang YZ, Boudreaux JP, Campeau RJ, Woltering EA, South Med J. 2010 Apr;103(4):374-7.

Article: (Abstract) "Dissection of the Internal Carotid Artery After SCUBA-Diving: A Case Report and Review of the Literature," Franz Hafner, MD,* Thomas Gary, MD,* Froehlich Harald, MD,* Ernst Pilger,* Reinhard Groell, PD,w and Marianne, Brodmann* "Neurologist. 17(2):79-82, March 2011. (NEW!)

Article: "Carotid-Cavernous Sinus Fistula," Bobby S. Korn, M.D., Ph.D., and Kang Zhang, M.D., Ph.D., N Engl J Med 2011; 364:e15, February, 24, 2011. (WARNING: GRAPHIC IMAGES)

Article: "Pulsatile Tinnitus Cured by Mastoidectomy," Duvillard C, Ballester M, Redon E, Romanet P., Department of Otolaryngology-Head and Neck Surgery, Hôpital Général, Dijon, France, Ann Otol Rhinol Laryngol, September 2004.

Article: "Pulsatile Tinnitus: A Symptom of Chronic Subclavian Artery Occlusion," Marcio Francisco Lehmann, Charbel Mounayer, Goetz Benndorf, Michel Piotin, and Jacques Moret, AJNR Am J Neuroradiol 26:19601963, September 2005 (PDF).

Article: "Carotid Endarterectomy Relieves Pulsatile Tinnitus Associated with Severe Ipsilateral Carotid Stenosis," J Kirkby-Bott, H.H Gibbs, European Journal of Vascular & Endovascular Surgery, Volume 27, Issue 6, Pages 651-653, June 2004.

Article: "MR Angiography Imaging of Absence Vertebral Artery Causing of Pulsatile Tinnitus: A Case Report," *Mehmet Cudi Tuncer; **Yekta Helbest Akgül & *Özlen Karabulut,* Department of Anatomy, Faculty of Dicle University, 21280, Diyarbak¹r, Turkey.** Department of Otorhinolaryngology, Özel Diyarbakr Hospital, 21100, Diyarbakr, Turkey, International Journal of Morphology, v.28 n.2 Temuco Jun. 2010."

Article: "Endovascular Treatment of Sigmoid Sinus Aneurysm Presenting as Devastating Pulsatile Tinnitus. A Case Report and Review of Literature." Mehanna R, Shaltoni H. Morsi H, Mawad M., Interv Neuroradiol. 2010 Dec;16(4):451-4. Epub 2010 Dec 17.

"Pulsatile Tinnitus Caused by an Aneurysm of the Transverse-Sigmoid Sinus: A New Case Report and Review of Literature," Lenck S, Mosimann PJ, Labeyrie MA, Houdart E., Department of Neuroradiology, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France, J Neuroradiol. 2012 Oct;39(4):276-9. doi: 10.1016/j.neurad.2012.02.001. Epub 2012 Sep 29. (NEW!)

Article: "Intractable Tinnitus and Sensorineural Deafness Cured by Surgical Correction of Coarctation of Aorta," S. Rathinam, A.M. Pettigrew, J.C.S. Pollack, Interactive Cardiovascular and Thoracic Surgery 3:431-433 (2004).

Article: "Pulsatile Tinnitus," Don McFerran FRCS Consultant Otolaryngologist Essex County Hospital, Colchester, British Tinnitus Association, October 2007.

Article: "Pulsatile Tinnitus and Dural Arteriovenous Malformation (Dural AVM)," G. A. J. Morrison, The Journal of Laryngology & Otology (1989), 103:1073-1075 Cambridge University Press (ABSTRACT).

Article: "Medical Mystery: Giving Birth Didn't Ease a Woman's Dangerous Hypertenstion," Sandra G. Boodman, The Washington Post, October 17, 2011.

Article: "That Noise Wasn't Just Tinnitus," Sandra G. Boodman, Special to The Washington Post, July 7, 2009

Article: "What's That Noise In Her?" H. Lee Kagan, Discovery Magazine, January 2006. (About a patient with arteriovenous malformation (AVM) and her doctor whose patience and persistence paid off).

Article: "The 'Rare' Disease That Isn't," Thomas M. Burton, The Wall Street Journal, June 27, 2009

Article: "Diseases and Conditions/ Fibromuscular Dysplasia (FMD)," Cleveland Clinic. Lists symptoms, details, treatments, and resources including Whooshers.com.

Article: Unraveling Pulsatile Tinnitus in FMD: A Report of the United States Registry For Fibromuscular Dysplasia."

Video: "A Rare Disease That May Be Underdiagnosed," Thomas M. Burton, June 26, 2009 (Hear an example of a whooshing sound in this short video)

Whooshers.com Pulsatile Tinnitus Sounds (Real Ones Recorded by Real Whooshers!)

Audio: Having trouble describing the sound you hear to others? Listen to this collection of sounds that whoosh and see if you can find a match to yours! Demonstrations: Heart Sounds & Murmurs, from the University of Washington Department of Medicine

Whooshers.com Review: SleepPhones- Soft, comfortable headphones to help mask the whoosh for a good night's sleep.

Replace "ringing" with "whooshing," and here it is: our theme song.