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pmid32437099      Evidence+review+for+imaging+to+investigate+the+cause+of+non-pulsatile+tinnitus:++Tinnitus:+assessment+and+management:+Evidence+review+J-/-NICE+Evidence+Reviews+Collection 2020 ; ä (ä): ä
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  • Evidence review for imaging to investigate the cause of non-pulsatile tinnitus: Tinnitus: assessment and management: Evidence review J #MMPMID32437099
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  • Evidence review for imaging to investigate the cause of non-pulsatile tinnitus: Tinnitus: assessment and management: Evidence review J-/-NICE Evidence Reviews Collection 2020[Mar]; ä (ä): ä PMID32437099show ga
  • In certain groups of individuals with tinnitus, it is important to image the head and neck to exclude an organic cause for their symptoms. The role of imaging is to detect specific pathology that can be treated. A variety of imaging modalities may be considered depending on the type of tinnitus (pulsatile/non-pulsatile) and/or associated symptoms reported. Imaging modalities include ultrasound, computerised tomography and magnetic resonance imaging. A thorough history and clinical examination can direct the decision for imaging and the type of imaging. Non-pulsatile tinnitus, which is heard as a continuous sound, is more common than pulsatile tinnitus. It can be idiopathic or associated with ontological, neurological or metabolic disorders. Unilateral or asymmetrical non-pulsatile tinnitus that is associated with neurological, audiological or head and neck signs and symptoms is more likely to indicate pathology than bilateral tinnitus or where there are no associated signs and symptoms. Following medical examination, healthcare professionals need to decide whether people with non-pulsatile tinnitus should be offered medical imaging, with options including CT scans, MRI and MRA. Scanning allows the diagnosis of significant and often treatable underlying diseases, for example a vestibular schwannoma which can cause tinnitus by compressing adjacent structures. Whilst it is crucial not to miss significant pathology, it is also important not to scan people where significant pathology is unlikely. Not only is this cost unnecessary, it may be unpleasant and stressful for the person and possibly expose them to an unnecessary dose of ionising radiation.
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