Treatment of venous pulsatile tinnitus in younger women.

BACKGROUND: We present 7 cases of pulsatile tinnitus (PT) of venous origin in younger women seen over a period of 24 years and treated by Internal Jugular Bulb ligation. METHODS: All patients had a pulsatile bruit in one side of the neck that disappeared when gentle pressure over the internal jugular vein (IJV) caused it to collapse as seen in a duplex scan. Their computed tomography showed a dominant venous system with a high jugular bulb on the side of the bruit. RESULTS: The IJV was ligated under local anesthesia. Five patients in whom the ligation was done above the facial vein were cured. Two patients in whom the ligation was done below the facial vein experienced a decrease but not disappearance of the PT. CONCLUSIONS: Once other possible causes for PT have been discarded, ligation of the IJV above the facial vein cures this condition.