Patients with pulse-synchronous tinnitus should be suspected to have elevated cerebrospinal fluid pressure

OBJECTIVE: This study was performed to evaluate the prevalence and clinical importance of elevated cerebrospinal fluid (CSF) pressure among patients with pulse-synchronous tinnitus. METHODS: Nineteen patients underwent height and weight measurements, routine otologic examinations, ear computed tomography, brain magnetic resonance imaging, fundus examination, and tinnitus score assessment. We analyzed the data with Fisher’s exact test, the t-test, and Pearson’s correlation. RESULTS: The mean age of the 19 patients was 39.2 ± 8.1 years (range, 27–54 years), and the mean body mass index was 22.2 ± 1.6 kg/m(2) (range, 19.9–24.6 kg/m(2)). The proportion of patients with elevated CSF pressure was 68%. No significant correlation between the severity of tinnitus and CSF pressure was found. Lumbar puncture and oral administration of diuretics resulted in significant improvement in tinnitus. CONCLUSIONS: If detailed physical and imaging examinations fail to detect the definite cause of pulse-synchronous tinnitus, a routine lumbar puncture should be performed to measure the CSF pressure. Elevated CSF pressure should be suspected in patients with pulse-synchronous tinnitus.