Just in the last week, a team of doctors in China reported on a combination of causes of pulsatile tinnitus, a combination
they say has not before been reported: Aberrant Internal Carotid Artery and Dehiscent High Jugular Bulb.
There is not much information provided in the abstract, but our doctors may be able to find the full report.
The patient, a 24-year-old man, experienced pulsatile tinnitus, a feeling of pressure or fullness in the ear, and mild hearing
loss on the side of the whooshing (his right). The cause was detected via a CT scan of the temporal bone and an MRA.
The abstract falls short of telling us whether the patient was "whoosh-free" after treatment; it reports
only that the patient was treated with a "conservative" treatment. The abstract also suggests that for a patient
with both aberrant internal carotid artery and dehiscent high jugular bulb there is an increased risk of serious bleeding
when fixing the underlying problems, which is why these doctors used a "conservative" approach to treat this particular
patient.
I found the limited information in this abstract interesting for a couple of reasons:
1) The
cause was identified with the use of a CT scan and MRA, two relatively non-invasive diagnostic tests.
2) It approaches
a possible connection between underlying causes of pulsatile tinnitus, and terms that we've seen reported separately in cases
of pulsatile tinnitus. We've heard of high jugular bulb being discussed in our cases before, as well as dehiscence (it looks like there can be different kinds of dehiscence).
I also find it interesting that this patient's
main symptoms were whooshing, fullness in the ear and mild hearing loss, yet the cause was obviously a serious one that required
quick medical attention. Often, as many of us have experienced, these symptoms are dismissed prior to any diagnostic
tests as sinus problems and we're given decongestants. This report suggests that even relatively mild symptoms like
these may indicate very serious medical issues. Pulsatile tinnitus was an important indicator in this case.
Which
is yet another reason why we need a pulsatile tinnitus diagnosis code! Please sign the petition if you haven't already.
Curious what an aberrant internal carotid artery looks like? Check out this link with pictures! If you click on "Quiz" and then "Answer," you'll see some images.
There are more images here.
Review this and other "cured whoosher" stories about causes of pulsatile tinnitus on our Cured Whooshers page with your doctors.
Sources:
"Aberrant internal carotid artery in the middle ear with dehiscent high jugular bulb," Lin
YY, Wang CH, Liu SC, Chen HC., Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital,
National Defense Medical Center, Taipei, Taiwan, Republic of China, J Laryngol Otol.,126(6):645-7, June 2012.