Virtual Conference
Nivedita Narayankar

Nivedita Narayankar

Rajiv Gandhi University of Health & Sciences, India

Title: Nutrimentum Vascularum as Pulsatile Tinnitus


Tinnitus is one of the most common otological symptoms encountered in Otorhinolaryngology. In recent times our understanding of tinnitus has significantly progressed but nonetheless, it still constitutes a very incapacitating symptom which greatly affects the quality of life. Objective tinnitus accounts for only 5% and has various aetiologies both non-otological & otological which include both non vascular and vascular. Vascular malformations like Dural Arteriovenous Fistulas (DAVFs) constitute about 10% of objective tinnitus and hence are of academic interest to an Otolaryngologist due to their scarcity.

We present one such exceptional case, where a 26 year old female presented to ENT out-patient department with chief complaints of a left pulsatile tinnitus for duration of 2 months. A thorough clinical examination revealed no abnormality. A Pure Tone Audiometry was then done which showed hearing of patient is within normal limits.

Given the clinical persistence of the symptom which was affecting her daily activities, further investigation of Magnetic Resonance Imaging (MRI) Brain was done. A suspicion of a dural arterio-venous fistula in the transverse sinus further warranted an arteriography which showed a low grade DAVF at the level of the left sigmoid sinus.

DAVFs, although infrequent, constitute a treatable cause of tinnitus and hence should be considered as a possible diagnosis in all patients with pulsatile tinnitus, especially if it is unilateral. We also carried out a review of the current medical and surgical management in an attempt to better understand this rare yet interesting condition.


Dr Nivedita has completed her masters in Rajiv Gandhi University of Health & Sciences, Bangalore.  Having trained in a prestigious institutions and hospitals and has enormous knowledge in ear, nose & throat surgeries under the guidance of skilled surgeons. She also has a work experience at Dr.RML hospital, New Delhi & Safdurjung hospital, New Delhi. And during her postgraduation in otorhinolaryngology & head and neck, she obtained training from:
KIDWAI memorial institute of  oncology , cancer research and training centr, and Dr. S.r.Chandrashekhar institute of speech & hearing