Pulsatile tinnitus associated with dehiscent internal carotid artery: An irremediable condition?

Tinnitus perception mediates the relationship between physiological and psychological problems among patients

“…Previous research has debated the relationship between tinnitus and PP (Alpini & Cesarani, 2006;Aqeel & Ahmed, 2018;Aqeel et al, 2017;Axelsson & Ringdahl, 1989;Coelho et al, 2004;Danesh et al, 2018;Scholes & Ramakrishnan, 2015;Vanneste et al, 2018). While some studies have shown that patients with HL and tinnitus were more inclined to mood swings, stress, anxiety, and depression than those who had tinnitus without HL (Bauer et al, 2017;Cima et al, 2018;Ibarra et al, 2018;Van Damme et al, 2017). Previous studies have also reported that tinnitus is often associated with significant psychological adjustment problems and mood swings (Alpini & Cesarani, 2006;Baguley et al, 2012;Cima et al, 2018;Ridner, 2004;Van Damme et al, 2017;Zoger et al, 2006).…”

Carotid-artery cochlear dehiscence

“…In addition, this type of anatomical change, especially canal bony dehiscence, may pose significant surgical risk during otologic procedures [1][2][3][4] . In general, middle ear surgeries are common, safe procedures, but always subject to complications, especially when anatomical changes such as ectopia and carotid-artery cochlear dehiscence are not previously recognized.…”

“…In general, middle ear surgeries are common, safe procedures, but always subject to complications, especially when anatomical changes such as ectopia and carotid-artery cochlear dehiscence are not previously recognized. A possible complication previously reported is the inadvertent introduction of bundles of electrodes into the carotid canal during cochlear implant surgery 3,4 .…”

“…Thus, the risk of injury is high upon rupture of this bone canal or of the dehiscent arterial wall 5 . Therefore, rigorous preoperative evaluation is necessary, and it should consider the anatomical relationships between the carotid canal, eardrum, and cochlea 3,4 .…”

“…Dehiscence of the bony canal that separates the ICA from other anatomic structures can occur in any portion along its course, including the carotid-cochlear bony plate. When this occurs, contact between the arterial wall and cochlear endosteum, in addition to its exposure to the tympanic cleft, can mimic otologic diseases such as otosclerosis, superior semicircular canal dehiscence syndrome, glomus tumors, and dehiscent jugular bulb 4 . Although clinical expression depends on the position of dehiscence and on how atypical the carotid canal is, the most common symptom is pulsatile tinnitus occasionally associated with conductive hearing loss 1 .…”