Spontaneous otoacoustic emission as a novel method to screen pulsatile tinnitus caused by sigmoid sinus wall abnormalities: a prospective study

Objective: To evaluate the diagnostic potential of spontaneous otoacoustic emissions (SOAE), distortion product otoacoustic emissions (DPOAE), and pure-tone audiometry (PTA) in patients with pulsatile tinnitus (PT) caused by sigmoid sinus wall anomalies (SSWA).

Methods: This study included 20 PT patients and 20 matched healthy controls. SOAE, DPOAE, and PTA were assessed before and after compression of the internal jugular vein. Statistical analysis included paired t-tests to compare differences in SOAE amplitude, DPOAE signal-to-noise ratios, and PTA thresholds, while independent t-tests assessed age differences, and one-way ANOVA evaluated mean PTA thresholds.

Results: SOAE amplitudes were significantly higher in ipsilesional ears compared to contralesional and control ears. DPOAE showed a significant difference in 0.5 kHz S/N-ratio between ipsilesional and contralesional ears. PTA revealed higher thresholds in ipsilesional ears at low frequencies, with differences decreasing after compression.

Conclusion: Besides radiological modalities, SOAE is a sensitive tool for diagnosing and assessing the severity of PT in patients with SSWA, with DPOAE and PTA providing supplementary information. These findings suggest a multimodal approach for the diagnosis of PT related to SSWA.