ENT Can't Help, Can You? I Have Pulsatile Tinnitus That Matches My Pulse

[Nathalie Wilkes]

I have always suffered from tinnitus. The high pitched squeal that seems to come from some area inside my brain. I always thought it normal until I first heard of tinnitus when I was 17. - This doesn't bother me, It's been there for as long as I've known and I can ignore it.

What DOES bother me is this pulsatile tinnitus that matches my pulse from my arteries. Sounds almost like an ultrasound in my ear. CONSTANTLY.

It started on the 13th March 2019. I know the date because it was exactly a day after a highly stressful day where my work had an inspection which I had prepared for, for 5 years. It came along with a severe earache.

I was given a course of antibiotics and sent on my way. Several ear drops and even a steroid nasal spray later and I'd been referred to ENT. Several hearing tests (all fine) and they just said there was nothing wrong UNTIL I pointed out that if I press on the artery behind this ear it stopped instantly. I have to lie with a hard pillow under that area to quieten it enough so that I can sleep. It is so loud that I can actually feel the pulsing.

I was referred for a CT scan to check all of my arteries. Since having the CT scan it seems to have gotten worse and I can't understand why? Could the dye they used of had a reaction somehow? They won't tell me the results over the phone and the waiting list for the results is ridiculous. It's been 6 weeks since I've had the scan now and I can't take it any more. I'm struggling to concentrate. I can't sleep. My hearing is suffering.

I would also like to add that although my stress levels have remained high since this, they have reduced since this has all began and there has been no change.

I want to go to this next appointment armed with possibilities and theories as to what is going on. So any and anything that could help. Please throw it at me.

 

[Dr. Nagler]

Hello @Nathalie Wilkes -

Thank you for your question. I am so sorry to hear of your struggles.

Unfortunately you have not given me enough information to be able to answer responsibly, but the main reason is that your doctors have not given you enough information!

So instead of directly responding, let me try to give you a roadmap.

It really comes down to three questions:

(1) Is your pulsatile tinnitus caused by something that is a threat to your health or life?

(2) Is your pulsatile tinnitus caused by something that can be safely fixed with the expectation that in so doing it will be eliminated or lastingly and significantly diminished in intensity?

(3) How confident is your ENT about the accuracy of his (or her) answers to the above two questions based upon the quality of and limitations of your CT scan?

The good news is that it is highly unlikely that the answer to (1) is yes. But obviously you'd like to know for sure.

The bad news is that it is highly unlikely that the answer to (2) is yes. But obviously you'd like to know for sure.

Which means that the real key is (3).

Now I do not know much about the healthcare system in the UK, but what I would like to see you do is make an appointment to speak face-to-face with whoever ordered your CT scan, and get some straightforward answers. You deserve those answers. And you deserve them sooner rather than later. In the final analysis healthcare is a service industry, and from what you say above you are getting rather poor service at the moment.

Anyway, as I see things, that's how you get started. Once those questions have been answered to your satisfaction, you will be in a far better position to move along in your journey.

I wish you well with it.

Stephen M. Nagler, M.D.