Pulsatile Tinnitus

Even though pulsatile tinnitus isn’t the most common type of tinnitus, there are some specific causes.  Some of causes of this form of tinnitus include hypertension, heart murmur, glomus tumor, or Eustachian tube disorder (abnormality of a vein or artery).  Another name for pulsatile tinnitus is vascular tinnitus because this form is caused by change in blood flow in the veins and arteries in the neck, head, and ear.

The positive thing about pulsatile tinnitus is that there are effective treatments.  If the blood flow can be managed, it is most likely that the symptoms will be alleviated.

Blood flow can change in your body by various different factors.  Increased blood flow can occur during strenuous exercise.  Or severe anemia can cause increased blood flow.

When a blood vessel is narrower than it is supposed to be, there can be localized increased blood flow.  If this is the case, there will be a need to adjoin blood vessels to carry the additional blood.  When there is additional blood flood, a noise of pulsing sound can occur, or pulsatile tinnitus.

Hardening of the arteries (constricted blood flow) can create turbulent blood flow.  This makes the blood flow erratic in nature instead of smooth.

If you are able to describe the noises of pulsatile tinnitus, it is likely that your medical practitioner will order additional tests to check blood pressure and blood flow inside your head.  Medical imagining like Ultrasound, CT scanning, Magnetic Resonance Scanning (MRI), Magnetic Resonance Angiography (MRA), or Angiography are some of the tests your doctor could order.

These tests will help determine the cause of your pulsatile tinnitus.  Possible results could include: 

• Arteriovenous malformations – these are abnormal grouping of arteries and veins in the cranium located near the auditory nerve.

• Carotid artery-cavernous sinus fistula – this disorder is normally the result of head trauma.  It is an abnormal connection between the large artery and venous pool in the head.

• Chronic inflammation and/ or infection in the middle ear – when there is chronic inflammation there is normally increased blood flow.  When this happens, some people can hear the increased blood flow.

• Middle ear fluid – normally, the middle ear doesn’t have any fluid in it.  It is only air-filled.  When or if there is an infection or inflammation, fluid can accumulate behind the middle ear.  This can result in pulsatile tinnitus.

• Vascular tumors in the middle ear – these are also known as glomus tumors of paragangliomas (globe-shaped tumors).  If this is the cause it is very likely surgery will be required to change the outcome of this problem.

• Atheroma (fatty deposits that create partial blockage in an artery) – obstruction of blood flow due to high cholesterol can also be a cause of pulsatile tinnitus.

Depending on what the cause of pulsatile tinnitus is will determine the treatment needed.  For example, if you have high cholesterol, it will be recommended to eat a healthy diet, exercise, and take a medication to lower it. 

In most cases, treating pulsatile tinnitus will involve a few different methods.  Usually patients with pulsatile tinnitus will be treated with drug therapy, alternative treatments, biofeedback, and sound therapy.