Pulsatile tinnitus due to stenosis of the supraclinoid segment of the internal carotid artery: Management with a low-profile self-expanding stent

Abstract

Atherosclerotic stenosis of the internal carotid artery is a rare cause of pulsatile tinnitus. Stenosis responsible for tinnitus is usually located in the petrous segment of the vessel or, even more uncommonly, in the extracranial segment. However, to the best of our knowledge, a stenosis of the intradural supraclinoid segment of the internal carotid had never been reported as a source of pulsatile tinnitus. We describe the case of a man with a history of previous ischaemic stroke and invalidating pulsatile tinnitus, caused by a high grade, diaphragm-like shaped, stenosis of the supraclinoid internal carotid artery. The stenosis was treated with angioplasty and stenting with a low-profile self-expanding high radial force stent (Acclino flex HRF, Acandis). Tinnitus disappeared immediately after the procedure. At the two-year follow-up no recurrence of the tinnitus and the stenosis occurred. Intradural internal carotid artery stenosis should be considered as a very rare cause of pulsatile tinnitus.

Adventitia Layer-Focused Microsurgical Flow Reconstruction for Long-Segment Tubular Stenosis of the Cervical Segment (C1) Internal Carotid Artery: Clinical Valuable Experience in 20 Cases

“…This observation is aligned with previous reports, which have indicated that ICA pathology (especially the petrous segment, because the closest nest to the inner auditory bones can manifest as pulsatile tinnitus) is further substantiated by the improvement following vascular interventions [ 19 ]. The existing academic discourse acknowledges instances of tinnitus arising from stenoses in the supraclinoid segment of the internal carotid artery, albeit less frequently reported [ 20 ]. In the literature, tinnitus associated with ICA stenosis is often attributed to turbulent flow across a localized narrowing, which generates a perceptible sound [ 21 ].…”