Abstract
My technical capstone project and STS research paper are connected by a shared focus on current clinical understanding of pulsatile tinnitus (PT) and how physicians treat the condition. Although both projects are centered on PT, they approach it from different perspectives. My technical work focuses on developing a model to study the physical mechanisms generating PT symptoms, while my STS research paper examines how PT is diagnosed in real clinical settings. Together, my work explores the causes of a condition not fully understood and analyzes how physicians attempt to diagnose it, revealing a gap between technical understanding and clinical practice.
My technical project centers on the design and construction of a patient-specific vascular model to study the hemodynamic and acoustic mechanisms of PT. Using patient CT scans, my team developed a protocol to fabricate a physiologically accurate silicone model of the sigmoid sinus, which is a vascular channel implicated in certain PT cases. By integrating controlled flow conditions with acoustic measurement, the model allows us to examine how changes in vessel geometry and flow characteristics influence sound generation, which is directly related to the symptoms experienced by PT patients. This system serves as a platform for linking physiological behavior to clinical symptoms in a way that is difficult to observe in mathematical models or directly in patients. The overall goal of this project is to improve the mechanistic understanding of PT and support better-informed diagnoses and treatment.
My STS paper examines PT diagnosis in clinical practice and why imaging has become the dominant method of evaluation. Using Thomas P. Hughes’s framework of technological momentum, I argue that institutional guidelines, clinical practices, and epistemic norms reinforce and stabilize imaging-centered diagnostic pathways, despite limited evidence to support this diagnostic consensus. The case analyzed in the paper is the structured application of imaging-based diagnostic algorithms in the examination of PT patients. The paper examines clinical literature and diagnostic protocols to show how imaging functions as the organizing framework for clinical reasoning and decision-making for clinicians treating PT.
Working on these two projects together illustrates the gap between the technical work of researching a medical condition and the actual treatment of the condition in practice. My capstone project demonstrates that alternative approaches like physical modeling and mechanistic analysis can provide meaningful insight into PT. The project also grounds my STS analysis with a foundational understanding of the mechanisms behind PT, allowing me to evaluate current clinical diagnostic approaches more effectively. However, my STS research reveals that clinical systems are often structured in ways that entrench established technologies like imaging, while new or alternative forms of evidence are ignored. This contrast helped me recognize that integration of engineering solutions into existing sociotechnical systems is just as important as technical effectiveness. I will apply this perspective in my future work by considering how new technologies align with clinical workflows, institutional structures, and accepted forms of knowledge to improve their likelihood of integration in clinical practice.
