Tortuous Carotid Artery Causing Pulsatile Tinnitus and Hyperacusis

[Joan W.]

Oct-2016 I had a sudden total hearing loss in my left ear. Prednisone treatment restored my hearing, much to the surprise of several ENT doctors. But ever since, I have suffered with ringing in both ears and whooshing in my left ear. With stress and physical exertion, it is worse.

After having an MRA/MRV in January, they found significant tortuosity in my left internal carotid artery at the skull base. On March 1, I had an angiogram which ruled out a suspected AVF (arteriovenous fistula), but found a 360° loop in my carotid artery near my left ear, and a small kink under that.

Today I consulted with a vascular surgeon and was refused surgery because it would involve actually cutting my jawbone to access it. I had a cervical fusion from C2 to T3 which prohibits my neck from bending enough for the surgeon to access the loop from my neck.

I am now without options and am looking for suggestions from anyone who has a similar condition. The noise is maddening and is present 24/7. I am feeling hopeless and the anxiety just compounds the noise.

I'd appreciate anyone's input at this point. Thank you.

 

[Tinniger]

My recommendation is to show your angiograms to a vascular radiologist for a second opinion.

 

[glynis]

Has your doctor or ENT mentioned a hearing aid or a small beta blocker to try....love glynis

 

[Frédéric]

Hypotympanic Sound Baffle for Amelioration of Pulsatile Tinnitus due to Carotid and Jugular Bulb Dehiscence

Liu, George S.; Blevins, Nikolas H.; Vaisbuch, Yona

Otology & Neurotology: August 2019 - Volume 40 - Issue 7 - p 920–926
doi: 10.1097/MAO.0000000000002293
MIDDLE EAR AND MASTOID DISEASE
BUY

• Abstract
• Author Information
• Article Metrics

Objective: To share our experience with treating pulsatile tinnitus by insulating a dehiscent carotid artery with a hypotympanic sound baffle, and compare outcomes with a similar resurfacing approach for jugular bulb wall anomalies.

Study Design: Retrospective case series.

Setting: Tertiary academic medical center.

Patients: Adult patients with troublesome pulsatile tinnitus with radiologic evidence of carotid artery dehiscence or jugular bulb wall anomaly within the temporal bone.

Intervention: Hypotympanic exposure of vessel followed by resurfacing using hydroxyapatite cement (carotid dehiscence) or autologous tissue (jugular bulb wall anomalies).

Main Outcomes Measures: Alleviation or reduction of pulsatile tinnitus.

Results: Two patients presented with unilateral, debilitating pulsatile tinnitus and history and imaging consistent with carotid dehiscence and underwent hypotympanic resurfacing with hydroxyapatite cement. Both had considerable initial improvement of tinnitus, and 40% resolution of tinnitus with improved quality of life at an average follow-up of 13.5 months. Two patients with jugular bulb dehiscence/diverticulum treated by resurfacinghad complete elimination of symptoms at an average follow up of 17.3 months. There were no major adverse outcomes (permanent hearing loss, vascular injury, or intracranial hypertension).

Conclusion: Creation of a hypotympanic sound baffle offers promise as a means of reducing pulsatile tinnitusemanating from a dehiscent carotid artery transmitted to the tympanum, with substantial improvement in reported functional ability. Treatment of venous etiologies of pulsatile tinnitus with similar techniques demonstrates higher success rates, which may be attributable to incomplete resurfacing of carotid artery dehiscence along its extent towards the petrous apex due to safety concerns.

https://journals.lww.com/otology-ne...anic_Sound_Baffle_for_Amelioration_of.15.aspx

 

[Frédéric]

Successful percutaneous treatment of pulsatile tinnitus, a rare symptom of carotid artery stenosis

 

[tiniturtle]

I see you're in MA, who did you go to?

 

[Stillsearching]

I see you're in MA, who did you go to?

Are you also in mass? I'm currently working with Dr. Abdalkader at Boston medical. Brilliant doctor.