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Pulsatile tinnitus

MedGen UID:
148340
Concept ID:
C0751559
Disease or Syndrome; Sign or Symptom
Synonyms: Pulsatile Tinnitus; Tinnitus, Pulsatile
SNOMED CT: Pulsatile tinnitus (232322006)
 
HPO: HP:0008629

Definition

Pulsatile tinnitus is generally classified a kind of objective tinnitus, meaning that it is not only audible to the patient but also to the examiner on auscultation of the auditory canal and/or of surrounding structures with use of an auscultation tube or stethoscope. Usually, pulsatile tinnitus is heard as a lower pitched thumping or booming, a rougher blowing sound which is coincidental with respiration, or as a clicking, higher pitched rhythmic sensation. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVPulsatile tinnitus

Conditions with this feature

Paragangliomas 3
MedGen UID:
340200
Concept ID:
C1854336
Disease or Syndrome
Hereditary paraganglioma-pheochromocytoma (PGL/PCC) syndromes are characterized by paragangliomas (tumors that arise from neuroendocrine tissues distributed along the paravertebral axis from the base of the skull to the pelvis) and pheochromocytomas (paragangliomas that are confined to the adrenal medulla). Sympathetic paragangliomas cause catecholamine excess; parasympathetic paragangliomas are most often nonsecretory. Extra-adrenal parasympathetic paragangliomas are located predominantly in the skull base and neck (referred to as head and neck PGL [HNPGL]) and sometimes in the upper mediastinum; approximately 95% of such tumors are nonsecretory. In contrast, sympathetic extra-adrenal paragangliomas are generally confined to the lower mediastinum, abdomen, and pelvis, and are typically secretory. Pheochromocytomas, which arise from the adrenal medulla, typically lead to catecholamine excess. Symptoms of PGL/PCC result from either mass effects or catecholamine hypersecretion (e.g., sustained or paroxysmal elevations in blood pressure, headache, episodic profuse sweating, forceful palpitations, pallor, and apprehension or anxiety). The risk for developing metastatic disease is greater for extra-adrenal sympathetic paragangliomas than for pheochromocytomas.
Paragangliomas 4
MedGen UID:
349380
Concept ID:
C1861848
Disease or Syndrome
Hereditary paraganglioma-pheochromocytoma (PGL/PCC) syndromes are characterized by paragangliomas (tumors that arise from neuroendocrine tissues distributed along the paravertebral axis from the base of the skull to the pelvis) and pheochromocytomas (paragangliomas that are confined to the adrenal medulla). Sympathetic paragangliomas cause catecholamine excess; parasympathetic paragangliomas are most often nonsecretory. Extra-adrenal parasympathetic paragangliomas are located predominantly in the skull base and neck (referred to as head and neck PGL [HNPGL]) and sometimes in the upper mediastinum; approximately 95% of such tumors are nonsecretory. In contrast, sympathetic extra-adrenal paragangliomas are generally confined to the lower mediastinum, abdomen, and pelvis, and are typically secretory. Pheochromocytomas, which arise from the adrenal medulla, typically lead to catecholamine excess. Symptoms of PGL/PCC result from either mass effects or catecholamine hypersecretion (e.g., sustained or paroxysmal elevations in blood pressure, headache, episodic profuse sweating, forceful palpitations, pallor, and apprehension or anxiety). The risk for developing metastatic disease is greater for extra-adrenal sympathetic paragangliomas than for pheochromocytomas.
Paragangliomas 2
MedGen UID:
357076
Concept ID:
C1866552
Disease or Syndrome
Hereditary paraganglioma-pheochromocytoma (PGL/PCC) syndromes are characterized by paragangliomas (tumors that arise from neuroendocrine tissues distributed along the paravertebral axis from the base of the skull to the pelvis) and pheochromocytomas (paragangliomas that are confined to the adrenal medulla). Sympathetic paragangliomas cause catecholamine excess; parasympathetic paragangliomas are most often nonsecretory. Extra-adrenal parasympathetic paragangliomas are located predominantly in the skull base and neck (referred to as head and neck PGL [HNPGL]) and sometimes in the upper mediastinum; approximately 95% of such tumors are nonsecretory. In contrast, sympathetic extra-adrenal paragangliomas are generally confined to the lower mediastinum, abdomen, and pelvis, and are typically secretory. Pheochromocytomas, which arise from the adrenal medulla, typically lead to catecholamine excess. Symptoms of PGL/PCC result from either mass effects or catecholamine hypersecretion (e.g., sustained or paroxysmal elevations in blood pressure, headache, episodic profuse sweating, forceful palpitations, pallor, and apprehension or anxiety). The risk for developing metastatic disease is greater for extra-adrenal sympathetic paragangliomas than for pheochromocytomas.
Paragangliomas 1
MedGen UID:
488134
Concept ID:
C3494181
Neoplastic Process
Hereditary paraganglioma-pheochromocytoma (PGL/PCC) syndromes are characterized by paragangliomas (tumors that arise from neuroendocrine tissues distributed along the paravertebral axis from the base of the skull to the pelvis) and pheochromocytomas (paragangliomas that are confined to the adrenal medulla). Sympathetic paragangliomas cause catecholamine excess; parasympathetic paragangliomas are most often nonsecretory. Extra-adrenal parasympathetic paragangliomas are located predominantly in the skull base and neck (referred to as head and neck PGL [HNPGL]) and sometimes in the upper mediastinum; approximately 95% of such tumors are nonsecretory. In contrast, sympathetic extra-adrenal paragangliomas are generally confined to the lower mediastinum, abdomen, and pelvis, and are typically secretory. Pheochromocytomas, which arise from the adrenal medulla, typically lead to catecholamine excess. Symptoms of PGL/PCC result from either mass effects or catecholamine hypersecretion (e.g., sustained or paroxysmal elevations in blood pressure, headache, episodic profuse sweating, forceful palpitations, pallor, and apprehension or anxiety). The risk for developing metastatic disease is greater for extra-adrenal sympathetic paragangliomas than for pheochromocytomas.

