Pulsatile Tinnitus                             

 

Another variation of head noises

 

Pulsatile tinnitus is a category of ear noise that occurs in about 3% of all tinnitus cases.   In pulsatile tinnitus the ear sounds resemble the heartbeat, as though it was coming from the ear.  The most common pulsatile tinnitus causes are turbulence within an artery (noisy blood flow caused by abnormal bends or plaques in arteries of the head or neck, although it can arise from cardiac or vascular malformations, high blood pressure, metabolic disorders, hyperdynamic circulatory states, elevated intracranial pressure and tumors.)

 

Pulsatile tinnitus and elevated blood pressure often exist at the same time. It is common for a doctor to hear the same sound during a stethoscope examination as the tinnitus sufferer; for this reason pulsatile tinnitus is also called objective tinnitus.

 

Pulsatile tinnitus is mentioned as a specific topic since it represents a special situation that is far different than other forms of tinnitus, even though it is relatively rare.  What makes pulsatile tinnitus especially important is that, unlike other tinnitus problems, the source of the ear noise can be potentially serious and even life threatening.  

 

For this reason, it is strongly recommended that all individuals with pulsatile tinnitus work with a physician who has special interest in the circulatory system and that a thorough examination is performed.  It is not uncommon for this type of tinnitus to defy diagnosis or identification of the source of the unusual tinnitus symptoms.

 

When pulsatile tinnitus is strongly associated with the timing of the heartbeat, it is most often caused by a blood vessel malformation of the arteries and veins of the head or neck area. These blood vessels can be located next to the hearing mechanism of the ear on the surface of the head or just inside the head.

 

This is a list of possible causes of pulsatile tinnitus:

          ●  Arteriovenous malformations (AVMs.) AVMs are large abnormal collections of arteries and veins that sometimes occur within the skull near the auditory nerve. These AVMs beat against the auditory nerve, resulting in a pulsating tinnitus.

          ●  Carotid artery-cavernous sinus fistula.  This is an abnormal connection or passage between a very large artery and a very large vein within the skull. It is usually the result of severe head trauma.  Treatment is usually non-surgical, requiring the services of a radiologist.

          ●  Chronic inflammation or infection of the middle ear. Chronic inflammation is often associated with increased blood flow to the inflamed tissue; since this tissue is in the ear, some people are able to hear the increase in blood flow.

          ●  Middle ear fluid. The middle ear is normally filled only with air.  If an infection, inflammation or Eustachian tube malfunction causes fluid to collect behind the ear drum, then pulsating tinnitus may result.

          ●  Blood vessel tumors in the middle ear. These are benign, non-cancerous, tumors that can be troublesome, requiring surgery.

          ●  Venous hum. Patients who are pregnant, anemic, or have thyroid problems can develop increased blood flow through the largest vein in the neck, the jugular vein that passes near the middle ear. Turbulent blood flow anywhere in the course of the jugular vein can be heard in the middle ear as a "hum" which may or may not fluctuate with the pulse.

 

Pulsatile tinnitus diagnosis

 If you have not already done so, you must first see your family doctor or specialist.  You will likely be referred for additional testing at a hospital.  Specifically, the eardrums and blood vessels of the neck and skull are thoroughly examined, and a special stethoscope is used to determine if the doctor can also hear a pulsatile noise.   If someone else can also hear the sound you notice, it is called “objective tinnitus” because it can be heard by other people.

Pulsatile tinnitus treatment

If a specific cause for pulsatile tinnitus can be found – such as elevated blood pressure or “glue ear” – then treatment will be directed to that condition.  If no underlying condition can be found to explain your pulsatile tinnitus, coping strategies are used, along with distraction sound therapy, relaxation techniques or tinnitus retraining therapy (TRT). 

Tinnitus Treatment Institute recommends that anyone with tinnitus begins active treating ear noise problems with the natural treatment for ringing in the ears found on this website.  The results are great and therapy will probably improve other aspects of your health while you are at it.