Pulsatile Tinnitus Going from Unilateral to Bilateral?

[Nicole C]

Has anyone experienced pulsatile tinnitus shifting from unilateral to bilateral? Lately, I've been worried that the pulsatile tinnitus I usually hear in my right ear is now starting in my left ear.

I've had chronic ear infections in my left ear for about six months. Of course, that's my "good ear."

I'd love to hear about others' experiences.

 

[HanaK]

Has anyone experienced pulsatile tinnitus shifting from unilateral to bilateral? Lately, I've been worried that the pulsatile tinnitus I usually hear in my right ear is now starting in my left ear.

I've had chronic ear infections in my left ear for about six months. Of course, that's my "good ear."

I'd love to hear about others' experiences.

Sorry to hear that. I too started out having tinnitus only in my right ear, but occasionally my left ear has tinnitus too. Whether it's permanent or temporary I'm not sure, but sometimes I hear it in my left, sometimes I don't.

 

[Bill Bauer]

Has anyone experienced this before? I've been fearing lately that my pulsatile tinnitus that's usually in my right is now starting in my left ear? I've been having chronic ear infections in my left ear for about six months. Of course, that's my "good ear." Would love to hear from people's experiences.

My tinnitus spread to my formerly good ear about 9 months after onset. It wasn't all bad. When I had tinnitus only in one ear, I was always reminded about what I had lost (as my good ear was dead silent).

 

[Greg Sacramento]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3719451/

Pulsatile tinnitus is usually unilateral, unless the underlying vascular pathology is bilateral.

A disorder known as "somatosensory pulsatile tinnitus" has been discussed. This is bilateral tinnitus with no vascular cause.

In case an individual loses hearing in only one ear, the whistling sounds will be heard in that particular ear hence result in pulsatile tinnitus in that ear only. This is totally different from and independent of continuous tinnitus which often results from damage to the cochlea and/or hearing nerve.

While with regular tinnitus the causes can range from ear infections and medication to eardrum ruptures and exposure to loud noise, the cause behind pulsatile tinnitus is usually due to abnormal blood flow. So pulsatile tinnitus heard in both ears follows different pathology than regular tinnitus being heard in both ears.

If, due to infection, inflammation or eustachian tube dysfunction, fluid accumulates behind the middle ear then pulsating tinnitus may result.

What tests have you had done/ Any complete bloodwork?

 

[TRISHTHEDISH12]

I have had tinnitus in my right ear for approximately 12 years. For the past couple of months I have been awakened each and morning at 4:00 am with ringing in my left ear which thank God goes away as the morning hours develop. I am at my wits' end, I attend a tinnitus support group which lets me know its a hopeless situation. I had my ears cleaned of ear wax at a hearing center and saw an audiologist; I am getting an ear MRI tomorrow.

Why am I awakened each and every morning around the 4 o'clock hour with the ringing in both ears?

Has anyone out there suffered like this it is now 5:47am and I'm still up for the day.

Please anyone that can relate to my situation I will be greatly appreciative.

 

[Nonna]

my uneducated guess wld be its some sort of clearing, or release going on.
The moment your body deflames is 4am. And flames back up when you get up and move around.

I have had tinnitus in my right ear for approximately 12 years. For the past couple of months I have been awakened each and morning at 4:00 am with ringing in my left ear which thank God goes away as the morning hours develop. I am at my wits' end, I attend a tinnitus support group which lets me know its a hopeless situation. I had my ears cleaned of ear wax at a hearing center and saw an audiologist; I am getting an ear MRI tomorrow.

Why am I awakened each and every morning around the 4 o'clock hour with the ringing in both ears?

Has anyone out there suffered like this it is now 5:47am and I'm still up for the day.

Please anyone that can relate to my situation I will be greatly appreciative.

 

[Greg Sacramento]

To quote myself, pulsatile tinnitus is usually unilateral, unless the underlying vascular pathology is bilateral.

Vascular pulsatile tinnitus seems to have more causes than any form of tinnitus. It can involve the pulp of a tooth to anything from the shoulders up. Unfortunately CTs (radiation) is often not recommended for PT. MRIs and other tests are better.

When a poster mentions that they have PT, as much information as possible is needed. From jaw pain to eye pain to face pain to neck pain to headaches.

