Pulsatile Tinnitus: What It Is and Treatments (2024)

Pulsatile tinnitus is a form of tinnitus that results in a person hearing whooshing, thumping, or throbbing in their ears. It can occur in one or both ears and often presents rhythmically with a person’s heartbeat. Pulsatile tinnitus can be mild only a minor annoyance, or it can be so intense that it becomes debilitating.

This article discusses the symptoms, causes, and treatment options for pulsatile tinnitus.

Pulsatile Tinnitus: What It Is and Treatments (1)

Types of Pulsatile Tinnitus

The three types of pulsatile tinnitus, categorized by where the sound originates, are:

  • Arterial: Arteries only
  • Arteriovenous: Arteries and veins
  • Venous: Veins only

The type is important because it helps narrow down where the issue stems from, assisting healthcare providers in diagnosing and treating the condition.

What Are the Symptoms of Pulsatile Tinnitus?

The main sign of pulsatile tinnitus is regularly hearing sounds, such as a beat. Other sounds can be:

  • Buzzing
  • Ringing
  • Whistling
  • Thumping
  • Whooshing

Unlike other forms of tinnitus, the sounds in pulsatile tinnitus come from a physical source. For example, sounds can develop because of changes in blood flow in veins or arteries near the ear.

They can also develop because the normal flow of sounds from within the body is met with an increase in bone conduction. Bone conduction helps to transmit acoustic vibrations so that sounds can be heard.

The Pulsatile Tinnitus Rhythm Origin

The sound heard in pulsatile tinnitus comes from blood flow and is often in the same rhythm as the pulse. Essentially, people with this condition can hear their hearts beating from the inside.

What Causes Pulsatile Tinnitus?

Pulsatile tinnitus is often considered a symptom of vascular or other issues with vascular health, such as the structure or blood flow through veins and arteries. Possible causes include:

  • Atherosclerosis: The hardening of plaque in the arteries resulting in blow flood interruptions
  • Aneurysms: Ballooning in blood vessel walls
  • Structural changes in the veins or arteries
  • Fistulas (irregular connections) in the veins or arteries
  • Tumors (abnormal masses) within blood vessels in the ear
  • Head or neck tumors
  • Capillary hyperemia: An increased amount of blood in the capillaries
  • An increase in intracranial (skull) pressure
  • Congenital (from birth) changes to the veins and arteries
  • Transverse sinus stenosis: A narrowing of the two areas under the brain that allow blood to drain from the back of the head
  • Paraganglioma: A type of tumor that forms near blood vessels and nerves by the adrenal glands
  • Lesions in the vascular system: Clusters of blood vessel growth
  • Anemia: Lack of healthy red blood cells
  • High blood pressure (hypertension)
  • Paget’s disease: A disease of the bone that disrupts normal bone remodeling (new bone tissue replacing old bone tissue)
  • Sigmoid sinus diverticulum: Small pouches push through the sigmoid sinus wall into the mastoid bone that sits right behind the ear
  • Bone loss in the temporal bone (a bone in the skull)
  • Tumors of the temporal bone
  • Inflammatory hyperemia: Extra blood flow and volume of blood
  • Cholesterol granulomas: Benign (noncancerous) cysts in the temporal bone
  • Perilymph fistula: A tear in the membrane that separates the inner and middle ear
  • Hyperthyroidism (overactive thyroid)
  • Conductive hearing loss: A blockage in the ear canal
  • Head trauma (injury)

In as many as 30% of pulsatile tinnitus cases, no cause is found.

Is Pulsatile Tinnitus Serious?

Since many health disorders can cause pulsatile tinnitus, it can be either mild or dangerous. It highly depends on the cause; some are benign, while others can be life-threatening.

How Is Pulsatile Tinnitus Diagnosed?

Diagnosing pulsatile tinnitus involves collecting a health history and a list of symptoms. If a medical provider suspects pulsatile tinnitus, they will investigate the cause of the symptom. Some possible tests used to do this are:

  • Magnetic resonance imaging (MRI) to closely examine the tissues in the neck and ears
  • Magnetic resonance angiography (MRA) to check for issues within the blood vessels located in the head and neck
  • Computed tomography (CT) or computed tomography angiography (CTA) to perform a scan using body-safe dye to highlight the problems within blood vessels and tissues
  • Temporal bone CT scan to check for bone loss or abnormalities
  • Ultrasound to examine tissue in the neck and ears
  • Blood tests to check for thyroid function and anemia

In some cases, digital subtraction angiography (DSA) will be used. This is typically a last resort if other imaging tests do not provide enough information.

