To begin with, what is pulsatile tinnitus? This is a type of tinnitus in which sufferers experience a sound that beats in time with the pulse. This type of tinnitus is also known as vascular tinnitus. In simpler terms, people hear something like their heartbeat in their ears.
People who suffer from pulsatile tinnitus may experience single or multiple rhythmic heartbeats that are usually heard as a low pitched thud or rumbling noise, or as a higher pitched click.
Although pulsatile tinnitus is not a common form of tinnitus, it does have some well-known causes including high blood pressure, heart murmur, balloon-shaped tumor, or due to a disorder in the vein or artery. In most cases, pulsatile tinnitus can be treated effectively and permanently.
The main known cause of pulsatile tinnitus is due to irregular blood flow in the large veins and arteries of the neck, the base of the skull, or even the smaller blood vessels inside the ears.
There are several factors that can influence blood flow. For starters, a systemic increase in blood supply that can occur during strenuous exercise or can be due to a severe lack of sufficient blood.
Another cause of pulsatile tinnitus is decreased blood supply to the veins that supply blood to the ears due to the veins. This forces the sister blood vessels to supply extra blood, which overloads them. This additional blood load to the veins causes a noise in the head known as vascular tinnitus.
The increased blood load stiffens the blood vessels, making the blood flow rough and causing pulses.
If pulsatile tinnitus is suspected, extensive tests should be done on the circulatory system, mainly on the vascular vessels, including checking the pressure in the head.
Some of the tests that need to be done to confirm pulsatile tinnitus include:
1. Ultrasound
2. CT scan
3. Magnetic resonance imaging (MRI) scan
4. Magnetic Resonance Angiography (MRA) or Angiography
Now let’s discuss the most common causes of pulsatile tinnitus.
1. Carotid Artery Cavernous Sinus Fistula: This is an abnormal connection between the large artery and the venous pool within the cranial cavity, usually as a result of severe head trauma.
2. Arteriovenous Malformations (AVMS): This is an abnormal group of arteries and veins that occur within the cranial cavity near the auditory nerve.
3. Long-term infection or inflammation of the middle part of the ear. Due to chronic inflammation, blood flow to the affected tissue increases, which increases the pressure on the tissue.
The increased pressure due to increased blood flow to the ears causes sufferers to hear sounds similar to their heartbeat and this is known as vascular tinnitus.
4. The accumulation of fluids in the middle ear is the fourth cause of vascular tinnitus that we are going to see.
The middle ear is normally filled with air and under normal circumstances there should not be any fluid in it.
Fluid can build up as a result of a Eustachian tune malfunction.
These circumstances will often lead to vascular tinnitus.
5. Another well-known cause of pulsatile tinnitus is vascular tumors in the middle ear.
This is often called a glomus because of the generally balloon shape of these tumors. In cases where these tumors have been confirmed, surgical intervention is the preferred option.
6. The sixth cause of vascular tinnitus is atheroma.
Atheroma is a fatty deposit in the inner lining of an artery. This fatty deposit causes narrowing or partial blockage of the arteries, which obstructs the flow of blood to the ears.
Atheroma is the result of increased levels of low-density lipoproteins in short LDL.
Due to the diversity of causes of pulsatile tinnitus, treatment depends on the specific cause of each individual case. In the event that high blood pressure is the cause of pulsatile tinnitus, lowering the pressure to the optimal level will take care of your tinnitus.
As we had discussed earlier, surgery will be required in case you have any growth in your ears.
The atheroma will be resolved by lowering the LDL and thus reducing the obstruction of blood flow in the arteries.
By now you know the six main causes of pulsatile tinnitus and, like any other tinnitus sufferer, you are eager to get rid of it permanently, but there is something you still don’t know.
What You Don’t Know Yet: I know that what I’m about to reveal to you may be almost impossible to believe.
