Pulsatile Tinnitus: Causes and Concerns

Unilateral ear pulsation?

In the past month, I have experienced intermittent pulsating sounds in my right ear, resembling a heartbeat.
Each episode lasts for about ten seconds, followed by a minute of normalcy, and then it repeats for approximately ten seconds.
Each occurrence lasts for about ten minutes, and this has happened around five times in the past month.
I would like to know what this condition might be and whether it could be related to prolonged use of headphones for listening to music.
Thank you.

Dà Wáng, 20~29 year old female. Ask Date: 2017/02/11

Dr. Ji Zhaoyun reply Otolaryngology

Hello Mr.
Wang,
The issues you mentioned could possibly be due to: 1) Eustachian tube dysfunction: This is the most common cause and can occur not only during flying, mountain climbing, or diving, but also when forcefully blowing your nose or bending over.
Rapid changes in body weight can also contribute to this condition.
2) Variations in cervical blood vessels: There are numerous blood vessels in the neck, and if those near the ear undergo variations, it could lead to such symptoms.
If there is also associated hearing loss, it may indicate sudden sensorineural hearing loss, and you should go to the hospital for a pure tone audiometry test (which requires headphones in a soundproof booth, where you will need to press a button in response to sounds, rather than just using a tuning fork).
Prolonged use of headphones to listen to music can significantly damage your hearing, so it should be avoided as much as possible.
If the above symptoms persist, it is advisable to consult an otolaryngologist.

Wishing you safety and good health.

Sincerely,
Dr.
Chi Chao-Yun,
Director of the Department of Otolaryngology, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2017/02/11

More Info

Pulsatile tinnitus is a type of tinnitus characterized by hearing a rhythmic sound that often corresponds to the heartbeat. This condition can be quite distressing, as it creates the sensation of hearing one's own pulse in the ear. Your description of experiencing a pulsing sound in your right ear for about ten seconds, followed by a minute of normalcy, and then repeating this cycle for several minutes, is consistent with pulsatile tinnitus.

There are several potential causes of pulsatile tinnitus, and understanding these can help in determining the underlying issue. Some common causes include:
1. Vascular Issues: Pulsatile tinnitus is often related to blood flow changes in the vessels near the ear. Conditions such as arteriovenous malformations, vascular tumors, or increased blood flow due to conditions like anemia can lead to this type of tinnitus.

2. Middle Ear Conditions: Issues within the middle ear, such as Eustachian tube dysfunction or middle ear infections, can also cause pulsatile tinnitus. These conditions can affect how sound is transmitted and perceived.

3. Intracranial Pressure Changes: Increased intracranial pressure can lead to changes in blood flow and may cause pulsatile tinnitus. This can be due to various factors, including certain medical conditions or medications.

4. Muscle Spasms: In some cases, muscle spasms in the middle ear can create a rhythmic sound that mimics pulsatile tinnitus. This is less common but can occur.

5. Hearing Loss: While not a direct cause, hearing loss can sometimes accompany tinnitus. If you have been exposed to loud sounds, such as listening to music through headphones for extended periods, it could contribute to auditory changes.

Regarding your concern about prolonged headphone use, while it is more commonly associated with noise-induced hearing loss, it can also exacerbate existing tinnitus or create a perception of sounds that may not be present. However, it is less likely to be the direct cause of pulsatile tinnitus unless there is an underlying vascular or structural issue.

It is essential to consult with a healthcare professional, preferably an otolaryngologist (ear, nose, and throat specialist), to evaluate your symptoms further. They may recommend imaging studies, such as an MRI or CT scan, to rule out any vascular abnormalities or other structural issues. Additionally, they may perform a thorough examination of your ears and assess your overall health to identify any contributing factors.

In summary, pulsatile tinnitus can arise from various causes, and understanding these can help in managing the condition. If your symptoms persist or worsen, seeking medical advice is crucial for proper diagnosis and treatment.

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