During the procedure, a small and thin tube known as a catheter will be placed into a leg artery and sent toward blood vessels in the brain. The dye that highlights issues within blood vessels goes through the catheter, and an X-ray takes a picture of the blood vessels.

Why Proper Diagnosis is Crucial

Pulsatile tinnitus can come before a stroke or bleeding in the brain. That is why it’s vital to get adequate testing at the first sign of symptoms.

New Device Could Provide Long-Term Relief from Tinnitus Symptoms

How Is Pulsatile Tinnitus Treated?

Treatment for pulsatile tinnitus begins with addressing the underlying cause. Because of that, treatments can vary widely. The good news is that once the underlying condition is treated effectively, pulsatile tinnitus symptoms will often go away completely.

Possible treatments can include:

  • Lifestyle changes: Quitting smoking, losing excess weight, and engaging in regular exercise may be advised.
  • Medications: To treat specific health disorders, such as anemia or hyperthyroidism, drugs will be prescribed.
  • Surgery: If a structural problem or a tumor is causing the issue, surgery may be needed.

Treatment for No-Cause Pulsatile Tinnitus

In the event a cause isn’t found, healthcare providers will suggest other management techniques, such as:

  • Sound therapy to help suppress the noises
  • White noise machines or other wearable noise-suppressing devices
  • Meditation and relaxation techniques
  • Tinnitus retraining therapy to teach coping techniques
  • Cognitive behavioral therapy, a common form of talk therapy

Natural Remedies for Tinnitus

Summary

Pulsatile tinnitus is a form of tinnitus that involves hearing whooshing, thumping, or buzzing in the ears that seem to be in rhythm with your heartbeat. The sounds can be mild and not affect your day-to-day life, but they can be debilitating in many cases.

Healthcare providers may conduct various imaging tests to help diagnose pulsatile tinnitus because there are many possible causes. Since a person experiencing the symptoms can be at risk for stroke or bleeding in the brain, it’s vital to get a proper diagnosis as soon as possible.

Healthcare providers will treat the underlying cause instead of the symptom unless there is no identifiable condition that causes it. In that case, you must manage your condition through various techniques, including sound therapy. If you experience pulsatile tinnitus, contact your healthcare provider immediately. It is curable; the faster you seek treatment, the better it will be for you.

4 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Hofmann E, Behr R, Neumann-Haefelin T, Schwager K. Pulsatile tinnitus: Imaging and differential diagnosis. Dtsch Arztebl Int. 2013 Jun;110(26):451-8. doi:10.3238/arztebl.2013.0451

  2. UCSF Department of Radiology and Biomedical Imaging. Pulsatile tinnitus causes and treatments.

  3. Pegge SAH, Steens SCA, Kunst HPM, Meijer FJA. Pulsatile tinnitus: Differential diagnosis and radiological work-up. Curr Radiol Rep. 2017;5(1):5. doi:10.1007/s40134-017-0199-7

  4. Penn Medicine. Pulsatile tinnitus.

Pulsatile Tinnitus: What It Is and Treatments (2)

By Angelica Bottaro
Bottaro has a Bachelor of Science in Psychology and an Advanced Diploma in Journalism. She is based in Canada.

See Our Editorial Process

Meet Our Medical Expert Board

Was this page helpful?

Thanks for your feedback!

What is your feedback?

Pulsatile Tinnitus: What It Is and Treatments (2024)

FAQs

What is the most effective treatment for pulsatile tinnitus? ›

Treating Underlying Health Conditions for Pulsatile Tinnitus

If your evaluation reveals that a blood vessel disorder or malformation, tumor or ear abnormality is causing your pulsatile tinnitus, your doctor will likely recommend otological or neurological surgery to correct that underlying condition.

What is the number one cause of pulsatile tinnitus? ›

Venous sinus stenosis/IIH is the most common cause of pulsatile tinnitus. Dural arteriovenous fistula is the most potentially dangerous cause of pulsatile tinnitus. Our team are experts in the diagnosis and treatments of all causes of pulsatile tinnitus.

How can I stop pulsatile tinnitus naturally? ›

Relaxation techniques, such as breathing exercises, mindfulness, and meditation, may also reduce the impact pulsatile tinnitus can have on everyday life. Cognitive behavioral therapy (CBT) aims to change the way people react to their tinnitus rather than remove the actual sounds.

