A Multidisciplinary Approach to Diagnose, Treat and Study Pulsatile Tinnitus

At some point in our lives, most of us have experienced some kind of unexplained sound deep in our ear, and most of the time, it stops after a little while. But what about when the sound doesn't stop? If that sound has a rhythmic component – often described as whooshing, swooshing, clicking, popping, rumbling or even a cement mixer sound – then you might have pulsatile tinnitus (PT). This is a symptom that affects nearly five million Americans.

PT can be maddening for those who suffer from it - difficult to diagnose, unrelenting - and it sometimes indicates a much larger serious health problem. For many, the near constant sound exceeds annoyance and becomes completely debilitating; a majority who experience symptoms also suffer from depression or anxiety. Overall, PT has many causes, including vascular abnormalities, abnormal cerebral pressure and unique blood flow patterns near the ear. PT can also be caused by the presence of a tumor. The effects of pulsatile tinnitus can be incapacitating which often leads to patients seeking help.

At UC San Francisco, the Pulsatile Tinnitus Clinic was founded by Matthew Amans, MD, assistant professor of radiology in the Department of Radiology and Biomedical Imaging, who serves as co-director along with Karl Meisel, MD, assistant professor of Neurology at UCSF. Specialists from the departments of Radiology, Neurology, Otolaryngology and Psychiatry collaborate to diagnose and treat this condition with a diagnosis success rate of over 90 percent.

The Pulsatile Tinnitus Clinic at UCSF is also involved in active research to help future patients and outcomes. The cause of pulsatile tinnitus is known to be related to blood flow, however, to date, the specific features of hemodynamics (blood flow) that result in symptoms has not been established. New non-invasive MRI capabilities have allowed scientists at UCSF to identify the presence of pronounced vortical flow components in individuals with venous etiologies of PT indicating a link between patterns of blood flow and symptom presentation. Current research is looking further into this phenomenon by characterizing the relevant flow patterns in flow models and then in patients with a spectrum of anatomic and hemodynamic conditions in order to provide the necessary insights for the development of treatment strategies for these patients.

At this time, physicians can consult or refer patients to Pulsatile Tinnitus Clinic at UCSF by calling (415) 502-3895. Patients can self-refer through UCSF's Second Opinion portal (please specify "Dr. Matthew Amans" to review).

Read one patient's story of triumphing over pulsatile tinnitus here.

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