Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes
-
The causes of tinnitus can be grouped according to whether the noise is continuous or pulsatile, whether it is subjective or objective and whether there is a retrotympanic mass. Imaging algorithms can be based on these symptoms and signs. ⋯ If the bruit is objective and the tympanic membrane normal, selective cerebral angiography should be the initial investigation, because most such patients have an acquired vascular abnormality, usually a dural arteriovenous fistula. If there is pulsatile tinnitus and a retrotympanic mass, HRCT should be the first examination because this technique allows differentiation of a vascular variation, such as an aberrant carotid artery or jugular dehiscence, from a paraganglioma.