Pulsatile Tinnitus
Pulsatile Tinnitus
Pulsatile tinnitus is a type of tinnitus which sounds like it is pulsating in your ears. It is a red flag and needs to be investigated appropriately at an early stage by a medical specialist. It can present with whooshing, thumping, or pulsing sound. It can be in keeping with your heart rate but not always.
Pulsatile tinnitus can be subjective (only heard by the patient) or rarely objective (can be heard by the patient and others).
Symptoms:
Whooshing, pulsing or thumping in one or both ears
Variable loudness based on head position, activity level, or stress
Associated symptoms such as ear fullness, dizziness, hearing loss or visual disturbance.
Common Causes of Pulsatile Tinnitus
1. Vascular
These can include some dangerous worrying causes arising from blood vessels such as Venous sinus stenosis, Arteriovenous malformations (AVMs), Carotid artery stenosis or dissection and Arteriovenous fistulas.
2. Intracranial Pressure Abnormalities
Abnormalities of the fluid in and around the brain (Cerebrospinal fluid aka CSF) can result in pulsatile tinnitus. Conditions include Idiopathic Intracranial Hypertension (IIH) and Cerebrospinal fluid leaks or low-pressure syndromes
3. Structural Abnormalities in and around the ears
Structural abnormalities in and around your ears can result in pulsatile tinnitus. Conditions include Superior Semicircular Canal Dehiscence (SSCD), prominent or dehiscent sigmoid sinus and Jugular bulb anomalies.
4. Other Causes
Middle ear tumours such as glomus tympanicum or glomus jugulare, Eustachian tube dysfunction, palatal myoclonus, hyperthyroidism, migraine, anaemia or any other causes of increased blood flow and circulation.
Diagnosis
Detailed medical history, examination and audiological assessment is required. Investigations including blood tests, MRI scan, MRA scan, CT temporal bones and occasionally Lumbar puncture.
Treatment Options
Management depends on the underlying cause. Can include a combination of Medical therapy, Blood pressure control, Migraine prophylaxis, surgery, stenting, tinnitus management techniques and tinnitus therapy.
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The Care Quality Commission (CQC) is a public body of the Department of Health and Social Care established to regulate and inspect health and social care services in England.
CQC registration is a marker for standards of care. It is a mandatory requirement of all organisations which provide vestibular care or diagnostics.
Harley Street Audiovestibular Clinic is fully registered and compliant with all the stringent CQC requirements, ensuring you care is in the best possible hands.
Pulsatile Tinnitus
Harley Street AVM provide diagnosis and treatment of pulsatile tinnitus that can mitigate the worst symptoms of this vexing condition. If you believe you suffer from pulsatile tinnitus there are two things to remember: you are not alone, and treatments are available for some forms of pulsatile tinnitus. Trust the experienced team at Harley Street AVM for reliable investigations and diagnosis.
What is Pulsatile Tinnitus?
Pulsatile tinnitus is usually not heard by others (like in objective tinnitus) and is typified by:
- A beating or throbbing sound in the ear, often in sync with your pulse.
- A sense of fullness or pressure inside the ear or ears.
- Issues with your balance or outright dizziness.
- Hearing loss in one or both ears.
- Migraines or headaches.
- Sounds that get louder when you lay down to sleep.
If you are experiencing any of the above, or a beating sound that gets louder during strenuous exercise, you may be experiencing pulsatile tinnitus. If so it is important that you seek professional help in order to obtain a proper diagnosis and to explore treatment options.
What Causes Pulsatile Tinnitus?
There are many more serious causes of pulsatile tinnitus compared to other types of tinnitus. Known causes include:
- Brain and Neck Blood vessel aneurysms
- Arterio-venous malformation – an abnormal connection between blood vessels.
- Hypertension (high blood pressure).
- Problems with the thyroid gland.
- Misshapen blood vessels in the ear.
- Anaemia
- Head and neck tumours.
- Atherosclerosis (hardening of the arteries in the ear).
Treatment Options
If you are diagnosed with pulsatile tinnitus, treatment will typically involve addressing the cause. Effective treatment of the cause can sometimes result in a cessation of the sounds. If the sound has not abated after the initial treatment additional treatments may be recommended, including:
- A wearable sound generator.
- White noise apps.
- A combination of sound therapy and counselling known as “tinnitus retraining”.
Contact Harley Street AVM
Symptoms of pulsatile tinnitus should not be ignored and a medical emergency. If you are experiencing any of the symptoms we mentioned above, get in touch with the experienced team at Harley Street AVM by calling us on 020 3480 9630, writing to info@harleyavm.com or using our contact form.
