Carotid Artery Stenosis and Tinnitus: Association, Mechanisms, and Clinical Implications

Abstract

Tinnitus is the perception of sound in the absence of an external acoustic stimulus, and its pulsatile form is frequently associated with vascular disorders. Carotid artery stenosis (CAS) has been repeatedly reported in patients with tinnitus; however, its role as an independent risk factor remains controversial due to overlapping cardiovascular confounders. This narrative review summarizes current clinical, epidemiological, and interventional evidence regarding the association between CAS and tinnitus. Particular emphasis is placed on hemodynamic mechanisms, prevalence patterns, and tinnitus outcomes following carotid revascularization.

Overall, available evidence supports a significant association between CAS and pulsatile tinnitus, with biological plausibility and partial reversibility after surgical or endovascular intervention. Nevertheless, existing data are insufficient to establish CAS as an independent risk factor. Future prospective studies with standardized tinnitus assessment tools and multivariate confounder adjustment are required to clarify causality and guide clinical screening strategies.