Herraiz Carlos, Aparicio José Miguel
Unidad de Acúfenos, Instituto ORL Antolí-Candela, Madrid, España.
Acta Otorrinolaringol Esp. 2007 Nov;58(9):426-33.
Pulsatile tinnitus is a sound from within the body, mostly of vascular origin, that stimulates the patient's hearing in the same way as an external sound does, generally at the same pace as the pulse. Although not frequent, the diagnosis of its cause is crucial because of its potential severity in some cases. This article describes some of the diagnostic clues for arterial causes (arteriosclerosis, aberrant carotid artery, arteriovenous fistula or malformations, increased vascularization in Paget's disease) and venous causes (benign intracranial hypertension, high jugular bulb). In some cases we have to rule out other systemic diseases as hypertension, cardiac arrhythmia or hyperthyroidism. A pathological otoscopy result may be secondary to a tympanic glomus. A guided medical history and an algorithm for complementary tests (magnetic resonance or angio-resonance imaging, computerized tomography, blood test, Doppler ultrasonography) may resolve the diagnostic puzzle of pulsatile tinnitus. We present our experience in 80 cases. The most frequent aetiology has been the arteriosclerosis of the carotid artery (17.5 %) and the benign intracranial hypertension syndrome (10 %).
搏动性耳鸣是一种源于身体内部的声音，大多起源于血管，它刺激患者听觉的方式与外部声音相同，通常与脉搏同步。尽管并不常见，但因其在某些情况下可能具有的严重性，对其病因进行诊断至关重要。本文介绍了一些动脉性病因（动脉硬化、颈动脉异常、动静脉瘘或畸形、佩吉特病中血管增生）和静脉性病因（良性颅内高压、高位颈静脉球）的诊断线索。在某些情况下，我们必须排除其他全身性疾病，如高血压、心律失常或甲状腺功能亢进。病理性耳镜检查结果可能继发于鼓室球瘤。详细的病史询问和一套辅助检查算法（磁共振或血管磁共振成像、计算机断层扫描、血液检查、多普勒超声检查）可能会解开搏动性耳鸣的诊断难题。我们展示了我们在80例病例中的经验。最常见的病因是颈动脉动脉硬化（17.5%）和良性颅内高压综合征（10%）。
