Unilateral Pulsatile Tinnitus in Young Female Adults: A Report of Two Cases

Pulsatile tinnitus (PT) manifests as an auditory sensation synchronised with the heartbeat, occurring without any external auditory stimuli. While its etiology is diverse, vascular factors predominate. We present two intriguing cases of unilateral PT with unremarkable otorhinolaryngological examinations: one attributed to tortuosity of the extracranial internal carotid artery (ICA) and the other to dehiscence of the sigmoid sinus wall. Both patients exhibited a common characteristic whereby compression of the ipsilateral jugulo-carotid region relieved their tinnitus. Diagnostic imaging, including High Resolution Computed Tomography (HRCT) of the temporal bone and Computed Tomography Angiography (CTA) of the head and neck, facilitated accurate diagnosis in both instances. The majority of PT cases have identifiable causes, with imaging modalities playing a pivotal role in diagnosis. Treatment options range from observation with reassurance to medical intervention or surgical management.