Can The Configuration of Petrous Bone Pneumatization be a Predictor of Tinnitus?

Abstract

Introduction: In this study, we tried to evaluate a possible relationship between petrous bone pneumatization and subjective pulsatile tinnitus (SPT).Methods: The temporal bone computed tomographic (CT) images of 35 patients with SPT admitted to our hospital between October 2013 and May 2014 were evaluated. We formed the control group by a retrospecti-ve evaluation of the reconstructed images of the petrous bones derived from the paranasal CT scans of 35 patients free of SPT complaints perfor-med because of chronic sinusitis.Results: Overall, 46 ears of patients with SPT were evaluated. Of these, 13 (28.26%) had petrous bone pneumatization. Of these, 11 of them had increased pneumatization formed of small aircells, whereas two had pre-dominant large aircells between internal carotid artery (ICA) and cochlea. In the control group, 15 (21.42%) of 70 ears had petrous bone pneumati-zation formed of small air cells. On comparing study and control groups, no significant relationship was found between petrous pneumatization and tinnitus (p>0.05).Conclusion: In our study, we did not find any significant relationship bet-ween pneumatization and tinnitus, but we detected two patients with bilateral pneumatization, who had SPT at the side of pneumatization, which mainly consisted of a unibody large air cell; however, the opposite sides, which consisted of multiple small aircells, were free of tinnitus. For these cases, a question arises whether a combination of thin bony lamellas and tiny air cells together causing multiple interfaces resulting in dispersion and reflection, thus reducing the energy of the sound and existence of a unibody large aircell conducting the sound with relatively less distortion, eventually resulting in not amplification but less interfe-rence on the sound can be perceived by cochlea as relatively increased conduction of the blood flow and result in SPT. To prove this theory, a study with a large number of cases in resemblance has to be conducted..