{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:39:31Z","timestamp":1760150371337,"version":"build-2065373602"},"reference-count":68,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Audiology Research"],"abstract":"<jats:p>Low-frequency air\u2013bone gap (ABG) associated with pulsatile tinnitus (PT) and normal impedance audiometry represents a common finding in patients with third window syndromes. Other inner disorders, including Meniere\u2019s disease (MD), perilymphatic fistula and intralabyrinthine schwannoma, might sometimes result in a similar scenario. On the other hand, PT is frequently associated with dural arteriovenous fistula (DAVF), while conductive hearing loss (CHL) is extremely rare in this clinical setting. A 47-year-old patient was referred to our center with progressive left-sided PT alongside ipsilateral fullness and hearing loss. She also experienced headache and dizziness. Otoscopy and video-oculographic examination were unremarkable. Conversely, a detailed instrumental audio-vestibular assessment revealed low-frequency CHL with normal impedance audiometry, slight left-sided caloric weakness, slightly impaired vestibular-evoked myogenic potentials on the left and normal results on the video-head impulse test, consistent with an MD-like instrumental profile. Gadolinium-enhanced brain MRI revealed an early enhancement of the left transverse sinus, consistent with a left DAVF between the left occipital artery and the transverse sinus, which was then confirmed by angiography. A trans-arterial embolization with Onyx glue was performed, resulting in a complete recession of the symptoms. Post-operatively, the low-frequency ABG disappeared, supporting the possible role of venous intracranial hypertension and abnormal pressure of inner ear fluids in the onset of symptoms and offering new insights into the pathomechanism of inner ear CHL.<\/jats:p>","DOI":"10.3390\/audiolres13060073","type":"journal-article","created":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T11:51:43Z","timestamp":1698839503000},"page":"833-844","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Low-Frequency Air\u2013Bone Gap and Pulsatile Tinnitus Due to a Dural Arteriovenous Fistula: Considerations upon Possible Pathomechanisms and Literature Review"],"prefix":"10.3390","volume":"13","author":[{"given":"Andrea","family":"Tozzi","sequence":"first","affiliation":[{"name":"Otorhinolaryngology-Head and Neck Surgery Department, University Hospital of Modena, 41125 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2874-5672","authenticated-orcid":false,"given":"Andrea","family":"Castellucci","sequence":"additional","affiliation":[{"name":"ENT Unit, Department of Surgery, Azienda USL\u2014IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Ferrulli","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology-Head and Neck Surgery Department, University Hospital of Modena, 41125 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5233-2478","authenticated-orcid":false,"given":"Salvatore","family":"Martellucci","sequence":"additional","affiliation":[{"name":"ENT Unit, Santa Maria Goretti Hospital, Azienda USL di Latina, 04100 Latina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pasquale","family":"Malara","sequence":"additional","affiliation":[{"name":"Audiology & Vestibology Service, Centromedico, 6500 Bellinzona, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Brandolini","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology and Audiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8230-3122","authenticated-orcid":false,"given":"Enrico","family":"Armato","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Lorraine, 54000 Vandoeuvre-l\u00e8s-Nancy, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelo","family":"Ghidini","sequence":"additional","affiliation":[{"name":"ENT Unit, Department of Surgery, Azienda USL\u2014IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"205","DOI":"10.31128\/AJGP-12-17-4420","article-title":"A Review of Tinnitus","volume":"47","author":"Esmaili","year":"2018","journal-title":"Aust. J. Gen. 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