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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have tinnitus. MRI showed large mastoid emissary vein. Which specialist should I consult?

Answered by
Dr. Shailja Puri

Pathologist and Microbiologist

Practicing since :2006

Answered : 7163 Questions

Posted on Sat, 2 Feb 2013 in Ear, Nose and Throat Problems
Question: I hear a whooshing in my right ear with movement. I already have tinnitus so I know what that is. I also have hearing loss in the right ear. I've had some tests (MRI, MRV) which show nothing abnormal except a large mastoid emissary vein. This additional whoosh or hiss is induced when I swallow, burp, walk/jog (with each stride). I think it is eustachian related or possibly sinus, which have never really been checked. Doctor thought it was related to that vein, so I agreed to have minimally invasive surgery to occlude the vein. The surgery did not work. Now he is recommending a neuro-interventional vascular specialist. Does this sound logical?
Answered by Dr. Shailja Puri 4 hours later

Tinnitus has many subjective and objective causes.
Hypertension is also known to cause tinnitus, as you have mentioned that you are mildly hypertensive.
Besides hypertension atherosclerosis, anemia, tumors like glomus tumor, aneurysms and other vascular tumors are also known to cause tinnitus.

The other category, which causes tinnitus, is Eustachian tube defects.
As you have mentioned that tinnitus occurs with swallowing, burping, walking, jogging, etc it seems to be related to the Eustachian tube.

I would suggest you to visit a skilled ENT specialist for complete examination of the middle ear before a neuro-intervention.

If you have more queries, I will be glad to help.
Dr Shailja P Wahal

Above answer was peer-reviewed by : Dr. Shanthi.E
Follow up: Dr. Shailja Puri 42 hours later
Thank you. I have had quite a few tests (brain MRI, MRV) which have eliminated any serious causes. I also had a catscan of the ear which showed nothing abnormal; but I have never had anyone really focus on the middle ear, the eustachian tube, nor the sinuses. Do you have any recommendations as to clinics that might specialize in this in the northeast, specifically the Philadelphia or Baltimore area? Or should I just try to find a good local ENT as you mentioned?
Answered by Dr. Shailja Puri 7 hours later
Hello and thanks for your query.

You can visit Dr. XXXXXXX T. Sataloff, MD, DMA, 1721 Pine Street, Philadelphia, PA 0000, Phone: 215-545-3322, Fax: 215-790-1192
OR 219 N. Broad Street, 10th Floor, Philadelphia, PA 0000, Phone: 215-762-5530, Fax: 215-762-5540

However, if it is far to your location, you can visit a local experienced ENT expert.

Take care
Dr Shailja P Wahal
Above answer was peer-reviewed by : Dr. Mohammed Kappan

The User accepted the expert's answer

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