이명치료 중 발견된 두개내 및 내이질환

Objectives: Tinnitus is one of the most common complaints in clinical field of otolaryngology but we often manage the tinnitus patient without definite diagnosis. We investigated the other causes except psychoacoustic factor in intractable tinnitus cases to medical treatment. Materials and Methods: We experienced 9 cases of intracranial and inner ear diseases in patients with intractable tinnitus to treatment, which were diagnosed using computed tomography (CT), magnetic resonance imaging (MRI), serum analysis, and vestibular function tests (VFTs) and report it with review of literature. Results: Of 9 cases, there are 2 cases of high jugular bulb, 2 cases of vascular anomalies, 2 cases of tumors (acoustic neuroma and meningioma) , a case of labyrinthine lues, neurovascular compression, and multiple sclerosis, respectively. Conclusions: In case of intractable tinnitus, whether it is pulsatile or nonpulsatile, we should suspect intracranial pathology and consider every kind of diagnostic tools as possible including routine laboratory evaluation, CT, MRI, and VFTs. Even in meningioma and labyrinthine lues, they complained pulsatile tinnitus. So it is very difficult to differentiate pulsatile tinnitus from nonpulsatile one clealy. Pitch and loudness of tinnitus have little relationship with the character of tinnitus, pulsatile or nonpulsatile. Because tinnitus patient without vestibular symptoms may have vestibular lesion, we should do VFTs in all cases of tinnitus patient. (J Clinical Otolaryngol 2002;13:56–64)