Pulsatile tinnitus is a type of tinnitus characterized by a rhythmic sound in the ears, often described as a whooshing, throbbing, or heartbeat. Unlike other forms of tinnitus, which may be a constant ringing or buzzing, pulsatile tinnitus is synchronized with an individual’s pulse. This rhythmic quality often indicates an underlying medical cause.
Understanding Pulsatile Tinnitus
Pulsatile tinnitus involves the perception of a rhythmic sound that mirrors the listener’s heartbeat, often described as a “whoosh,” “throb,” or “pulse.” This differs from non-pulsatile tinnitus, which typically presents as a continuous ringing or buzzing. The rhythmic quality suggests a connection to blood flow or vascular activity.
A notable characteristic is that it can be “objective,” meaning a medical professional might hear the sound with a stethoscope near the ear or neck. This contrasts with subjective tinnitus, which is only audible to the affected individual. A doctor’s ability to hear the sound provides important clues about its origin, often indicating an underlying physical cause related to the circulatory system or altered blood flow dynamics.
Does Pulsatile Tinnitus Resolve Spontaneously?
Pulsatile tinnitus rarely resolves on its own because it is almost always a symptom of an underlying medical condition. Unlike temporary forms of tinnitus linked to noise exposure or earwax buildup, its rhythmic nature strongly suggests a specific physiological cause. Therefore, simply waiting for the symptom to disappear is generally not an effective approach.
While mild or transient cases might occasionally occur, such as due to temporary changes in blood pressure, persistent pulsatile tinnitus warrants medical investigation. The sound often indicates an alteration in blood flow or a structural issue requiring targeted intervention. Addressing the root cause is typically necessary for the sound to diminish or cease.
Common Causes of Pulsatile Tinnitus
Pulsatile tinnitus stems from various underlying conditions, primarily involving issues with blood flow or structural abnormalities. Vascular problems are frequent culprits, as altered blood flow through vessels near the ear can create audible sounds. Conditions such as atherosclerosis, where arteries narrow due to plaque buildup, can cause turbulent blood flow that is perceived as a pulsing sound. Arteriovenous malformations (AVMs), which are abnormal connections between arteries and veins, can also lead to pulsatile tinnitus.
Aneurysms, balloon-like bulges in a blood vessel, and dural arteriovenous fistulas, abnormal connections between arteries and veins in the brain’s covering, can similarly produce turbulent flow. Venous hums, caused by turbulent blood flow in large veins near the ear, are another common vascular cause. Elevated blood pressure can also increase the force of blood flow, making it more audible.
Beyond vascular issues, certain ear-related conditions can contribute to pulsatile tinnitus. These include glomus tumors, which are benign but vascular tumors in the middle ear or jugular bulb, causing a pulsing sound. Issues with the eustachian tube, such as patulous eustachian tube where it remains abnormally open, can also allow blood flow sounds to be perceived.
Additionally, systemic conditions like anemia, which increases blood flow velocity, or hyperthyroidism, which elevates metabolic rate and blood circulation, may lead to pulsatile tinnitus. Increased intracranial pressure, often termed idiopathic intracranial hypertension, can also manifest with a pulsing sound due to altered cerebrospinal fluid dynamics affecting venous outflow.
Diagnosis and Management
Prompt medical attention is important for pulsatile tinnitus, as it often signals an underlying condition requiring diagnosis and treatment. A primary care physician or an otolaryngologist (ENT specialist) is typically the first contact for evaluation. The diagnostic process begins with a thorough medical history, including the sound’s characteristics, duration, and any associated symptoms.
A physical examination follows, which may include listening for the sound with a stethoscope over the neck and around the ear. Imaging tests are frequently necessary to identify the specific cause. These can include magnetic resonance imaging (MRI) or magnetic resonance angiography (MRA) to visualize blood vessels and soft tissues, computed tomography (CT) scans to assess bone structures, and sometimes conventional angiography for detailed blood flow visualization.
Management focuses on addressing the identified underlying cause. If high blood pressure is the culprit, medication may be prescribed. Surgical intervention might be necessary for vascular malformations or tumors. Conditions like anemia or hyperthyroidism are managed with appropriate medical treatments. When a specific cause cannot be identified or fully resolved, symptom management strategies, such as sound therapy or counseling, may be employed to help individuals cope with the persistent sound.