Professional guidelines

PubMed

Goyal A, Zarroli K
Medicine (Baltimore) 2023 Oct 20;102(42):e35545. doi: 10.1097/MD.0000000000035545. PMID: 37861536Free PMC Article
Wang MTM, Bhatti MT, Danesh-Meyer HV
J Clin Neurosci 2022 Jan;95:172-179. Epub 2021 Dec 17 doi: 10.1016/j.jocn.2021.11.029. PMID: 34929642
Markey KA, Mollan SP, Jensen RH, Sinclair AJ
Lancet Neurol 2016 Jan;15(1):78-91. Epub 2015 Dec 8 doi: 10.1016/S1474-4422(15)00298-7. PMID: 26700907

Curated

UK NICE Guideline NG155, Tinnitus: assessment and management, 2020

Recent clinical studies

Etiology

Narsinh KH, Hui F, Saloner D, Tu-Chan A, Sharon J, Rauschecker AM, Safoora F, Shah V, Meisel K, Amans MR
JAMA Otolaryngol Head Neck Surg 2022 May 1;148(5):476-483. doi: 10.1001/jamaoto.2021.4470. PMID: 35201283
Wang MTM, Bhatti MT, Danesh-Meyer HV
J Clin Neurosci 2022 Jan;95:172-179. Epub 2021 Dec 17 doi: 10.1016/j.jocn.2021.11.029. PMID: 34929642
van Twist DJL, de Leeuw PW, Kroon AA
Hypertens Res 2018 Sep;41(9):639-648. Epub 2018 Jul 3 doi: 10.1038/s41440-018-0063-z. PMID: 29968847
Serulle Y, Miller TR, Gandhi D
Neuroimaging Clin N Am 2016 May;26(2):247-58. Epub 2016 Feb 28 doi: 10.1016/j.nic.2015.12.003. PMID: 27154607
Wanna GB, Sweeney AD, Haynes DS, Carlson ML
Otolaryngol Clin North Am 2015 Apr;48(2):331-41. doi: 10.1016/j.otc.2014.12.007. PMID: 25769354

Diagnosis

Narsinh KH, Hui F, Saloner D, Tu-Chan A, Sharon J, Rauschecker AM, Safoora F, Shah V, Meisel K, Amans MR
JAMA Otolaryngol Head Neck Surg 2022 May 1;148(5):476-483. doi: 10.1001/jamaoto.2021.4470. PMID: 35201283
Wang MTM, Bhatti MT, Danesh-Meyer HV
J Clin Neurosci 2022 Jan;95:172-179. Epub 2021 Dec 17 doi: 10.1016/j.jocn.2021.11.029. PMID: 34929642
Markey KA, Mollan SP, Jensen RH, Sinclair AJ
Lancet Neurol 2016 Jan;15(1):78-91. Epub 2015 Dec 8 doi: 10.1016/S1474-4422(15)00298-7. PMID: 26700907
Sismanis A
Otolaryngol Clin North Am 2003 Apr;36(2):389-402, viii. doi: 10.1016/s0030-6665(02)00169-x. PMID: 12856306
Corr P, Tsheole-Marishane L
Br J Radiol 2001 Jul;74(883):669-70. doi: 10.1259/bjr.74.883.740669. PMID: 11509407

