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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 a rhythmical noise that is synchronous with the patient's heartbeat.

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Dear Whooshers: Happy Halloween!

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To read more on Edgar Allan Poe and my spooky theory that he may have been a Whoosher, click here!

Sat, October 25, 2014 | link          Comments

Another Cured Whoosher: Transverse Sinus Stenosis and Enlarged Arachnoid Granulation

Nothing makes me happier than to receive a personal story from another cured whoosher! I received this one recently from a woman whom I will call "Jill."  Her story is yet another example that many pulsatile tinnitus patients face obstacles to proper evaluation and treatment.  The writer is also very honest about the terrible - even suicidal - feelings that some of us experience as a result of this rare symptom.  On the brightest note, Jill shares an example of how persistence really can pay off.  Jill, good for you for being your best advocate!  Your story will be posted along with many others on our Cured Whooshers page.  Thank you for sharing your experience, take care of yourself during this recovery, and ENJOY the SILENCE!

For years, I’ve had this noise in my head. Loud. Whooshing. I heard a lot of doctors say, “Mm-hmm,” when I told them I heard a whooshing in my ear. I was told I was anxious, depressed, and given Trazadone so I could sleep, told to see a therapist (which I did), etc.

I don't remember a time when I couldn't hear the whooshing, but in the last several years, it became unbearably loud or I became less able to withstand the relentlessness of it. The neurosurgeon doesn't think that I was born with it. I'm not sure. It took a long time (years) for me to believe myself - that this was a real problem that was causing me suffering. I'd say that overall, the most severe whooshing lasted for the last three years, but that's also when I began seeking a solution so I think that my resistance and strength were waning.

I told my husband that it sounded like a whooshing so he searched for that and found Whooshers.com. Knowing about the Whooshers.com site helped so much in my long search for a resolution.
 
The whooshing drove me to tears sometimes. And, it drove me to have what I would call suicidal thoughts. It was deeply painful and because I'm a mother and a teacher, I hesitate to write about this because of the effects that this knowledge could have on my daughter (now grown) and on the children I teach. I do think that the truth is healing and so, in writing about these thoughts, I hope that truth helps someone else. My whooshing was on the right side and was a 24/7/365 thing. Very loud. I teach kids so during the day, when I was busy or the kids were noisy, I was ok. I spent a lot of time at noisy places - restaurants, cafes, roaring rivers, you name it - wherever I could sit and focus on my work or have some relief. I could hear it in loud restaurants, but it was more bearable.
 
Once, during an evening crying jag, I asked my husband if he could hear it. He put his ear to my ear and he could hear it!
 
Objective Whooshing [Pulsatile] Tinnitus. I used these words when I talked to doctors and nurses and I didn’t let them talk me out of it. I told every health care professional to put their ear to mine, but they wouldn’t. They used stethoscopes. Most could not hear it using a stethoscope.
 
I talked to Dr. Halbach at UCSF in California who has had a great deal of success dealing with certain causes of whooshing. He talked me through some evaluative “tests” – does the whooshing ever stop? Does it stop when you push on your neck? Can you still hear it when you push on the vein behind your ear? He knew Dr. Warren at Oregon Health and Science University. I jumped the insurance hoops and got an exam with him. My goal at that exam was to get Dr. Warren to hear the whooshing. An intern came in first. The intern couldn’t hear it. A doctor walked into the room and I told him about my goal. He put his stethoscope to my ear and pushed his chair back in awe of it. He heard it. He called other doctors in so they could hear it, too.

The ENT ordered CT and MRI scans. The MRI showed narrowing of the vein on my right side, but the cause was inconclusive so he refereed me to the neuroradiologist, Dr. Gary Nesbit. The angiogram didn’t show anything new (or terrible – like aneurysm, etc.), but it confirmed that the original MRI picture held the most likely answer to the whooshing: arachnoid granulation extended on the right side against the transverse sinus. The neurosurgeon wouldn't go in without doing the angiogram because the MRI wasn't conclusive enough. It showed the narrowing, but it wasn't clear why there was narrowing. He wanted to rule out aneurism, fistula, etc.

I was elated to have a diagnosis and a solution. At first, I was worried about having an angiogram. My understanding was it was a risky procedure, but so was living with the whooshing due to the extreme stress of it and the horrible effect it had on my sleep. I hadn't slept well in years. Trazadone helped, but it wasn't a great solution. It was all worth the risk, but it was scary, too. I had the support of my husband and daughter. They pushed me through some of these procedures when I was ready to give up. Whooshing, lack of sleep, the relentlessness of it all wore me down in ways that are difficult to explain to someone unless they have experienced this or something else that is chronic.

The angiogram was not fun at all. It was harder than the MRI (for the MRI, ask for a mirror if you're claustrophobic and ask for music!). The angiogram is more invasive and strange things happen to the brain. You're awake for the procedure, and the doctor [usually] goes into your artery through your hip. For me it was really unpleasant, but I was on drugs that calmed me a bit. There were times when I saw lightning flashes and lots of color combinations and it was a lot like a Pink Floyd laser light show I once went to, and once, my brain felt like it was on fire. I looked at it as a psychedelic experience - one that I could have had if I'd ever done really hard drugs. But, again, it was worth it. It also had to be done. It wasn't a choice if I wanted to find a solution.

In the end, The amazing and wonderful staff at the Oregon Health and Sciences University performed an endovascular stenting and angioplasty of the right transverse sinus. I showed up at 5:30 a.m. and had my in-patient procedure. When I woke up, someone asked me how I was. I just smiled and kept smiling. I couldn't stop smiling, in fact. The sound was gone. I had silence. When my husband came into the ICU, I had him listen and he couldn't hear the whooshing. He cried happy tears along with me. I recovered in the ICU at OHSU and the people there were fantastic. I was released the next day after I slept (not perfectly because sleeping in the ICU isn't easy, but I slept better than I had in years).

There were surgeons on the team who didn’t understand why we were doing all of this – it’s only noise after all, they said. They are the ones who need to hear the whooshing. If we can get doctors to listen with their ears rather than stethoscopes, they will hear it. Until that happens, let them know that some doctors can hear it and some can’t. Make it a competition! Doctors thrive on that. Make doctors hear your whooshing if at all possible.

I have no more whooshing. I’m so happy and relieved. I don't like taking the blood thinners - Plavix and aspirin, but I will have to take the Plavix for six months. Blood thinners are very important for this phase of my recovery, I am told. I don't like the bruising and the difficulty of healing from small cuts, but it's all a very small price to pay for such a great reward. The puncture site at my hip took a little bit of healing, but it has completely healed - it's been 3 weeks now. I have had tiny headaches from time to time and I never suffered from them before. Again, small price to pay for such glorious silence. I’m really looking forward to decades (hopefully) of life as a cured whoosher. I sleep!

I wish all good things for other whooshers. Don’t give up.

Sat, October 4, 2014 | link          Comments


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RESOURCES

NEW: Click Here to Download the PDF, "Top Ten Pulsatile Tinnitus Tips for Doctors." Review it with your GPs and ENTs!

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 "Physician Locator"

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

Blog: Tales From Clark Street

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: "Emma's Story," A Personal Account of Pulsatile Tinnitus, The British Tinnitus Association (BTA).

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.

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

Audio: FREE White Noise from White Noise MP3s.com

Audio: SimplyNoise.com

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

Click Here for the International Association for Suicide Prevention (IASP)

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