Tinnitus is one of the commonest complaints in otolaryngology. It may be classified as subjective, perceived only by the patient, or objective, perceived by the patient and the examiner alike. When tinnitus is synchronous to pulse, a vascular etiology is suggested. Objective tinnitus is uncommon and vascular origin is especially rare. The most common cause is a dural arteriovenous malformation(AVM), usually involving branches of the external carotid artery and the transverse sinus. Other causes include traumatic or spontaneous caroticocarvenous fistulae, AVM's of the neck, increased intracranial pressure, high cardiac output state (anemia, thyrotoxicosis, or beri-beri), intracranial aneurysms and vascular tumor of the temporal bone. There have been few documented cases ascribed to ectatic, dissected, stenotic, or occluded craniocervical arteries. The authors experienced a case of pulsatile tinnitus due to ectatic posterior auricular artery, which was treated by embolization with polyvinyl alcohol foam(PVA) under trans-femoral angiography.
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