
A whooshing sound in the ear, also known as pulsatile tinnitus, is often a rhythmic pulsing noise that occurs in sync with the heartbeat. While it is not always dangerous, it can sometimes indicate an underlying vascular or neurological condition that requires medical attention. Pulsatile tinnitus is caused by blood flow changes near the ears or head, with blood vessels close to the middle ear usually being the cause. It can be caused by various factors, including high blood pressure, stress, head trauma, and arteriovenous malformations. While some cases of pulsatile tinnitus may resolve on their own or be treated with medication, others may require targeted treatment or minimally invasive procedures. If you are experiencing a whooshing sound in your ear, it is important to consult a healthcare professional for a thorough evaluation to determine the underlying cause and appropriate treatment.
| Characteristics | Values |
|---|---|
| Name of the phenomenon | Pulsatile Tinnitus |
| Description | Rhythmic swooshing or whooshing noise inside the head that often keeps pace with the pulse |
| Occurrence | Rare, accounts for about 10% of the estimated 50 million people who have tinnitus |
| Causes | Atherosclerosis, Sinus Wall Abnormalities, Arteriovenous Malformations, High Blood Pressure, Tumors, Head Trauma, Anxiety, Stress, Idiopathic Intracranial Hypertension, etc. |
| Treatment | Medication, Lifestyle changes, Minimally invasive procedures, Sound therapy, Cognitive Behavioral Therapy, Tinnitus Retraining Therapy, etc. |
| When to see a doctor | If you suddenly hear a rhythmic swooshing sound in your head, hear that sound in one ear only, or have other issues like difficulty walking, balance troubles, or difficulty seeing |
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Pulsatile tinnitus
People with pulsatile tinnitus are often able to hear their heartbeat in their ears due to blood flow near the auditory system. This is usually caused by disorders or malformations in the blood vessels and arteries, especially those near the ears. These abnormalities or disorders, including aneurysms and arteriovenous malformations, can cause a change in the blood flow through the affected blood vessels. For example, high blood pressure can cause turbulent blood flow through the carotid artery, resulting in a pulsating sound. In some cases, pulsatile tinnitus is caused by an enhanced ability to hear normal blood flow.
While pulsatile tinnitus is often benign, it can be a symptom of a more serious underlying condition. For example, it can be caused by idiopathic intracranial hypertension, a buildup of cerebrospinal fluid around the brain that can lead to permanent vision loss if untreated. Pulsatile tinnitus can also be caused by sigmoid sinus diverticulum, where small pouches protrude through the wall of the sigmoid sinus into the mastoid bone behind the ear. This can result in symptoms such as headaches, double vision, and pain behind the eye.
If you are experiencing pulsatile tinnitus, it is important to seek medical evaluation as it may indicate an underlying vascular or neurological condition that requires treatment. Healthcare providers will typically use a stethoscope to listen to the neck and skull and may perform imaging tests such as angiography to examine the blood vessels. While pulsatile tinnitus is rarely life-threatening, it can be very disruptive to daily life, and treatments are available to reduce the noise and improve quality of life.
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Vascular disease
Pulsatile tinnitus is a rare form of tinnitus, affecting around 3-5 million Americans. It is characterised by a rhythmic swooshing or whooshing noise inside the head, which often keeps pace with the person's pulse. This is caused by turbulent blood flow in the veins and arteries near the ears, which can be the result of vascular disease.
High blood pressure, or hypertension, can also lead to pulsatile tinnitus. This can be caused by various factors, including stress, alcohol, caffeine, severe anaemia, or an overactive thyroid gland. These factors can increase blood flow speed and volume, leading to a louder whooshing sound.
In addition, arteriovenous malformations, or tangles of blood vessels affecting the connections between veins and arteries, can cause pulsatile tinnitus if they are located near the ears. Sinus wall abnormalities (SWAA) can also lead to pulsatile tinnitus by increasing blood flow and creating noise inside the sinus channel near the brain.
While pulsatile tinnitus is often not dangerous, certain underlying causes can be serious. For example, dural arteriovenous fistula is a potentially dangerous cause that requires medical attention. Additionally, untreated pulsatile tinnitus caused by issues with the blood vessels in the head or neck can lead to blindness, stroke, or even death in rare cases. Therefore, it is important to consult a doctor to determine the root cause and receive appropriate treatment.
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Neurological conditions
Pulsatile tinnitus is a rare condition that accounts for about 10% of the estimated 50 million people who experience tinnitus. People with pulsatile tinnitus hear rhythmic thumping, whooshing or throbbing in one or both ears. The whooshing sound tends to happen in time with their heartbeats. While pulsatile tinnitus is often benign, it can be a symptom of an underlying vascular or neurological condition that requires medical attention.
