Pacheco-López Sofía, Martínez-Barbero Jose Pablo, Busquier-Hernández Heriberto, García-Valdecasas-Bernal Juan, Espinosa-Sánchez Juan Manuel
Division of Otology, Audiology and Lateral Skull Base Surgery, Department of Otolaryngology, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain.
Division of Neuroradiology, Department of Radiology, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain.
J Clin Med. 2025 Jun 22;14(13):4428. doi: 10.3390/jcm14134428.
Pulsatile tinnitus (PT) is a subtype of tinnitus characterized by a perception of heartbeat-synchronous sound. It represents approximately 5-10% of all tinnitus cases and may have either a vascular or non-vascular etiology. Accurate diagnosis is crucial due to the potentially serious implications this condition can entail. Assessment through anamnesis and physical examination may often suggest a diagnosis of PT, but it is rarely definitive. Therefore, a comprehensive and specific imaging diagnostic protocol is essential when evaluating PT. A lack of consensus has been identified regarding the use of a standardized protocol for both pulsatile and non-pulsatile tinnitus, whether unilateral or bilateral. Consequently, neuroradiologists, otologists, and otoneurologists from a tertiary hospital have developed a new imaging diagnostic protocol for PT. The aim of this article is to present an updated approach to the diagnostic and therapeutic management of PT, aiming to establish a protocol that serves as a guide for clinicians assessing this symptom. In patients with bilateral PT, systemic conditions leading to increased cardiac output should generally be ruled out; in unilateral cases, focused imaging studies should be performed to exclude organic etiologies at the cervical and cranial levels.
搏动性耳鸣（PT）是耳鸣的一种亚型，其特征为感知到与心跳同步的声音。它约占所有耳鸣病例的5-10%，可能有血管性或非血管性病因。由于这种情况可能带来的潜在严重影响，准确诊断至关重要。通过问诊和体格检查进行评估往往可提示PT的诊断，但很少能确诊。因此，在评估PT时，全面且特定的影像学诊断方案必不可少。对于搏动性和非搏动性耳鸣，无论单侧还是双侧，在使用标准化方案方面尚未达成共识。因此，一家三级医院的神经放射科医生、耳科医生和耳神经科医生制定了一种新的PT影像学诊断方案。本文的目的是介绍一种更新的PT诊断和治疗管理方法，旨在建立一个可为评估该症状的临床医生提供指导的方案。对于双侧PT患者，一般应排除导致心输出量增加的全身性疾病；对于单侧病例，应进行针对性的影像学检查以排除颈椎和颅脑水平的器质性病因。
