Neila L Kline1, Kristen Angster1, Erica Archer2, Prashant Raghavan3, Robert E Morales3, Michaela K Mathews2, David J Eisenman4. 1. Department of Otorhinolaryngology-Head & Neck Surgery, University of Maryland School of Medicine, Frenkil Building, 16 S. Eutaw St. Suite 500, Baltimore, MD 21201, United States of America. 2. Department of Ophthalmology, University of Maryland School of Medicine, 419 West Redwood St. Suite 420, Baltimore, MD 21201, United States of America. 3. Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 22 S Greene St, Baltimore, MD 21201, United States of America. 4. Department of Otorhinolaryngology-Head & Neck Surgery, University of Maryland School of Medicine, Frenkil Building, 16 S. Eutaw St. Suite 500, Baltimore, MD 21201, United States of America. Electronic address: deisenman@som.umaryland.edu.
Abstract
PURPOSE: Pulse synchronous tinnitus (PT) is common in patients with idiopathic intracranial hypertension (IIH) and in those with sigmoid sinus wall abnormalities (SSWAs). Although patients with SSWAs and IIH share many clinical features, the incidence of SSWAs in patients with IIH and its relationship to PT in this cohort is less well established. The purpose of this study is to assess the incidence of SSWAs in patients with IIH and PT, and to determine if there is an association between SSWAs and PT in this population. MATERIALS AND METHODS: Prospective computed tomography (CT) study of adults with IIH. Subjective PT was correlated with presence or absence of SSWAs on CT. RESULTS: 22 subjects were enrolled and 14 subsequently underwent CT. The incidence of SSWAs was significantly higher in subjects with PT than without (70% vs. 0%, p = 0.02). Mean age, BMI and opening pressures did not differ between those with and without SSWAs or PT. CONCLUSIONS: There is a high incidence of SSWAs in subjects with IIH and PT. These findings support an association between SSWAs and PT, and implicate SSWAs as a possible cause of, or contributing factor to, PT in patients with IIH. Patients with IIH and PT that does not resolve with reducing intracranial pressure should undergo diagnostic CT and consider treatment of a SSWA if present.
PURPOSE: Pulse synchronous tinnitus (PT) is common in patients with idiopathic intracranial hypertension (IIH) and in those with sigmoid sinus wall abnormalities (SSWAs). Although patients with SSWAs and IIH share many clinical features, the incidence of SSWAs in patients with IIH and its relationship to PT in this cohort is less well established. The purpose of this study is to assess the incidence of SSWAs in patients with IIH and PT, and to determine if there is an association between SSWAs and PT in this population. MATERIALS AND METHODS: Prospective computed tomography (CT) study of adults with IIH. Subjective PT was correlated with presence or absence of SSWAs on CT. RESULTS: 22 subjects were enrolled and 14 subsequently underwent CT. The incidence of SSWAs was significantly higher in subjects with PT than without (70% vs. 0%, p = 0.02). Mean age, BMI and opening pressures did not differ between those with and without SSWAs or PT. CONCLUSIONS: There is a high incidence of SSWAs in subjects with IIH and PT. These findings support an association between SSWAs and PT, and implicate SSWAs as a possible cause of, or contributing factor to, PT in patients with IIH. Patients with IIH and PT that does not resolve with reducing intracranial pressure should undergo diagnostic CT and consider treatment of a SSWA if present.