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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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Poll Results: Are You a Female Whoosher or a Male Whoosher?

79.5% Female (89 votes)

20.5% Male (23 votes)

Total Votes: 112

Well ladies, we've taken the prize against the men, except I'm not sure it's something to brag about.  Seems many more women than men experience pulsatile tinnitus.  

This poll was originally posted back in 2009.  I was interested, since we have so many more visitors to this site now, to post the same question again. This is the first time I've posted the same question twice.   

Even though we had many more votes this time (112!), statistically, the results of each poll were almost exactly the same: about 80% women; 20% men. 

While these polls are not scientific, it is interesting, isn't it?

Thanks to all of you who answered the last poll.  You can view these poll results and the results from all of the previous Whooshers.com polls on our Poll Results page.  

And please be sure to vote in the brand new poll posted on the right-hand side of the page.  Happy voting!

Sun, June 19, 2011 | link          Comments

Correcting the Pulsatile Tinnitus Record

Recently, an article about pulsatile tinnitus was published in "The Altamont Enterprise & Albany County Post," a local weekly paper in upstate New York. I was contacted to include comments for the article and provided them; I was thrilled that the paper had decided to devote a portion of their paper to pulsatile tinnitus. 

However, after the article was published in hard copy and posted online, I was surprised to read that it included some inaccurate and unclarified information about pulsatile tinnitus and the doctors who treat the symptom.  Further, the article was published without my review nor (more significantly) the review of a doctor. 

I quickly brought these concerns and an opportunity to correct them to the paper's attention, and well, for a variety of reasons, changes were not made to the article, which is still available online since its original April 2011 publication.

Like many of you, I first discovered the term "pulsatile tinnitus" online, not in a doctor's office.  Hardly any of my doctors even knew what pulsatile tinnitus was, not to mention what might be the cause of it.  

And, as many of you have probably figured out, there's a ton of misinformation online.  There are trolls on message boards that cut and paste misguided bullets lists of "things to do" when you have pulsatile tinnitus.  There are articles written about tinnitus that mistakenly and misleadingly mingle pulsatile tinnitus symptoms and causes with those of regular tinnitus.  There are ads for medication and supplements that falsely claim to "cure" pulsatile tinnitus.  I could go on and on. 

Sometimes, the intentions are good and sometimes they are not.  It's not easy for the typical online reader to distinguish the intentions behind any piece online, especially since virtually anyone with any level of knowledge can publish content online.  

It's safe to say that we all feel the same about the bad-intended predators out there... especially those who are out to make a quick buck or a quick page view, with promises of helping patients (victims) who buy their products, these people are in a group by themselves.  Instead of writing what I really think about these people, I'd rather leave them there and leave it at that.  

But then there is the murkier group: those with good intentions who just don't dig deep enough to provide the information necessary for a complete and accurate account of pulsatile tinnitus, a rarely diagnosed and extremely complex medical issue.  

In my view, the only thing worse than no information and bad information is MISinformation. When it comes to health issues, details matter. 

When I was told that no changes or notations would be made to the original article, I was sort of flabbergasted.  It's a health issue... why not correct the record?  Or, as I suggested many times, don't take my word for it... why not have the piece reviewed and commented on by doctors who study, know and understand pulsatile tinnitus?  My offer to help connect the paper to doctors I know and trust to provide this sort of clarification was met with silence. 

In response to the lack of response, I decided to clarify portions of the piece by writing a "Letter to the Editor," which was generously printed in the paper.  The problem?  To my knowledge, an online version of my letter was not published, even though the original article was, and still is, available online.  I had hoped that my letter would supplement the original article, both online and offline, so that *all* readers who find the original article would have a reference for -or at least an opportunity to consider- what I thought were significant points.  Hard copies may get tossed in the garbage but, as we all know, articles posted online are searchable and accessible forever (unless they are taken down or changed), as is the original article to which I refer. 

