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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
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.
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

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
Ward BK, van de Berg R, van Rompaey V, Bisdorff A, Hullar TE, Welgampola MS, Carey JP
J Vestib Res 2021;31(3):131-141. doi: 10.3233/VES-200004. PMID: 33522990Free PMC Article
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
Settecase F, Rayz VL
Handb Clin Neurol 2021;176:81-105. doi: 10.1016/B978-0-444-64034-5.00016-X. PMID: 33272412
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
Willinsky RA
Can Assoc Radiol J 1992 Apr;43(2):93-9. PMID: 1562895

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
Chari DA, Limb CJ
Med Clin North Am 2018 Nov;102(6):1081-1093. doi: 10.1016/j.mcna.2018.06.014. PMID: 30342610
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

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
Zhou D, Ding JY, Ya JY, Pan LQ, Yan F, Yang Q, Ding YC, Ji XM, Meng R
CNS Neurosci Ther 2018 Jun;24(6):473-482. Epub 2018 Apr 23 doi: 10.1111/cns.12859. PMID: 29687619Free PMC Article
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
Kumar R, Rice S, Lingam RK
Eur J Radiol 2021 Jun;139:109722. Epub 2021 Apr 14 doi: 10.1016/j.ejrad.2021.109722. PMID: 33894642
Eisenman DJ, Raghavan P, Hertzano R, Morales R
Laryngoscope 2018 Oct;128 Suppl 2:S1-S13. Epub 2018 May 14 doi: 10.1002/lary.27218. PMID: 29756346
Elhammady MS, Ambekar S, Heros RC
Handb Clin Neurol 2017;143:99-105. doi: 10.1016/B978-0-444-63640-9.00009-6. PMID: 28552162
Ozge A, Bolay H
Curr Pain Headache Rep 2014 Jul;18(7):430. doi: 10.1007/s11916-014-0430-7. PMID: 24880802

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
Hsieh YL, Wu Y, Wang H, Xu X, Guo P, Wang X, Hsieh YD, Lu H, Wang W
ORL J Otorhinolaryngol Relat Spec 2022;84(3):219-228. Epub 2021 Jul 26 doi: 10.1159/000517610. PMID: 34311465
Eisenman DJ, Raghavan P, Hertzano R, Morales R
Laryngoscope 2018 Oct;128 Suppl 2:S1-S13. Epub 2018 May 14 doi: 10.1002/lary.27218. PMID: 29756346
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

Recent systematic reviews

Sun WYL, Switzer NJ, Dang JT, Gill R, Shi X, de Gara C, Birch D, Nataraj A, Karmali S
Can J Surg 2020 Mar 20;63(2):E123-E128. doi: 10.1503/cjs.016616. PMID: 32195557Free PMC Article
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
Chadha NK, Weiner GM
Clin Otolaryngol 2008 Feb;33(1):5-11. doi: 10.1111/j.1749-4486.2007.01597.x. PMID: 18302544

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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