Pulsatile tinnitus is a sign of certain medical conditions, and its severity depends on the condition causing it. If the cause is treatable, pulsatile tinnitus is likely to get cured.
Pulsatile tinnitus is not a disease but rather a sign of certain medical conditions. Its severity depends solely on the condition causing it. If the cause is treatable, pulsatile tinnitus is likely to get cured. For example, if the cause is anemia, the resulting pulsatile tinnitus can be cured with medications or blood transfusion. Additionally, a condition such as a glue ear can be treated with grommets, while ear perforations can be managed with grafts. Other causes, such as hyperthyroidism and elevated intracranial hypertension, can also be treated with medications.
Pulsatile tinnitus that is caused by the abnormal formations in the large blood vessel (carotid artery) of the neck may not be treatable. Surgery is the only treatment in such cases, and the location of the blood vessel makes it more dangerous than the structural problem itself.
For cases of pulsatile tinnitus in whom the cause has not been identified, one or more of the following therapies may be used:
- Sound therapy
- Relaxation therapy
- Cognitive-behavioral therapy (CBT)
- Counseling
- Mindfulness meditation
- Tinnitus retraining therapy (TRT)
What is the most common cause of pulsatile tinnitus?
Pulsatile tinnitus is a rhythmic thumping, pulsing, throbbing or whooshing sound that can be heard only by you in sync with your heartbeat. You may suffer from the condition in one or both of your ears. The sound results from the turbulent blood flow in the arteries situated near your ear (such as the carotid artery).
The most common causes of pulsatile tinnitus include:
- Conductive hearing loss. This may make the sounds of breathing, chewing and blood flowing through the ear more audible and result in pulsatile tinnitus. You may also be able to hear the blood flowing through two large vessels that travel through each ear.
- Conductive hearing loss can itself be caused by any of the following:
- An infection or inflammation of the middle ear
- The accumulation of fluid in the middle ear
- Problems with the ossicles (small bones involved in hearing)
- Conductive hearing loss can itself be caused by any of the following:
- Carotid artery disease. The accumulation of plaques inside the carotid artery can increase the blood flow in the artery giving rise to pulsatile tinnitus.
- Hypertension (high blood pressure). Having hypertension may also mean that the pressure in the carotid artery has increased enough to cause pulsatile tinnitus.
- Blood vessel disorders. Structural defects or malformations in the blood vessel may also result in pulsatile tinnitus, which can include:
- Aneurysm (a weakened, bulging patch)
- Arteriovenous malformation (an abnormal connection between an artery and vein)
- Twisted arteries
- Tumor in the blood vessel
How is pulsatile tinnitus diagnosed?
Your doctor will take your complete medical history. Next, they will examine the blood vessels in your head and neck. They will also conduct hearing tests and a few blood tests.
If physical examination and blood tests fail to identify the cause, your doctor will order imaging tests. These tests will help confirm the condition that is causing the tinnitus, and may include:
- Ultrasound of the neck
- Magnetic resonance imaging (MRI) of the brain
- Magnetic resonance angiography (MRA)
- Magnetic resonance venography (MRV)
- Computed tomographic angiography (CTA)
- Computed tomographic venography (CTV)
- Computed tomography (CT) scan of the brain
- Conventional angiography