Straightforward Information About Tinnitus
Pulsatile tinnitus is a distinct form of tinnitus where the perceived sound follows a rhythmic pattern, typically in time with the heartbeat. Unlike the more common forms of tinnitus, pulsatile tinnitus often has an identifiable physical source and may require different diagnostic approaches.
While most tinnitus is subjective and originates from neural activity in the auditory system, pulsatile tinnitus frequently falls into the objective tinnitus category. It is often caused by blood flow that the ear can detect — either because the flow is turbulent, because a blood vessel is unusually close to the ear structures, or because something is amplifying the sound of normal blood flow.
People typically describe pulsatile tinnitus as a whooshing, thumping, or pulsing sound. You may notice it more when lying down, exercising, or when the room is quiet.
High blood pressure — Elevated blood pressure can make blood flow more forceful and turbulent, especially in the arteries near the ear.
Atherosclerosis — Hardening and narrowing of the arteries can create turbulent blood flow that produces a detectable sound.
Venous hum — Variations in the jugular vein or other large veins near the ear can cause an audible hum, particularly when turning the head.
Arteriovenous malformations (AVMs) — Abnormal connections between arteries and veins can create turbulent flow near the ear.
Glomus tumors — These are benign vascular tumors that can grow near the middle ear. They are treatable but require medical evaluation.
Idiopathic intracranial hypertension (IIH) — Increased pressure in the fluid surrounding the brain can cause pulsatile tinnitus, often accompanied by headaches and visual changes.
Middle ear conditions — Fluid in the middle ear, Eustachian tube dysfunction, or middle ear muscle spasms can sometimes produce pulsatile sounds.
Pulsatile tinnitus should always be evaluated by a medical professional. While many cases turn out to be benign (such as those related to mild hypertension or benign venous hum), it is important to rule out conditions that may require treatment. Seek evaluation promptly if you experience:
Pulsatile tinnitus in only one ear, sudden onset of pulsatile tinnitus, pulsatile tinnitus accompanied by headaches or vision changes, or any pulsatile tinnitus that you can feel as well as hear.
See When to See a Doctor About Tinnitus for general guidance on seeking help. Your doctor may refer you to an ENT specialist or order imaging studies such as an MRI, CT angiogram, or ultrasound of the blood vessels in the head and neck.
Because pulsatile tinnitus often has a specific cause, treatment may be more targeted than for other forms of tinnitus. Treating underlying high blood pressure, repairing a vascular abnormality, or managing IIH can sometimes resolve the tinnitus entirely. This makes proper diagnosis especially important.
For more information, the Whooshers.com community is a resource specifically for people with pulsatile tinnitus.