{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T18:41:47Z","timestamp":1791830507626,"version":"4.3.4"},"reference-count":77,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,6,22]],"date-time":"2025-06-22T00:00:00Z","timestamp":1750550400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Pulsatile tinnitus (PT) is a subtype of tinnitus characterized by a perception of heartbeat-synchronous sound. It represents approximately 5\u201310% of all tinnitus cases and may have either a vascular or non-vascular etiology. Accurate diagnosis is crucial due to the potentially serious implications this condition can entail. Assessment through anamnesis and physical examination may often suggest a diagnosis of PT, but it is rarely definitive. Therefore, a comprehensive and specific imaging diagnostic protocol is essential when evaluating PT. A lack of consensus has been identified regarding the use of a standardized protocol for both pulsatile and non-pulsatile tinnitus, whether unilateral or bilateral. Consequently, neuroradiologists, otologists, and otoneurologists from a tertiary hospital have developed a new imaging diagnostic protocol for PT. The aim of this article is to present an updated approach to the diagnostic and therapeutic management of PT, aiming to establish a protocol that serves as a guide for clinicians assessing this symptom. In patients with bilateral PT, systemic conditions leading to increased cardiac output should generally be ruled out; in unilateral cases, focused imaging studies should be performed to exclude organic etiologies at the cervical and cranial levels.<\/jats:p>","DOI":"10.3390\/jcm14134428","type":"journal-article","created":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T07:42:34Z","timestamp":1750664554000},"page":"4428","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Pulsatile Tinnitus: A Comprehensive Clinical Approach to Diagnosis and Management"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9752-2996","authenticated-orcid":false,"given":"Sof\u00eda","family":"Pacheco-L\u00f3pez","sequence":"first","affiliation":[{"name":"Division of Otology, Audiology and Lateral Skull Base Surgery, Department of Otolaryngology, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4217-0633","authenticated-orcid":false,"given":"Jose Pablo","family":"Mart\u00ednez-Barbero","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology, Department of Radiology, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain"},{"name":"TECe22-Imagen M\u00e9dica Avanzada, Instituto de Investigaci\u00f3n Biosanitaria ibs.GRANADA, 18012 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heriberto","family":"Busquier-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology, Department of Radiology, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Garc\u00eda-Valdecasas-Bernal","sequence":"additional","affiliation":[{"name":"Division of Otology, Audiology and Lateral Skull Base Surgery, Department of Otolaryngology, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8436-5629","authenticated-orcid":false,"given":"Juan Manuel","family":"Espinosa-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Division of Otoneurology, Department of Otolaryngology, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain"},{"name":"Otology and Neurotology Group CTS495, Instituto de Investigaci\u00f3n Biosanitaria ibs.GRANADA, 18012 Granada, Spain"},{"name":"Division of Otolaryngology, Department of Surgery, Universidad de Granada, 18016 Granada, Spain"},{"name":"Sensorineural Pathology Programme, Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Raras (CIBERER), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2792","DOI":"10.1007\/s00330-006-0306-2","article-title":"The radiologic evaluation of tinnitus","volume":"16","author":"Branstetter","year":"2006","journal-title":"Eur. 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