Therapy

Wang MTM, Bhatti MT, Danesh-Meyer HV
J Clin Neurosci 2022 Jan;95:172-179. Epub 2021 Dec 17 doi: 10.1016/j.jocn.2021.11.029. PMID: 34929642
Tan MG, Worley B, Kim WB, Ten Hove M, Beecker J
Am J Clin Dermatol 2020 Apr;21(2):163-172. doi: 10.1007/s40257-019-00485-z. PMID: 31741184
van Twist DJL, de Leeuw PW, Kroon AA
Hypertens Res 2018 Sep;41(9):639-648. Epub 2018 Jul 3 doi: 10.1038/s41440-018-0063-z. PMID: 29968847
Markey KA, Mollan SP, Jensen RH, Sinclair AJ
Lancet Neurol 2016 Jan;15(1):78-91. Epub 2015 Dec 8 doi: 10.1016/S1474-4422(15)00298-7. PMID: 26700907
Kreuzer PM, Landgrebe M, Vielsmeier V, Kleinjung T, De Ridder D, Langguth B
J Head Trauma Rehabil 2014 Sep-Oct;29(5):432-42. doi: 10.1097/HTR.0b013e31829d3129. PMID: 23982788

Prognosis

Expert Panel on Neurological Imaging, Jain V, Policeni B, Juliano AF, Adunka O, Agarwal M, Dubey P, Friedman ER, Gule-Monroe MK, Hagiwara M, Hunt CH, Lo BM, Oh ES, Rath TJ, Roberts JK, Schultz D, Taheri MR, Zander D, Burns J
J Am Coll Radiol 2023 Nov;20(11S):S574-S591. doi: 10.1016/j.jacr.2023.08.017. PMID: 38040471
Hitier M, Zhang M, Labrousse M, Barbier C, Patron V, Moreau S
Surg Radiol Anat 2013 Dec;35(10):883-91. Epub 2013 May 3 doi: 10.1007/s00276-013-1127-z. PMID: 23640742
Rudnick E, Sismanis A
Otol Neurotol 2005 Mar;26(2):166-8. doi: 10.1097/00129492-200503000-00006. PMID: 15793399
Guillon B, Lévy C, Bousser MG
J Neurol Sci 1998 Jan 8;153(2):146-58. doi: 10.1016/s0022-510x(97)00287-6. PMID: 9511874
Harris S, Brismar J, Cronqvist S
Acta Otolaryngol 1979;88(3-4):220-6. doi: 10.3109/00016487909137163. PMID: 227223

Clinical prediction guides

Williams AP, Gourishetti SC, Flaherty MA, Eisenman DJ
Laryngoscope 2023 Mar;133(3):683-688. Epub 2022 Jun 2 doi: 10.1002/lary.30238. PMID: 35655445
Narsinh KH, Hui F, Saloner D, Tu-Chan A, Sharon J, Rauschecker AM, Safoora F, Shah V, Meisel K, Amans MR
JAMA Otolaryngol Head Neck Surg 2022 May 1;148(5):476-483. doi: 10.1001/jamaoto.2021.4470. PMID: 35201283
Robbins JO, Chhaya N, Schaefer JL
R I Med J (2013) 2021 Nov 1;104(9):70-72. PMID: 34705914
Wanna GB, Sweeney AD, Haynes DS, Carlson ML
Otolaryngol Clin North Am 2015 Apr;48(2):331-41. doi: 10.1016/j.otc.2014.12.007. PMID: 25769354
Harris S, Brismar J, Cronqvist S
Acta Otolaryngol 1979;88(3-4):220-6. doi: 10.3109/00016487909137163. PMID: 227223

Recent systematic reviews

Schartz D, Finkelstein A, Akkipeddi SMK, Williams Z, Vates E, Bender MT
World Neurosurg 2024 Oct;190:e992-e999. Epub 2024 Aug 12 doi: 10.1016/j.wneu.2024.08.048. PMID: 39142383
Yuhan BT, Trang A, Hutz MJ, Leonetti JP
Otolaryngol Head Neck Surg 2020 Apr;162(4):458-468. Epub 2020 Feb 25 doi: 10.1177/0194599820907303. PMID: 32093508
Tan MG, Worley B, Kim WB, Ten Hove M, Beecker J
Am J Clin Dermatol 2020 Apr;21(2):163-172. doi: 10.1007/s40257-019-00485-z. PMID: 31741184
Liu GS, Boursiquot BC, Blevins NH, Vaisbuch Y
Otolaryngol Head Neck Surg 2019 May;160(5):749-761. Epub 2019 Jan 22 doi: 10.1177/0194599818823205. PMID: 30667295
Wang AC, Nelson AN, Pino C, Svider PF, Hong RS, Chan E
Otol Neurotol 2017 Dec;38(10):1390-1396. doi: 10.1097/MAO.0000000000001612. PMID: 29135862

Supplemental Content

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    Clinical resources

    Practice guidelines

    • PubMed
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    • Bookshelf
      See practice and clinical guidelines in NCBI Bookshelf. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Curated

    • NICE, 2020
      UK NICE Guideline NG155, Tinnitus: assessment and management, 2020

    Consumer resources

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