Pulsatile Tinnitus: Causes and Concerns for Patients

Q: Pulsatile Tinnitus: Causes and Concerns for Patients

Hello Mr. <br>Wen： You asked, "Does an acoustic neuroma always result in hearing loss?" The hearing loss associated with acoustic neuroma typically progresses gradually. <br>Subsequently, as the tumor compresses the brainstem, other cranial nerve symptoms and cerebellar signs may

Tinnitus issues?

Hello Doctor: I have been experiencing pulsatile high-frequency tinnitus in my left ear for the past three months.
The tinnitus is persistent throughout the day, but it usually diminishes briefly after taking a hot shower, only to return shortly afterward.
A month ago, I visited a major hospital and underwent a hearing test in the otolaryngology department, which showed normal results.
Recently, I have noticed that my nose has been twitching frequently (which I rarely experienced before).
I tend to be quite anxious, and I'm unsure if this could have a direct impact.
I would like to ask if a tumor could directly affect the occurrence of these two issues (tinnitus and nose twitching).
Does an acoustic neuroma always result in hearing loss? Thank you for your response, and I wish you a Happy New Year.

Wen, 20~29 year old female. Ask Date: 2023/01/22

Dr. Jiang Junyi reply Neurology

Hello Mr.
Wen: You asked, "Does an acoustic neuroma always result in hearing loss?" The hearing loss associated with acoustic neuroma typically progresses gradually.
Subsequently, as the tumor compresses the brainstem, other cranial nerve symptoms and cerebellar signs may appear.
The "twitching of the nose" should raise concerns about facial nerve dysfunction.
For nerve repair, it is recommended to supplement with B vitamins and manage risk factors such as secondhand smoke, insomnia, and irregular lifestyle habits.
Thank you for your question, and feel free to discuss further.
If symptoms progress, I suggest consulting a neurologist for evaluation and treatment.
Wishing you good health and peace.
Dr.
Jiang Junyi, Taoyuan Medical Center, cares about you.

Reply Date: 2023/01/22

More Info

Pulsatile tinnitus is a type of ear ringing that is characterized by a rhythmic sound that often matches the heartbeat. It can be a concerning symptom for patients, particularly when it persists for an extended period, as in your case where it has lasted for three months. Understanding the potential causes and implications of pulsatile tinnitus is crucial for managing your health and addressing any underlying issues.

The causes of pulsatile tinnitus can vary widely. It may be related to vascular conditions, such as abnormalities in blood vessels near the ear, increased blood flow, or changes in blood pressure. Conditions like arteriovenous malformations (AVMs) or vascular tumors can lead to pulsatile tinnitus. Additionally, it can be associated with conditions affecting the middle ear, such as Eustachian tube dysfunction or otosclerosis, which can alter the normal flow of blood and sound in the ear.

In your case, the fact that the tinnitus seems to diminish after a hot shower may suggest that changes in blood flow or pressure are influencing your symptoms. Hot water can cause blood vessels to dilate, potentially affecting the sound you perceive in your ear. However, this is not a definitive diagnosis and should be further evaluated.

Regarding your concern about a tumor affecting both the tinnitus and the recent onset of nasal twitching, it is essential to consider that while certain tumors, such as acoustic neuromas (a type of tumor on the vestibulocochlear nerve), can cause tinnitus, they do not always present with hearing loss. Some patients may experience tinnitus without any significant changes in their hearing ability, especially in the early stages of the tumor's development. Acoustic neuromas typically cause unilateral hearing loss, but the absence of hearing loss does not rule out the possibility of a tumor.

The nasal twitching you mentioned could be a separate issue, potentially related to anxiety, stress, or even benign conditions like muscle spasms. Anxiety can exacerbate physical symptoms, including tinnitus, and may lead to increased awareness of bodily sensations, which can create a cycle of worry and discomfort. It is essential to address both the tinnitus and any anxiety you may be experiencing, as managing stress can sometimes alleviate symptoms.

Given the complexity of your symptoms, it would be advisable to follow up with an ear, nose, and throat (ENT) specialist for a comprehensive evaluation. They may recommend imaging studies, such as an MRI or CT scan, to rule out any structural abnormalities, including tumors. Additionally, discussing your anxiety with a healthcare professional may provide you with strategies to manage stress and its potential impact on your symptoms.

In summary, while pulsatile tinnitus can be alarming, it is essential to approach it with a thorough understanding of potential causes and implications. Regular follow-ups with healthcare providers, including ENT specialists and mental health professionals, can help you navigate your symptoms and ensure that any underlying conditions are appropriately addressed. Remember, early intervention and comprehensive care are key to managing health concerns effectively.

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