New to Pulsatile Tinnitus Which Comes and Goes Like Magic

[Dick Stack]

Hi, I'm posting from the UK about my experience over the last week.

About a week ago I had a very sudden onset of what I now think is pulsatile tinnitus. My hearing in my right ear suddenly turned inwards - everything sounded muffled and there was a regular whooshing sound. I initially linked this to having a build up of ear wax. My right ear is a bit of a funny shape, and ear wax doesn't drain too well. This isn't normally a problem, but if I go swimming then it gets compacted and hardened and I get muffled hearing in that ear.

What was odd this time is that I haven't swam in about 18 months, and the muffled sound went away as the day went on. I then proceeded to forget about it. If I have an ear wax problem, it never goes away by itself until I've dealt with it.

Yesterday I finished work (working from home in my basement), sat down with a cup of tea, and got the sudden onset of these symptoms again. This time I tried to focus in on them, and realised that the whooshing was rhythmic, like my heartbeat. After a few minutes, I held the pulse point on my wrist, and the beats matched perfectly. I also felt a kind of hot pulsing feeling around my ear - difficult to describe, but it just felt like this experience was related to my circulation rather than anything to do with earwax or my hearing.

Later on as the symptoms subsided, I felt around my ear, and have noticed that I can feel a very strong pulse right at the back of my right ear - in the crease at the top of my jawbone. This is not present on the left side, and it is present all the time, even when the pulsatile tinnitus subsides.

What is really striking to me about this, is how the pulsatile tinnitus symptoms come and go like magic, apparently unrelated to anything I am doing. It is a bit scary but I am taking some steps.

So far I have booked an appointment for a hearing test tomorrow morning, just to rule out anything in this area, and also to check for the ear wax issue.

I also messaged my GP (family doctor) about the symptoms and they have asked me to go in - its not until a week on Monday though.

I am very happy to read all of the information other people have shared here, and will keep you posted about what happens next. If anyone can suggest any points to raise when I have my GP appointment, that would be much appreciated. I'm 49, fit, BP and cholesterol all normal as far as I know.

I should add that I am slightly worried about turning into a hypochondriac after developing retinal tears all around my right eye last summer, and needing surgery to patch it up! A sobering experience, but one that taught me how important it is not to ignore sudden symptoms, as I could have lost my sight in that eye if I'd ignored the symptoms.

 

[FocusRS]

Hey! How long do these sudden onset attacks last for? Its great your getting yourself checked out, this could just be bouts of eustachian tube disfunction or SSHL as opposed to Pulsatile Tinnitus. It's possible if there is some sort of wax blockage it could happen but it did seem to go away and it would have to be severely impacted for that to occur. It's always possible that it could be coming on slowly but you say you have dealt with this in the past after swimming so it's more unlikely.

There can be things near your ear like sigmoid plate dehiscence or a sigmoid sinus diverticulum to problems with tumors that can cause it however the noise normally wouldn't go away like it does in your case. Much of the Pulsatile Tinnitus cases are more vein or arterial based where the noise doesn't go away (unless it becomes worse) and can cause numerous other symptoms like constant headaches, massive pressure in your head, dizziness/vertigo, eye blurriness etc. The pulse your feeling around your ear (around the top of your jaw) is fairly normal so try not to read to much into that. Try not to over think it, and just keep tabs on yourself if it happens again. Keep checking your symptoms on what your going through - especially during these sudden attacks. If it gets worse or more consistent make sure you seek out an ENT who can recommend you to a Neuroradiologist or at least a Neurologist who can read any scans they recommend.
Hope this helps a little!

 

[Dick Stack]

Thanks for your reply. The attacks can last for 1-2 hours. They are very intermittent. Today I woke up very aware of the pulsing in my ear and I think it was much more noticeable because I was in bed and everything was very quiet. I am still aware of it now (3 hours later) but because I'm at work there is quite a bit of noise and so I don't notice it so much.

My GP was pretty good but has started off down the wax route. So I was booked to have my ears irrigated to see if that makes a difference. So far, it hasn't, but I've only just had that done, so am wondering if I am just more aware of my ear right now, and am trying to tune out and not think about it. The GP said he would refer me to ENT if the symptoms don't go away.

Something that I hadn't thought of before, is that I don't have much of an ear canal on my right side, which makes it harder for wax to drain naturally - the opening to the ear is very small. This stems from a condition I had called Branchial Arch Syndrome as a baby. There are lots of presentations of this syndrome, but I was pretty lucky as it just affected my right ear, mouth, jaw and the muscle and tissue on that side of my face. It happens when there is disruption to the nerve supplying the embryo in the womb (I'm on the edge of my knowledge here) so facial malformations occur. For me I had to have lumps cut away from my outer ear, and I've already mentioned the lack of a full ear canal. My mouth also extended a centimetre or so beyond my lips on the right side, and I had lumps and scarring on the right side of my face. So I went through a fair bit of plastic surgery as a child, although I rarely think about it now. The biggest surgical intervention I had was a bone graft to my right jaw, to encourage it to grow evenly with the left side, which worked out pretty well.

So, years later I suddenly wonder if this might be involved somehow. It might explain some of the differences I feel in terms of pulse etc., and perhaps it would be good to go ahead with the referral and get it all checked out for peace of mind at the very least.

I'd be really interested to know if there is anyone else out there who has had Branchial Arch Syndrome and subsequent issues with pulsatile tinnitus. I've never met anyone else who had the same syndrome as me. Will keep you posted.