Role of the Radiologist in Management of Pulsatile Tinnitus

NCT ID: NCT05338684

Last Updated: 2022-04-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-04-17

Study Completion Date

2023-12-31

Brief Summary

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The aim of this study is to detect the role of interventional radiology in management of Pulsatile tinnitus and to detect the best imaging modality for Diagnosis.

Detailed Description

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Tinnitus is a broad and complex subject concerning a symptom rather than a syndrome or a disease (1 ),New studies indicate that prevalence of tinnitus is 14.5% among those less than 40 years old and 17.5 - 35% among age over 40 years Old( 2-3 ). Vascular tinnitus causes are multiple , Arterial causes like Atherosclerosis , Fibromuscular dysplasia or Dissection of the carotid or vertebral artery , Arteriovenous causes like Cerebral head and neck arteriovenous malformation , Dural arteriovenous fistula and Carotid cavernous fistula Venous like Systemic diseases with hyperdynamic circulation . Chronic anemia, pregnancy, thyrotoxicosis , Idiopathic intracranial hypertension and Dural venous sinus stenosis , Tumors also like Paraganglioma which Some authors believe that para-gangliomas are the most common cause of vascular tinnitus and Vascular metastasis And other Miscellaneous Causes like Paget's disease m Otosclerosis or Otomastoiditis , but others see dural arteriovenous fistula (AVF) ,idiopathicvenous tinnitus, or idiopathic intracranial hypertension the most common causes. (4 - 9) , Also One of the Most important Arterial causes is Atherosclerosis , Atherosclerotic plaques ma produce turbulence of carotid flow and occasionally cause pulsatile tinnitus (10 ) , FMD ( Fibromuscular Dysplasia ) seen in 0.5% to0.6% of carotid angiograms and autopsies, is the second most common cause of extracranial carotid narrowing (11) information obtained from both CT and MRI is complementary In some casesThe angiographic findings may include luminal stenosis, abrupt reconstitution of the lumen, dissecting aneurysm, intimal flap, slow flow, occlusion, and distal emboli (12-15)

Conditions

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Pulsatile Tinnitus (Diagnosis)

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

patients diagnosed with pulsatile tinnitus clinically
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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diagnostic catheter intervention then therapeutic if indicated

Group Type EXPERIMENTAL

Colour doppler,MSCT,MRI

Intervention Type DEVICE

ultrasound/color duplex at Jugular veins \& carotid and vertebral arteries first ,then MSCT/CTA mainly with relation of neck \& Bain arteries to the bone of the skull in 6 mm cuts and/or MRI/MRA/MRV by standardized multi-parametric MR protocol will be implemented for all patients. All sequences will be acquired on a 1.5T MR scanner.

Interventions

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Colour doppler,MSCT,MRI

ultrasound/color duplex at Jugular veins \& carotid and vertebral arteries first ,then MSCT/CTA mainly with relation of neck \& Bain arteries to the bone of the skull in 6 mm cuts and/or MRI/MRA/MRV by standardized multi-parametric MR protocol will be implemented for all patients. All sequences will be acquired on a 1.5T MR scanner.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patients with pulsatile tinnitus of unknown origin referred by a physician to diagnostic radiology to be assessed by imaging will be included in the study.
* Patient's with clinical diagnosed pulsatile tinnitus.
* patient refused surgical intervention.

Exclusion Criteria

* History of allergy to the contrast media , Contraindication to MRI and Refusal to sign a consent
* Pregnant women
* patients with atherosclerosis cause only or vascular loop more than 50% in internal auditory canal
Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Mohab Mohammed

OTHER

Sponsor Role lead

Responsible Party

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Mohab Mohammed

Role of the Radiologist in Management of Pulsatile tinnitus

Responsibility Role SPONSOR_INVESTIGATOR

Central Contacts

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Mohab Mohammed, Dem

Role: CONTACT

01555151888

Hany Mohamed, Prof

Role: CONTACT

01005618665

References

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Noell CA, Meyerhoff WL. Tinnitus. Diagnosis and treatment of this elusive symptom. Geriatrics. 2003 Feb;58(2):28-34.

Reference Type BACKGROUND
PMID: 12596495 (View on PubMed)

Heller AJ. Classification and epidemiology of tinnitus. Otolaryngol Clin North Am. 2003 Apr;36(2):239-48. doi: 10.1016/s0030-6665(02)00160-3.

Reference Type BACKGROUND
PMID: 12856294 (View on PubMed)

Mehanna R, Shaltoni H, Morsi H, Mawad M. Endovascular treatment of sigmoid sinus aneurysm presenting as devastating pulsatile tinnitus. A case report and review of literature. Interv Neuroradiol. 2010 Dec;16(4):451-4. doi: 10.1177/159101991001600413. Epub 2010 Dec 17.

Reference Type BACKGROUND
PMID: 21162777 (View on PubMed)

Schleuning A. Neurotologic evaluation of subjective idiopathic tinnitus. J Laryngol Otol Suppl. 1981;(4):99-101. No abstract available.

Reference Type BACKGROUND
PMID: 6946175 (View on PubMed)

Dietz RR, Davis WL, Harnsberger HR, Jacobs JM, Blatter DD. MR imaging and MR angiography in the evaluation of pulsatile tinnitus. AJNR Am J Neuroradiol. 1994 May;15(5):879-89.

Reference Type BACKGROUND
PMID: 8059655 (View on PubMed)

George B, Reizine D, Laurian C, Riche MC, Merland JJ. Tinnitus of venous origin. Surgical treatment by the ligation of the jugular vein and lateral sinus jugular vein anastomosis. J Neuroradiol. 1983;10(1):23-30. No abstract available. English, French.

Reference Type BACKGROUND
PMID: 6864262 (View on PubMed)

Sismanis A. Pulsatile tinnitus. A 15-year experience. Am J Otol. 1998 Jul;19(4):472-7.

Reference Type BACKGROUND
PMID: 9661757 (View on PubMed)

Sismanis A. Pulsatile tinnitus. Otolaryngol Clin North Am. 2003 Apr;36(2):389-402, viii. doi: 10.1016/s0030-6665(02)00169-x.

Reference Type BACKGROUND
PMID: 12856306 (View on PubMed)

Waldvogel D, Mattle HP, Sturzenegger M, Schroth G. Pulsatile tinnitus--a review of 84 patients. J Neurol. 1998 Mar;245(3):137-42. doi: 10.1007/s004150050193.

Reference Type BACKGROUND
PMID: 9553842 (View on PubMed)

Sandok BA, Whisnant JP, Furlan AJ, Mickell JL. Carotid artery bruits: prevalence survey and differential diagnosis. Mayo Clin Proc. 1982 Apr;57(4):227-30.

Reference Type BACKGROUND
PMID: 7070118 (View on PubMed)

Corrin LS, Sandok BA, Houser OW. Cerebral ischemic events in patients with carotid artery fibromuscular dysplasia. Arch Neurol. 1981 Oct;38(10):616-8. doi: 10.1001/archneur.1981.00510100044005.

Reference Type BACKGROUND
PMID: 7295104 (View on PubMed)

Gelbert F, Assouline E, Hodes JE, Reizine D, Woimant F, George B, Hagueneau M, Merland JJ. MRI in spontaneous dissection of vertebral and carotid arteries. 15 cases studied at 0.5 tesla. Neuroradiology. 1991;33(2):111-3. doi: 10.1007/BF00588245.

Reference Type BACKGROUND
PMID: 2046892 (View on PubMed)

Other Identifiers

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Radiology role in tinnitus

Identifier Type: -

Identifier Source: org_study_id

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