What Is Pulsatile Tinnitus?

Pulsatile tinnitus is a rare form of tinnitus (ringing in the ears) that is accompanied by a whooshing or thumping sound in one or both of your ears. This sound does not come from an external source, but from within your body and sounds like an amplification of your blood circulating through your arteries. This is also probably why the sound seems to be in sync with your pulse. Some people report the sound as an annoyance, but they can continue to function normally while a solution is found. Others that suffer with pulsatile tinnitus report that the noise is intense and debilitating to the point that it is difficult to sleep, concentrate, and hold conversations with other people. Unlike regular tinnitus, pulsatile tinnitus has a physical source that occasionally can be heard by a doctor using a stethoscope. Because there is a source of the sound, there is also usually an identifiable cause of the issue and sometimes an underlying condition as well.

Symptoms of Pulsatile Tinnitus

The primary symptom is obvious from reading the introduction, you hear a sound from within your own body that is consistent and syncs with your own pulse. You may hear it in one ear or both, but the sound is constant and occurs at a steady beat. There may or may not be other symptoms or underlying issues, but the constant with pulsatile tinnitus is the whooshing or thumping sound.

The other potential symptoms of pulsatile tinnitus will be associated with other issues that will be mentioned below. A rare but serious condition called idiopathic intracranial hypertension, which is high pressure in the fluid around your brain, can also cause pulsatile tinnitus. Its symptoms are characterized by the following:

  • Headaches
  • Dizziness
  • Vision Problems
  • Hearing Loss

If you experience any of these things along with the whooshing sound, you should see a doctor right away.

Causes of Pulsatile Tinnitus

The following is a list of possible underlying health problems that can cause pulsatile tinnitus. As mentioned above, this type of tinnitus has a physical source that can often be attributed to an underlying problem. Here are some of those possible underlying issues:

  • Atherosclerosis 

When you have atherosclerosis, plaque can build up in your arteries. When that plaque hardens, it limits the flow of blood through that artery and in turn throughout your body including your brain, ears, neck, and/or head. If the flow of blood is obstructed in any of these areas, it could easily present as pulsatile tinnitus. 

  • Blood Vessel Disorders and Malformations 

Having abnormal blood vessels is actually a fairly common problem. When blood flows through damaged, kinked, or misshapen vessels, especially around the brain or ear, it will often present as pulsatile tinnitus. Small blood vessels can also cause the same effect.

  • Ear Abnormalities 

Patients who have superior semicircular canal dehiscence syndrome, a condition where the temporal bone that overlies the superior semicircular canal is abnormally thin or missing, often experience pulsatile tinnitus. Another cause of pulsatile tinnitus related to ear abnormalities is when there is a thin or missing bone on top of the arteries running near the ear.

  • High Blood Pressure 

High blood pressure can lead to a change in the speed and force of blood flowing through your arteries. Your carotid artery in particular is more likely to be turbulent and cause the whooshing or thumping sound in your ear.

  • Head and Neck Tumors 

Head and neck tumors can press into the blood vessels causing pulsatile tinnitus and other symptoms. Most often these are glomus tumors that usually show up in the jugular vein positioned below the inner ear and may grow into the inner ear or brain causing deeper issues. While glomus tumors are almost always benign, they can press into arteries and grow in places that cause pulsatile tinnitus and other issues.

  • Idiopathic Intracranial Hypertension 

This condition is described above, but it is important to list here as well because it is one of the most dangerous underlying issues.

  • Sinus Wall Abnormalities 

Sinus wall abnormalities like diverticulum and dehiscence can cause pressure, blood flow, and noise changes within the sinus cavity which can result in pulsatile tinnitus.

Diagnosis of Pulsatile Tinnitus

If you think you have pulsatile tinnitus, you should undergo a thorough medical evaluation including hearing tests and having the doctor check your ears. Your doctor will also check your eyes and look at your jaw to check for increased pressure in the brain. They will also check the blood vessels in your head, neck, and ear canal. Your medical team may also want to take images or do other tests to diagnosis pulsatile tinnitus including:

  • Angiography
  • Blood Tests
  • Thyroid Function Tests
  • CT Scan
  • Magnetic Resonance Angiography (MRA)
  • Brainstem Auditory Evoked Response (BAER)
  • Magnetic Resonance Imaging(MRI)
  • Ultrasound

For some patients, the cause of pulsatile tinnitus may remain unknown, but it is important to rule out all of the serious possible causes and many of those can be either found or ruled out with the tests above.

How Serious is Pulsatile Tinnitus?

In and of itself, pulsatile tinnitus is not a serious condition. It is always annoying and sometimes debilitating in terms of interrupting your daily life, but it is very rarely life-threatening. The problem is not the pulsatile tinnitus itself, but the potential underlying causes that could be present based on the condition. It is important to speak with your doctor at the earliest onset signs of pulsatile tinnitus so that you can catch these underlying issues if they are present. Things like high blood pressure, abnormal arteries, tumors, and hypertension are all dangerous and potentially life-threatening issues that are tied to pulsatile tinnitus while others are simple annoyances..

Pulsatile Tinnitus Treatment

One of the most important and concerning issues of pulsatile tinnitus is that there can be dangerous underlying conditions causing it. If it does not go away easily or if the management techniques below do not work, you should go and see a doctor right away. Some of the underlying causes will only be dealt with through medicine, some require surgery, and others simply need a change in diet and exercise routine. Your physician can come up with a personalized action plan so that you can get the pulsatile tinnitus under control quickly, before it turns into a more serious problem that is difficult to treat.

Techniques for Managing Pulsatile Tinnitus Symptoms

If there are no underlying health conditions causing your pulsatile tinnitus, your doctor may give you some self-management techniques to help alleviate the symptoms. Some potential relief may be found in through the following techniques:

  • White Noise. Listening to white noise while you fall asleep.
  • Tinnitus Retraining. You wear a device that plays music in a tone that helps you tune out the pulsing sound.
  • Relaxation Techniques. Common relaxation techniques may help you forget about the annoyance of the tinnitus.
  • Wearable Sound Generators. They look like hearing aids, but they emit a low-level background noise to combat the pulsatile tinnitus.

Some of these techniques are simple lifestyle and behavioral modifications that can greatly lessen or even completely alleviate your symptoms. When these techniques are viable you should pursue them prior to pursuing more invasive or medicine heavy alternatives.

Dr. Eleanor Wilson

Eleanor Wilson, Doctor of Audiology, has been a practicing Audiologist for 28 years and specializes in diagnostics, amplification and cochlear implants. She is the owner of Hear Again 2 in Bakersfield and Mountain Hearing Center in Tehachapi.
Table of Contents

Dr. Eleanor Wilson

Eleanor Wilson, Doctor of Audiology, has been a practicing Audiologist for 28 years and specializes in diagnostics, amplification and cochlear implants. She is the owner of Hear Again 2 in Bakersfield and Mountain Hearing Center in Tehachapi.
Table of Contents