Prevalence of pulsatile tinnitus among patients with migraine

Objective: To examine the prevalence of pulsatile tinnitus (PT) among patients with a diagnosis of migraine and to determine if treatment of migraine improves symptoms. Study Design: Single-institution retrospective patient review. Setting: Academic tertiary referral center. Patients: Billing data capturing ICD-9 codes 346.XX and 388.3x was used to identify patients with history of migraine and tinnitus. Patients were excluded if the symptom of PT could be attributed to an alternate diagnosis. Data were extracted from the patients' electronic medical records. Intervention(s): Therapeutic patients were prescribed a strict migraine diet with or without migraine medication. Main Outcome Measure(s): Subjective improvement in tinnitus as documented in electronic medical records. Results: One thousand two hundred four patients were identified with an ICD-9 code for migraine and of those patients, 12% (n=145) had an ICD-9 code for tinnitus. After ruling out alternative causes, the prevalence of PT among all patients with migraine was 1.9%. Of migrainers with PT who underwent migraine treatment, 11 out of 16 reported resolution or improvement of their PT. Conclusion: PT can be observed in the context of migraine. Migraine treatment with avoidance of dietary triggers with or without medication can possibly lead to resolution of PT.