So, I'm pasting the text of my "Letter to the Editor" below.  I do this not because I'm angry or because I want to one-up the source in the story, the reporter, the editor, the publisher or the paper.  The reason is simply to provide readers and pulsatile tinnitus patients clarified information and the opportunity to learn more about a health issue that debilitates many of us and frustrates all of us.  I am not happy that folks reading the original article online are still provided no indication that the paper has been made aware that it printed information that, in my view, may not be completely accurate.  I should add that I was quoted accurately in the original article; my concerns surround the other parts of the article and my and Whooshers.com's perceived --but nonexistent-- association with that other information. 

As I mentioned in my letter, I am pleased that the paper decided to devote a piece to pulsatile tinnitus; we who suffer from this rarely diagnosed symptom do not yet get all the attention we deserve.  I just wish more thoughtful consideration would have been made in preparation of the piece and to my concerns.  Every bit of consideration that we do get --good OR bad-- matters. 

I started Whooshers.com to fill in the void of lack of information AND misinformation about pulsatile tinnitus.  Every "Cured Whoosher" story / pulsatile tinnitus cause described on this site is supported by a medical institution(s) and the doctors who work very hard to help their pulsatile tinnitus patients.  Links to those sources are provided.  

As I say all the time, the Internet isn't a place to diagnose ourselves or each other, or to "cure" pulsatile tinnitus; doctors' offices are.  And, like many of you, I am not a doctor-- I'm just a patient who has navigated and continues to navigate the road to treatment, with the help of doctors who know and understand pulsatile tinnitus.  The Internet is a great resource to pool information and support for what can be an isolating and debilitating symptom, but we need to be careful about what and whom we trust.  

That's an unfortunate but necessary lesson to learn and remember.

Here is my Letter to the Editor, published May 5, 2011:

I appreciate the attention to pulsatile tinnitus, often an invisible health issue and one that is so misunderstood.  I wish to make a few clarifications, so that people who research this issue will find accurate and consistent information wherever possible.

Pulsatile tinnitus is a symptom of an underlying cause -- it is not a condition.  The list of possible causes is not limited to one medical realm.  For one individual the cause may, in fact, pertain to problems in and around the ears, while for another the underlying cause may manifest in veins, arteries, head, neck or a different area of the body.

There are many doctors around the world who research and investigate pulsatile tinnitus cases and have so for some time.  Whooshers.com highlights dozens of examples of medical journal articles and case studies, written by doctors, for doctors, which patients are encouraged to review with their own doctors.  We help patients find medical professionals who are familiar with pulsatile tinnitus cases whenever possible.  Indeed, compared to more common health issues, there are far fewer medical professionals who have seen a pulsatile tinnitus patient walk into their offices, but there are more than two, and they do not receive enough attention.
In addition, aneurysms and tumors, while potential causes of pulsatile tinnitus, are not common causes of pulsatile tinnitus.  The article's mention of these possibilities and not others shades a devastating prospect on a symptom that is typically not as serious.  There simply is not enough research on pulsatile tinnitus cases to conclude that all cases are caused by any one, two or three causes.

Also, there is no specific diagnostic test that will detect the underlying cause for every pulsatile tinnitus patient, so we often endure multiple tests.  The success of any diagnostic test depends on the cause(s) it is created to detect, as well as on the eyes that are reading the films.  Contrary to the article, MRIs (more precisely, the doctors reading the MRI films) do detect underlying causes in some pulsatile tinnitus patients; there are links to studies on Whooshers.com that support this.  Patients should discuss diagnostic options with doctors who are familiar with the symptom and the long list of possible underlying causes before ruling out the use of any particular test.  

Without a doubt, the underlying cause of pulsatile tinnitus sometimes is serious. In some cases, pulsatile tinnitus is the only symptom of a condition that is life threatening.  But it is not “always serious.”  For these reasons, pulsatile tinnitus, unlike the "regular" more common form of tinnitus, warrants distinguishable, individualized, prompt and thorough medical attention.

It is important to note that there are idiopathic causes of pulsatile tinnitus that are not able to be determined. Patients should accept this diagnosis only after diagnostic tests and a full medical work-up have been done.

Pulsatile tinnitus is a symptom that few people understand and endure, but it no longer has to be an isolating one.  With the help of doctors, increased awareness, accurate information and support, many of us are finding proper diagnoses, treatments and even cures.
Sat, June 11, 2011 | link          Comments


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RESOURCES

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.