If a specific cause is found this may point to a specific solution. For example anaemia can be treated with medication or blood transfusion, glue ear can be treated with grommets, perforations can be closed with grafts and narrowed segments of artery can be repaired.

Some causes are less amenable to treatment: if a patient is born with ‘odd’ blood vessels in the neck these may not be treatable.

For those patients with pulsatile tinnitus who have no demonstrable abnormality, standard methods of tinnitus treatment will be used. These include techniques such as Tinnitus Retraining Therapy (TRT), counselling, sound therapy and relaxation therapy

Pulsatile tinnitus is due to a change in blood flow in the vessels near the ear or to a change in awareness of that blood flow. The involved vessels include the large arteries and veins in the neck and base of the skull and smaller ones in the ear itself. The blood flow can be altered by a variety of factors:

Generalised increased blood flow.

Blood that is flowing quickly generates more noise than blood that is flowing slowly. Increased blood flow throughout the body can occur in strenuous exercise orpregnancy. It can also occur in severe anaemia or when the thyroid gland is over active, a condition known as hyperthyroidism or thyrotoxicosis.

Localised increased flow.

Sometimes blood flow is increased in a single blood vessel or group of blood vessels rather than a generalised increase. For example, during foetal development we all

have an artery in our middle ear called the stapedial artery. This normally closes before birth but it can occasionally persist and in this case blood flow adjacent to middle ear structures can generate pulsatile tinnitus.

Turbulent blood flow.

If the inside of a blood vessel becomes irregular due to atherosclerosis (hardening of the arteries) the blood flow will become turbulent rather than smooth. This flow then becomes noisy in the same way that a smoothly running river will become noisier at a set of rapids or waterfall.

Altered awareness.

Awareness can be increased by several factors:

• Conductive hearing loss such as perforated ear drums or glue ear tend to make patients more aware of sounds inside their body because they no longer have the masking effect of external sounds.

• Heightened sensitivity in the auditory pathways can alert the brain to normal noise in blood vessels in much the same way that the awareness of non-pulsatile tinnitus is generated.

Miscellaneous

Some causes of pulsatile tinnitus do not fall into any of the above categories. In particular, there is a condition called benign intracranial hypertension, also known as idiopathic intracranial hypertension or pseudotumor cerebri. This is characterised by headaches and visual disturbance as well as pulsatile tinnitus. It is said to occur most frequently in overweight young or middle aged women. However, it can occur at any age and in men as well as women. Its cause remains unknown.

It is important to state that this is not an exhaustive list of the causes of pulsatile tinnitus and that anyone with this symptom should seek assessment by an appropriate doctor.

Source: British Tinnitus Association

What is tinnitus?

Tinnitus is the sensation of sound in the absence of an external source. The perceived sound may simply be a ringing, whistling, or rushing sound, or it may be more complex like machinery or the twittering of birds. Although the sound may not be present all the time, when it is noticeable it tends to be a steady noise with no frequent or regular changes in its loudness.

What is different about pulsatile tinnitus?

By contrast, pulsatile tinnitus is a rhythmical noise with the same rate as the heart. This is easily checked by feeling the pulse at the same time as listening to the tinnitus. When doctors investigate most cases of tinnitus it is rare for them to find a single identifiable cause for the problem. With pulsatile tinnitus, the chances of finding a specific cause are greater than in the non-pulsatile form. This is therefore an important subgroup that merits detailed investigation. However, even with pulsatile tinnitus it is common not to identify a definite cause.What is tinnitus?

Tinnitus is the sensation of sound in the absence of an external source. The perceived sound may simply be a ringing, whistling, or rushing sound, or it may be more complex like machinery or the twittering of birds. Although the sound may not be present all the time, when it is noticeable it tends to be a steady noise with no frequent or regular changes in its loudness.

What is different about pulsatile tinnitus?

By contrast, pulsatile tinnitus is a rhythmical noise with the same rate as the heart. This is easily checked by feeling the pulse at the same time as listening to the tinnitus. When doctors investigate most cases of tinnitus it is rare for them to find a single identifiable cause for the problem. With pulsatile tinnitus, the chances of finding a specific cause are greater than in the non-pulsatile form. This is therefore an important subgroup that merits detailed investigation. However, even with pulsatile tinnitus it is common not to identify a definite cause.

Source: British Tinnitus Association

Forty-five subjects suffering from an idiopathic tinnitus with or without hyperacusis for at least 6 months were recruited. There were significant improvements during therapy and the mean Tinnitus Handicap Inventory (THI) was lowered by more than 20 points.

These improvements persisted 18 months after treatment completion. Furthermore, the percentage of patients reporting the disappearance of their difficulties in various activities (relaxation, concentration, sleep, social relations and work) increased continuously after treatment completion. TRT improved self-perceived disability induced by chronic tinnitus for a long time after the end of therapy.

Copyright © 2009 S. Karger AG, Basel.

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Thankyou for choosing to read my blog! My name is Mus Abdi and I am creating this blog for the many thousands of Pulsatile Tinnitus sufferers who are looking for up to date and trustworthy information on the condition. I am a graduate in Immunology from one of the top research centres in the world, and I have a great interest in disorders of the ear and auditory cortex. I have also had medical training from Bristol University, UK. In addition, am also a music producer with a particular interest in sound therapies, and last but least I am a tinnitus sufferer.

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