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Case Reports in Otolaryngology
Volume 2013, Article ID 938787, 4 pages
Case Report

Pulsatile Tinnitus due to a Tortuous Siphon-Like Internal Carotid Artery Successfully Treated by Arterial Remodeling

TRI Tinnitus Clinic, BRAI2N & Department of Neurosurgery, Antwerp University Hospital, 2650 Edegem, Belgium

Received 12 February 2013; Accepted 6 March 2013

Academic Editors: A. Casani, P. A. Fagan, and G. Zhou

Copyright © 2013 Dirk De Ridder et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


A patient is described with a right-sided tortuous siphon-like extracranial internal carotid artery leading to highly distressing ipsilateral heart beat synchronous pulsatile tinnitus, scoring 9/10 measuring loudness. Dilating the balloon during the occlusion test in or distal to the siphon-like anomaly reduces the arterial pulsations. Subsequently, surgery is performed using Teflon as an external construct to straighten the siphon-like anomaly. Postoperatively, the pulsations improve to 5/10 in a standing position and disappear during a reclined position. By adding a hearing aid, the pulsations are almost completely gone during a standing position (1/10) and remain absent in a reclined position.