What is the prognosis for pulsatile tinnitus? ›

The prognosis for pulsatile tinnitus varies considerably based on the etiology. Pulsatile tinnitus due to extensive cardiovascular disease may have a detrimental impact on patient morbidity and mortality. However, other causes may have no serious long-term effects on the patient.

What worsens pulsatile tinnitus? ›

Pulsatile tinnitus symptoms can increase or decrease when you lie down or turn your head. Symptoms can also change when you put pressure on the jugular vein.

What vitamin helps with pulsatile tinnitus? ›

Deficient vitamin B12 levels may also lead to damage in the tiny blood vessels in the ear. Both factors could contribute to tinnitus symptoms. Additionally, study participants with vitamin B12 deficiency and tinnitus reported a reduction in tinnitus symptom severity following therapy with vitamin B12 injections.

What will an ENT do for pulsatile tinnitus? ›

If your ENT specialist finds a specific cause for your tinnitus, they may be able to offer specific treatment to eliminate the noise. This may include removing wax or hair from your ear canal, treating middle ear fluid, treating arthritis in the jaw joint, etc.

What causes pulsatile tinnitus to stop? ›

Pulsatile tinnitus can disappear, but this will vary on a case-by-case basis and depend entirely on the underlying cause. Common occurrences of pulsatile tinnitus, such as during exercise when blood pressure increases, tend to abate once the body regulates itself.

Should I go to the ER for pulsatile tinnitus? ›

Facial paralysis, severe vertigo, or sudden onset pulsatile tinnitus can indicate a seri- ous intracranial condition. These symptoms may point to cerebrovascular disease or neo- plasm, and should be treated as an otologic emergency.

What kind of doctor do you see for pulsatile tinnitus? ›

The ENT doctor will likely also order a brain and neck imaging study. If the tinnitus is only present in one ear, it is best to also see a specialist such as a neurosurgeon or neurointerventional doctor specializing in pulsatile tinnitus.

Can ear drops help pulsatile tinnitus? ›

The short answer is no. There is no evidence to support ear drops, prescription or OTC, as a valuable treatment option for the majority of those who suffer from tinnitus. This is because 90% of tinnitus cases result from sensorineural hearing loss, which is permanent damage to the inner hair cells within the cochlea.

What is the simple trick to stop tinnitus? ›

If tinnitus is especially noticeable in quiet settings, try using a white noise machine to mask the noise from tinnitus. If you don't have a white noise machine, a fan, soft music or low-volume radio static also may help. Limit alcohol, caffeine and nicotine.

What happens if pulsatile tinnitus is left untreated? ›

The most common causes of pulsatile tinnitus are abnormalities of the carotid artery or jugular venous systems, which may require treatment. If left untreated, however, some vascular abnormalities can lead to catastrophic outcomes.

What medication is used for pulsatile tinnitus? ›

Pulsatile tinnitus: treatment with clonazepam and propranolol.

Can pulsatile tinnitus be caused by anxiety? ›

There may be a link between anxiety and pulsatile tinnitus, as many people with pulsatile tinnitus also experience anxiety. However, anxiety is unlikely to directly cause it. Pulsatile tinnitus typically occurs due to an underlying condition, such as atherosclerosis or blood vessel disorders.

What deficiency causes pulsatile tinnitus? ›

Iron deficiency can lead to pulsatile tinnitus, where those affected can hear their pulse or heartbeat in their ears. Pulsatile tinnitus must be reported right away as it might indicate a serious heart condition.

Do you need surgery for pulsatile tinnitus? ›

If a vascular or osteological source of pulsatile tinnitus is identified (e.g. tumors, malformations, etc.), otological or neurological surgery is most often needed to correct, according to Dr. Brant. This is occasionally combined with adjunct therapy (i.e., stenting for aneurysms).

References

Top Articles
Latest Posts
Recommended Articles
Article information

Author: Prof. Nancy Dach

Last Updated:

Views: 6235

Rating: 4.7 / 5 (77 voted)

Reviews: 84% of readers found this page helpful

Author information

Name: Prof. Nancy Dach

Birthday: 1993-08-23

Address: 569 Waelchi Ports, South Blainebury, LA 11589

Phone: +9958996486049

Job: Sales Manager

Hobby: Web surfing, Scuba diving, Mountaineering, Writing, Sailing, Dance, Blacksmithing

Introduction: My name is Prof. Nancy Dach, I am a lively, joyous, courageous, lovely, tender, charming, open person who loves writing and wants to share my knowledge and understanding with you.