Pulsatile tinnitus is a rhythmic whooshing, thumping, or pulsing sound perceived within one or both ears. This internal sound often synchronizes with an individual’s heartbeat, distinguishing it from other forms of tinnitus like ringing or buzzing. Given that earwax is a common and usually harmless ear issue, a natural question arises regarding its potential connection to this specific type of auditory perception.
Understanding Pulsatile Tinnitus
Pulsatile tinnitus is characterized by a sound that typically matches the rhythm of a person’s pulse, often described as a “whoosh” or “thump.” Unlike other forms of tinnitus, which can be constant and without a clear pattern, pulsatile tinnitus is frequently linked to a detectable change in blood flow or sound perception within or near the ear. It often has an identifiable physical origin.
The sounds experienced in pulsatile tinnitus arise from the body’s internal processes, particularly blood flow through vessels close to the ear. These sounds are usually present but are typically unnoticed due to the masking effect of external environmental sounds. When these internal sounds become noticeable, it often indicates an alteration in their volume, the pathway they travel, or the ear’s ability to perceive them.
Earwax and Pulsatile Tinnitus
Earwax does not directly create the pulsatile sound, as this sound originates from the flow of blood within the body’s vascular system. However, excessive or impacted earwax can significantly influence how these internal sounds are perceived. When earwax builds up and completely blocks the ear canal, it acts as an obstruction, preventing external sounds from effectively reaching the eardrum. This reduction in external noise can then make the sounds of blood flow within nearby arteries and veins much more prominent.
A significant earwax blockage can also alter the acoustics within the ear canal, amplifying how internal vibrations are conducted to the eardrum. This amplified conduction can cause pulse-synchronized sounds from blood vessels to be perceived as pulsatile tinnitus. The pressure exerted by a large earwax impaction on the eardrum or ear canal walls might also contribute to an increased awareness of these internal bodily sounds. Removing the earwax often resolves the pulsatile tinnitus in such cases, highlighting its role as an amplifying factor rather than a direct cause.
Other Potential Causes of Pulsatile Tinnitus
Beyond earwax, other conditions can lead to pulsatile tinnitus, often involving the vascular system or structural elements near the ear. Conditions affecting blood vessels are common causes, as altered blood flow dynamics can make normally unnoticed sounds audible.
Vascular Issues
Atherosclerosis: Hardening and narrowing of arteries, creating turbulent blood flow.
Carotid artery stenosis: Narrowing of the main arteries supplying blood to the head and brain, producing turbulent flow.
Venous hums: Sounds produced by normal blood flow through large veins that become audible under certain conditions.
Arteriovenous malformations: Abnormal connections between arteries and veins that can cause noisy, turbulent blood flow.
Structural Changes
Structural changes within or near the ear can also be a factor. Examples include glomus tumors, which are benign, highly vascular tumors located in the middle ear or jugular bulb, and a dehiscent jugular bulb, a condition where part of the jugular vein’s bony covering is missing, allowing sounds to be transmitted more easily.
Systemic Conditions
Systemic conditions can also manifest as pulsatile tinnitus. Anemia (low red blood cell count) can lead to increased blood flow velocity. Hyperthyroidism (an overactive thyroid gland) can increase metabolic rate and blood flow. High blood pressure, while not always a direct cause, can sometimes exacerbate the perception of existing vascular sounds. Increased intracranial pressure, often due to conditions like idiopathic intracranial hypertension, can also lead to pulsatile tinnitus by affecting blood flow dynamics within the head.
When to Seek Medical Attention
Anyone experiencing pulsatile tinnitus should seek medical attention, especially if the sound is new, persistent, or accompanied by other symptoms. Consulting a healthcare professional is important for an accurate diagnosis, as underlying causes can range from benign conditions like earwax impaction to more serious medical issues. A doctor can perform a physical examination, including otoscopy to inspect the ear canal for earwax or other abnormalities.
Further diagnostic tests may be recommended. These could include imaging studies such as Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scans to visualize blood vessels and surrounding structures, or an audiogram to assess hearing function. The specific treatment for pulsatile tinnitus depends on the identified underlying cause. Solutions can be as straightforward as earwax removal or may involve managing complex medical conditions through medication, lifestyle changes, or surgical intervention.