Pulsatile tinnitus symptoms
Tinnitus sounds can vary from person to person, but most people say their tinnitus sounds like:
People with pulsatile tinnitus can hear any of these sounds, or more of a thumping or throbbing, that seems to beat in time with their pulse. You can experience it in one or both ears.
What causes pulsatile tinnitus?
Compared to normal tinnitus, it’s more likely that an exact cause can be identified for pulsatile tinnitus. Most cases are caused by a change in the blood flow of the vessels near the ear, in the neck or head. This can happen for a number of reasons, including (but not limited to):
Things like strenuous exercise, pregnancy, certain medications, or a severe iron deficiency (anaemia) can cause an increase in general blood flow around the body. Fast-moving blood makes more noise than a slower blood flow.
If a blood vessel has an irregular shape it can cause the blood to flow faster and make more noise
A condition called atherosclerosis causes the artery to clog up with fatty substances and stops the blood flowing smoothly
Another cause of pulsatile tinnitus is an increased awareness of the blood flowing near the ears. This might happen if you have an ear condition that blocks outside noise and makes you more aware of internal sounds, including things like glue ear, a perforated eardrum or impacted earwax.
There is also a link between a condition known as benign or idiopathic intracranical hypertension, which is when the pressure inside your head is raised and can cause headaches, sight problems and pulsatile tinnitus. Its exact cause is still unknown, but it is more common in overweight women.
Treatment for pulsatile tinnitus
If an exact cause of pulsatile tinnitus is found, then treatment will be based on the underlying condition, which would be taking some medication or even surgery in some cases.
Otherwise, treatment for pulsatile tinnitus will involve therapy techniques to help your brain to ignore your tinnitus sounds and reduce the impact it can have on your everyday life. These can include:
Sound therapy and learning distraction techniques
Cognitive behavioural therapy (CBT)
Tinnitus retraining therapy (TRT)
Diagnosing pulsatile tinnitus
Pulsatile tinnitus will usually be diagnosed by a doctor. They’ll ask you about your medical history as well as the symptoms you’ve been having. They’ll also examine your ears and assess the blood vessels of the neck.
Sometimes the doctor will be able to hear your pulsatile tinnitus using a stethoscope on your neck or skull – this is known as objective tinnitus.
The may also want to carry out some other tests which can include:
MRI or CT scan
Angiography (a way of assessing the inside of blood vessels)
Blood test (to check for anaemia, for example)
Pulsatile tinnitus in one ear
Pulsatile tinnitus usually only occurs in one ear, but some people may experience it in both.
The seriousness of tinnitus will vary from person to person. Any case of pulsatile tinnitus will need to be referred on to see an ENT (ear, nose and throat specialist) so that further tests can be carried out and to investigate any potential causes.
Some cases of pulsatile tinnitus can go away on its own, but this will depend on its underlying cause. For example, once your blood pressure has calmed down after strenuous exercise.
Pulsatile tinnitus is usually a symptom of a blood vessel change around the ear, head and neck. Sometimes it can be caused by reduced hearing from a different ear condition (like glue ear or a perforated eardrum) that means you can hear internal sounds more than external. It can also be a symptom of another condition, called benign or idiopathic intracranial hypertension.
There is no evidence to suggest that stress causes any form of tinnitus. However, there is evidence to suggest that tinnitus can sometimes happen after or during a stressful or anxious period of time.
It’s also thought that stress can worsen existing tinnitus, which in turn can lead to further stress and anxiety.
A throbbing or thumping sound in the ear is a common symptom of pulsatile tinnitus.
It’s best to go and seek advice from your GP if you experience symptoms of pulsatile tinnitus.
The most common cause of pulsatile tinnitus is a change in the blood vessels around the ear, head or neck.