Causes and treatments of pulsatile tinnitus

Pulsatile tinnitus is like the sound of a beating pulse. In clinical practice, pulsatile tinnitus is also classified as objective tinnitus. There are many causes of pulsatile tinnitus. Anemia and hyperthyroidism may cause pulsatile tinnitus. This type of tinnitus should be treated as early as possible to avoid serious illness.

1. Causes

In addition to the above-mentioned high jugular glomus tumor and mastoid emissary vein malformation, vascular diseases that can cause pulsatile tinnitus include carotid artery aneurysm, carotid artery stenosis, arteriovenous fistula, and compression of the internal jugular vein by the hyperplastic transverse process of the atlas during cervical spondylosis. Anemia, hyperthyroidism, hypertension and arteriosclerosis may cause abnormal blood viscosity, increased cardiac output or changes in blood vessels, which may change the hemodynamics of blood supply to the skull and cochlea, thereby producing vascular murmurs, which in turn cause pulsatile tinnitus when transmitted to the cochlea.

2. Symptoms

Pulsatile tinnitus refers to the patient's complaint of tinnitus in the ear that sounds like the beating of the heart or blood vessels. Some are like the sound of waves or some are like the sound of a pulse. They are very regular. If you observe the rhythm carefully, most of them are consistent with the number of heart beats.

3. Treatment

Pulsatile tinnitus caused by glomus jugularis tumor, skull base and temporal bone hemangioma, otosclerosis, etc. should be treated for the corresponding primary disease. Clonus associated with the palatine, tensor tympani, and stapedius muscles can be treated by cutting the corresponding muscles. Diseases caused by vascular malformations, stenosis, arteriovenous fistula, etc. can be treated through surgery such as vascular ligation, arterial diversion, angioplasty, gamma knife, and selective arterial embolization. Especially with the development of interventional radiology, selective arterial embolization and intravascular stents have achieved gratifying results in the treatment of this type of vascular disease. For example, super-selective arterial embolization has been used to cure pulsatile tinnitus caused by vascular malformations, arteriovenous fistulas, etc. For idiopathic spontaneous leukemia, treatment methods such as internal jugular vein ligation can only be considered after other causes have been completely ruled out.