Author(s)
Kavita Bhatnagar, BA
David Eisenman, MD
Affiliation(s)
University of Maryland School of Medicine;
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to demonstrate an understanding of the patterns of hearing loss caused by pulsatile tinnitus due to sigmoid sinus wall anomalies.
Objectives: To determine the contribution of pulsatile tinnitus (PT) to hearing loss (HL) among subjects with sigmoid sinus wall anomalies (SSWA).
Study Design: Retrospective chart review.
Methods: 39 patients with SSWAs and preoperative audiograms were examined. Audiometric data were compared between affected and unaffected ears, as well as between those with sigmoid sinus diverticulum and dehiscence. The change in hearing due to PT was calculated by subtracting hearing thresholds on the unaffected side from affected. Additionally, postoperative change was examined in 6 patients.
Results: 21/39 subjects had ipsilateral HL (53.8%). Most had slight-mild (81%) sensorineural (85.7%) HL, with 47.6% in the low and low-mid frequencies. The mean pure tone average was 19 and word recognition score was 96%. Of the 21, 15 (71.4%) had HL on the unaffected side (p<0.01), significantly fewer with low frequency HL (p<0.01). Of those with ipsilateral hearing loss, 14 (66.7%) had a 10-30dB increase in hearing thresholds attributable to PT, the majority of which were in the low and low-mid frequencies. There were no significant preoperative differences between those with sigmoid sinus diverticulum and dehiscence. Postoperatively, 4/6 subjects had improvement or complete resolution of their HL.
Conclusions: PT due to SSWAs may cause up to 10-30dB of low frequency sensorineural hearing loss in the affected ear. For patients with hearing loss of greater magnitude, other potential causes should be considered.