- Idiopathic intracranial hypertension: This occurs when cerebrospinal fluid builds up around the brain, putting pressure on blood vessels and affecting blood flow. It is most common in obese women between the ages of 20 and 50. If left untreated, it can lead to permanent vision loss.
- Head trauma: About 53% of people who have experienced a traumatic head injury develop tinnitus, including pulsatile tinnitus.
- Hyperthyroidism: This condition may cause an increased heart rate, which in turn increases blood flow.
If you are experiencing pulsatile tinnitus, it is important to seek medical evaluation to determine the underlying cause and receive appropriate treatment.
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Anxiety and stress
Pulsatile tinnitus, a condition where you hear pulsing, rhythmic thumping, or whooshing sounds in one or both ears, can be caused by stress and anxiety. While it is not typically dangerous, it can sometimes indicate an underlying issue that requires medical attention.
Anxiety increases awareness of internal body sounds, making you more sensitive to hearing your heartbeat in your ears. This heightened awareness can create a cycle where tinnitus anxiety amplifies the sound, which in turn heightens anxiety further. Living with pulsatile tinnitus can be mentally taxing, especially when you are constantly aware of a noise that others don’t hear. Anxiety and mental health concerns can develop or worsen as people struggle with uncertainty about their health or worry that the sound might be a sign of something serious.
If you are experiencing pulsatile tinnitus, it is important to seek medical evaluation to rule out any serious underlying causes. Physicians have developed comprehensive programs to streamline the evaluation and potential treatment of pulsatile tinnitus. In some cases, there may be no clear medical cause found, and sound therapy or sound generators may help mask the pulsating sound and reduce stress. Techniques like mindfulness, cognitive-behavioral therapy (CBT), and sound therapy are effective in breaking the cycle of tinnitus anxiety and improving quality of life. Sound generators produce calming sounds to mask tinnitus, and white noise machines, apps, and hearing aids with masking features are popular options that can make tinnitus less disruptive.
Additionally, relaxation techniques can help individuals better deal with the frustration and stress caused by tinnitus. Counseling options such as CBT or acceptance and commitment therapy (ACT) can be beneficial for managing mental wellness. Joining a support group and talking to others with tinnitus may also help individuals cope with the condition.
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Tumours
Pulsatile tinnitus is a rare condition that accounts for about 10% of the estimated 50 million people who have tinnitus. It is characterised by a rhythmic swooshing or whooshing noise inside the head that often keeps pace with the pulse. While pulsatile tinnitus is not a condition in itself, it is a symptom of other disorders. One of the potential causes of pulsatile tinnitus is tumours.
Middle ear tumours, also known as glomus tumours, are benign but invasive tumours that often grow within the middle ear. They can essentially become sound receptors, allowing individuals to hear the sound of their own blood flow, resulting in pulsatile tinnitus. These tumours create additional pressure in the ear, leading to the perception of a whooshing sound.
Head and neck tumours can also contribute to pulsatile tinnitus by pressing on blood vessels and disrupting normal blood flow. This compression can cause changes in pressure and noise within the affected blood vessels, resulting in the characteristic whooshing sound associated with pulsatile tinnitus.
If a tumour is found to be the underlying cause of pulsatile tinnitus, treatment options may include otological or neurological surgery to remove or alleviate the tumour. In some cases, adjunct therapies, such as stenting for aneurysms, may be recommended in conjunction with surgery.
While tumours are a less common cause of pulsatile tinnitus, it is important to seek medical evaluation to rule out more serious underlying conditions. Early diagnosis and treatment are crucial to prevent potential complications and ensure the best possible outcome.
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Frequently asked questions
Not always, but it can be. Pulsatile tinnitus isn't usually dangerous, but it can sometimes indicate an underlying issue that requires medical attention.
Pulsatile tinnitus is a rare condition that accounts for about 10% of the estimated 50 million people who have tinnitus. It is often described as a rhythmic pulsing noise in one or both ears that tends to be in sync with the person's heartbeat.
Pulsatile tinnitus is caused by blood flow changes near the ears or head. Blood vessels close to the middle ear are usually the cause, transmitting the beat of your pulse. Factors like high blood pressure, stress, and arteriovenous malformations can make this sound more noticeable.
People with pulsatile tinnitus often hear rhythmic thumping, whooshing, or throbbing in one or both ears. Some patients report the sounds as annoying, while others find them intense and debilitating, making it difficult to concentrate or sleep.
Pulsatile tinnitus is not a condition but a symptom of other disorders. Treatment options include sound generators, environmental enrichment devices, relaxation techniques, medication, and in some cases, surgery.





