Two articles of thousands of conditions articles that can involve pulsatile tinnitus. I had one of the world's best radiologists (in the top three) note my scans this past week and he found dozens of problems after 2 hours of study. My problems were all caused from physical trauma. He sent my scans to another doctor who I saw today. A hundred scan pictures of problems that have developed including a lot of what's in these links. There is no condition as complexed as tinnitus because it can involve almost anything and any condition.
https://www.sciencedirect.com/topics/neuroscience/optic-canal
https://www.sciencedirect.com/topics/medicine-and-dentistry/optic-chiasm

 

[Lilah]

Vascular pulsatile tinnitus seems to have more causes than any form of tinnitus.

@Greg Sacramento Do you know why some PT have a whooshing sound and others have a high-pitch pulsatile sound. Do they point to different causes? Do all PT correspond to the heart beat...what about the high pitch whining sounds (sounds like blood flow?)

 

[Greg Sacramento]

@Lilah: If I remember correctly you had some pulsatile tinnitus a few years ago. Any problems such as Lupus, TMJ/D, ETD, nasal, pain behind the eyes, sore neck, ear aches or temple headaches, the time when first developed is important. Blood flow or intercranial hypertension from arteries of neck and cranial arteries often associate to PT. This may cause fleeting tinnitus when turning neck. I don't know as to your cause, but a firm discussion with your doctors to explore is needed and there are a few tests that would help pinpoint problems.

There are hundreds of causes and cross pattern associations of just one particular concern with tinnitus. One is salivary gland trauma where there are hundreds of causes that can have input from anywhere or anything. In depth articles on any biological problem may mention salivary glands. No one or any computer has ever been able to establish complete flow charting problems just for salivary, never mind any other problems that may be associated to physical tinnitus such as ear fullness or fleeting tinnitus. The only way to try to find reasons is by multiple radiological testing.

In this first link, read the Conclusion. Then study intercranial hypertension where I have posted on that and then study the second link just to get an idea of how involved any physical association can be. With wide open physical tinnitus and/or PT that a few posters have, it's hard to completely pinpoint the cause(s). For PT, suspect of jugular or vertebral arteries involvement due to hypertension and injury is one area to investigate. My PT is like people marching, so I know the cause in bold letters above and location by very softy touching blood flow areas at both my jugular vein and temporal side areas.

https://journals.sagepub.com/doi/full/10.1177/0300060516688600
https://www.hydroassoc.org/what-are-the-cranial-nerves/

 

[Lilah]

The only way to try to find reasons is by multiple radiological testing.

Thanks @Greg Sacramento. Yes, I had loud whooshing pulsatile tinnitus in my left ear when I was first diagnosed with lupus around 12 years ago for less than a year. However, now the sound is so much different and in both ears. Now is mostly high (sometimes flat) pitch whining with pulsing sometimes, and sometimes tonal or loud white noise. There is a layer of whisking sound also. I've already done around 5 or so head/neck scans (MRA, MRV, MRI, doppler), all normal. Are there any other tests I should look into such as to look for intercranial hypertension? Unfortunately, my doctors are not really interested in finding the cause; they just referred me to TRT. So, I think I need to precisely ask what I want.

I went to the NUCCA chiropractor and my C1 bone is slanted (by around 4 degrees I believe). Can this all be related? The chiropractor also put his fingers in my ears and said I have some grinding.

I think I also have mild reactive tinnitus/hyperacusis; is this related to vascular/PT?

 

[Lillcal]

I'm fairly new to the experience of tinnitus. Mine started about a month and a half ago after I was diagnosed with unilateral sensorineural hearing loss in my left ear, which happened suddenly on November 4, 2024. It has been a constant high-pitched ringing in my left ear, with some days better than others. I got a hearing aid about a month ago, which seemed to help reduce the loudness of my tinnitus at times, though intermittently.

I am currently in the process of switching to another hearing aid, so I have been without one for almost a week. I have definitely noticed the difference in both my hearing and tinnitus. However, about two to three weeks ago, I started hearing tones in my non-affected right ear. It began when I was lying down at night, mostly when I was on my right side with my right ear covered by the pillow. This happened for two or three nights but disappeared by the next day.

Then, I began noticing these tones occasionally during the day—about once every other day—but they would go away after 15 to 20 minutes. This is very concerning because my right ear has no hearing loss or issues. I am unsure whether this will progressively worsen to the point where I will have tinnitus full-time in that ear or if it will remain intermittent.

I'm curious if anyone else has experienced this phenomenon, particularly those diagnosed with unilateral hearing loss and tinnitus. Did it eventually spread to your other ear? The only other explanation I have read about for this occurring is Meniere's disease, but I am certain I do not have it. I have none of the associated symptoms, and my ENT and audiologist did not suggest it as a possible diagnosis.