title: Objectification and Differential Diagnosis of Vascular Pulsatile Tinnitus by Transcanal Sound Recording and Spectrotemporal Analysis: A Preliminary Study.
abstract: Although frequently classified as "objective tinnitus," in most cases vascular pulsatile tinnitus (VPT) is not equal to objective tinnitus because it is not easy to objectively document VPT. The present study was conducted to develop a novel transcanal sound recording and spectrotemporal analysis method for the objective and differential diagnosis of VPT.
  
  
  
  A case series with a control group.
  
  
  
  Tertiary referral center.
  
  
  
  Six VPT subjects with radiological abnormalities and six normal controls.
  
  
  
  The method was tested based on recordings obtained from the ipsilateral external auditory canal (EAC) using an insert microphone with the subject's head in four different positions. The recorded signals were first analyzed in the time domain, and short-time Fourier transform was performed to analyze the data in the time-frequency domain.
  
  
  
  From the temporal analysis, the ear canal signals recorded from the VPT subjects exhibited large peak amplitudes and periodic structures, whereas the signals recorded from the control subjects had smaller peak amplitudes and weaker periodicity. From the STA represented by two-dimensional spectrograms and three-dimensional waterfall diagrams, all of the VPT subjects demonstrated pulse-synchronous acoustic characteristics that were representative of their respective presumptive vascular pathologies, whereas the control subjects did not display such characteristics.
  
  
  
  The present diagnostic approach may provide additional information regarding the origins of VPT cases as well as an efficient and objective diagnostic method. Furthermore, this approach may aid in the determination of appropriate imaging modalities, treatment planning, and evaluation of treatment outcomes.
authors.affiliation: *Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea†Music and Audio Research Group, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea‡Department of Communication Sciences and Disorders, University of Iowa, Iowa City, Iowa, U.S.A.§Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand||BRAI2N, Sint Augustinus Hospital, Antwerp, Belgium¶Department of Otorhinolaryngology-Head and Neck Surgery, Dongguk University Ilsan Hospital, Goyang, Republic of Korea.
authors.forename: Jae-Jin
authors.initials: JJ
authors.lastname: Song
authors.forename: Gwang Seok
authors.initials: GS
authors.lastname: An
authors.forename: Inyong
authors.initials: I
authors.lastname: Choi
authors.forename: Dirk
authors.initials: D
authors.lastname: De Ridder
authors.forename: So Young
authors.initials: SY
authors.lastname: Kim
authors.forename: Hyun Seok
authors.initials: HS
authors.lastname: Choi
authors.forename: Joo Hyun
authors.initials: JH
authors.lastname: Park
authors.forename: Byung Yoon
authors.initials: BY
authors.lastname: Choi
authors.forename: Ja-Won
authors.initials: JW
authors.lastname: Koo
authors.forename: Kyogu
authors.initials: K
authors.lastname: Lee
mesh_terms: D003937:Diagnosis, Differential; D003939:Diagnostic Techniques, Otological; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014012:Tinnitus / Q000175:diagnosis* / Q000209:etiology; D016896:Treatment Outcome