title: The relationship between tinnitus and vascular anomalies on temporal bone CT scan: a retrospective case control study.
abstract: BACKGROUND
  Tinnitus is a common symptom in which etiology is unclear in a group of patients. Some of anatomic or vascular variations diagnosed on temporal bone computed tomography (CT) has been known to cause tinnitus particulary pulsatile form. Therefore significance of these anatomic variations has not been validated in patients with nonpulsatile tinnitus. The aim of this study is to ascertain several anatomic variations previously attributed to pulsatile tinnitus in nonpulsatile tinnitus patients. And secondly to assess the relationship between the amount of sigmoid sinus bulging and mastoid emissary vein (MEV), enlargement of those was not evaluated before in tinnitus patients.
  
  
  METHODS
  Retrospectively, temporal bone CT scans of 70 patients with an existing complaint of tinnitus with unexplained etiology were enrolled. As a control group, 70 patients were selected from paranasal sinus CT scans without any otological or clinical findings.
  
  
  RESULTS
  The type of tinnitus was subjective and nonpulsatile in the overall group. The diameters of enlarged MEV on the left side were significantly higher in the tinnitus group. Carotid canal dehiscence and high riding jugular bulb were significantly higher in the tinnitus patients. Petrous bone pneumatization was significantly lower in the tinnitus patients than in the control group.
  
  
  CONCLUSIONS
  In patients who complained of subjective nonpulsatile tinnitus with unknown etiology, some temporal bone vascular variations, including high riding jugular bulb, dehiscent carotid canal, left-sided MEV enlargement, and petrous bone pneumatization, seemed to have an association with tinnitus. Further studies comparing all these entities between pulsatile and nonpulsatile groups and healthy controls should be undertaken.
authors.affiliation: School of Medicine, Sutcuimam University, Kahramanmaras, Turkey. dr.betulkizildag@hotmail.com.
authors.forename: Betul
authors.identifier: http://orcid.org/0000-0002-2567-4330
authors.initials: B
authors.lastname: Kizildag
authors.affiliation: School of Medicine, Sutcuimam University, Kahramanmaras, Turkey.
authors.forename: Nagihan
authors.initials: N
authors.lastname: Bilal
authors.affiliation: School of Medicine, Sutcuimam University, Kahramanmaras, Turkey.
authors.forename: Nursel
authors.initials: N
authors.lastname: Yurttutan
authors.affiliation: School of Medicine, Sutcuimam University, Kahramanmaras, Turkey.
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Sarica
authors.affiliation: School of Medicine, Sutcuimam University, Kahramanmaras, Turkey.
authors.forename: Gulay
authors.initials: G
authors.lastname: Gungor
authors.affiliation: School of Medicine, Sutcuimam University, Kahramanmaras, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Baykara
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013701:Temporal Bone / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D014012:Tinnitus / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D054079:Vascular Malformations / Q000150:complications; D055815:Young Adult
keywords: Bulging sigmoid sinus; Mastoid emissary vein; Temporal bone computed tomography; Tinnitus
references.citation: Radiology. 1990 Feb;174(2):383-9
references.pmid: 2296650
references.citation: Clin Radiol. 2009 Mar;64(3):319-28
references.pmid: 19185662
references.citation: Lancet. 2013 Nov 9;382(9904):1600-7
references.pmid: 23827090
references.citation: Clin Imaging. 2007 Mar-Apr;31(2):102-8
references.pmid: 17320776
references.citation: Radiographics. 1985 Nov;5(6):985-93
references.pmid: 3880011
references.citation: Surg Radiol Anat. 2011 Nov;33(9):827-31
references.pmid: 21603953
references.citation: AJNR Am J Neuroradiol. 1994 May;15(5):879-89
references.pmid: 8059655
references.citation: Neuroradiology. 2015 Jul;57(7):747-53
references.pmid: 25845808
references.citation: Int J Audiol. 2011 May;50(5):313-20
references.pmid: 21309642
references.citation: Int J Pediatr Otorhinolaryngol. 2000 Apr 15;52(2):163-7
references.pmid: 10767464
references.citation: AJNR Am J Neuroradiol. 2006 Sep;27(8):1635-8
references.pmid: 16971601
references.citation: J Otolaryngol. 1989 Aug;18(5):232-5
references.pmid: 2769838
references.citation: Otolaryngol Head Neck Surg. 2014 May;150(5):841-6
references.pmid: 24468899
references.citation: Otol Neurotol. 2014 Jan;35(1):16-21
references.pmid: 24005164
references.citation: Am J Otol. 1986 May;7(3):204-7
references.pmid: 3717312
references.citation: Otol Neurotol. 2011 Sep;32(7):1116-9
references.pmid: 21799456
references.citation: J Craniofac Surg. 2013 Mar;24(2):461-3
references.pmid: 23524715
references.citation: J Korean Med Sci. 2013 Apr;28(4):628-30
references.pmid: 23580003
references.citation: Laryngoscope. 2004 Apr;114(4):656-60
references.pmid: 15064619
references.citation: Neurosurgery. 2009 Feb;64(2):E393-4; discussion E394
references.pmid: 19190447
references.citation: AJR Am J Roentgenol. 1985 Sep;145(3):473-81
references.pmid: 3875250
references.citation: Eur Radiol. 2016 Jan;26(1):9-14
references.pmid: 25991486
references.citation: Diagn Interv Radiol. 2014 Jan-Feb;20(1):78-81
references.pmid: 24047723