Mukherji SK, consulting ed. Raghavan P, Gandhi D, guest eds. Tinnitus: Imaging, Endovascular, and Surgical Approaches. Elsevier, May 2016. Neuroimaging Clinics of North America; vol. 26; no. 2; pgs. 187–316; $360.00
The May 2016 issue of Neuroimaging Clinics of North America addresses a topic, tinnitus, which confronts a neuroradiologist on a frequent basis. Because most requests for temporal bone imaging state simply “tinnitus” without additional potentially important clinical information, one is obliged to consider the entire gamut of diagnostic possibilities. In that regard, this 130-page issue of the Neuroimaging Clinics of North America is a valuable resource because it covers the spectrum of causes of tinnitus—even those which have no overt imaging findings. That is important for us to appreciate as we search for underlying structural abnormalities.
This book starts off with a 9-page description of the neuroscience of tinnitus, and a reading of this material helps one understand the central changes in the auditory pathways. While neuroradiologists do not have to understand the features of sound production, propagation, and modulation, one quickly appreciates how tinnitus, along with other associated symptoms, can have root causes beyond what we see on imaging. One also sees how difficult it is to treat many of the causes of primary tinnitus.
A chapter of the clinical evaluation of tinnitus follows, and it reinforces the concept of knowing whether the tinnitus is objective or subjective, what type of tinnitus one is dealing with, and whether somatosounds are present. The authors of this chapter nicely outline the types of imaging studies that should be obtained for the specific type of tinnitus.
The next 5 chapters, which constitute the bulk of the book, involve imaging findings, with topics in tinnitus that include systematic approaches to image interpretation, arterial abnormalities, venous abnormalities (particularly interesting and easily overlooked), dural AVFs and their management, and paragangliomas. The imaging in all these chapters is of uniformly high quality.
The remaining 3 chapters in sequence deal with surgical treatment of tinnitus, endovascular treatment of IIH and tinnitus, and advanced MR techniques, which gives insights into the basic science considerations of tinnitus.
Particular attention should be paid to the description and illustration of venous anomalies. These may be easily overlooked when imaging patients with tinnitus and include sigmoid sinus wall anomalies (said to be common in tinnitus), protocol tables for CT of the temporal bones and protocols for the evaluation of paragangliomas, and the postoperative appearance of a sigmoid sinus wall reconstruction.
This is an important issue of the Neuroimaging Clinics of North America, and Dr. Mukherji is to be congratulated for developing this symptom-centric issue, as are the editors of this issue, Drs. Raghavan and Gandhi, for putting together the key topics relative to tinnitus.
