Pulsatile Tinnitus Only at Certain Angles

[Lous22]

I am hoping someone can help. I have pulsatile tinnitus...a whooshing that corresponds with my pulse. It is in my right ear, but I don't hear it all the time. I only hear it when I bend my neck in certain angles, mainly to the right and also if I look down and to the left. I have had my thyroid checked and all is well. Went to the ENT who did a thorough examination and said there was no fluid or wax buildup. I did have a baby 4 months ago, and this started when she was about 2 months old. Not sure if that has anything to do with it. It gets worse as the day goes on. If I bend my head in the morning I really have to listen hard for the noise. However, by the evening, I can easily find it. I am terrified that something is seriously wrong and this has given me horrible anxiety. Can anyone relate???? The ENT told me to stop worrying but I can't. I did have an MRI w/o contrast for headaches not long ago but that came back negative. I do have TMJ and wonder if its all related. Any info would be appreciated.

 

[Karen]

Hi, @Lous22,

I have pulsatile tinnitus in my right ear only, too. Mine started almost five years ago, after taking blood pressure medicine for the first time. I got myself off the blood pressure drugs (weaning off gradually), but the pulsatile tinnitus is still there. However, I will say that it has been calmer recently. I have both hissing tinnitus and pulsatile tinnitus in my right ear, and, like you, mine is at its best early in the morning. Then, it gradually gets worse during the day, and is at its height in the late afternoon/early evening.

I've heard of other women whose pulsatile tinnitus started either during pregnancy or after childbirth. In fact, my daughter had regular tinnitus during her pregnancy, but it faded after her baby was born. It is possible that your PT will fade, too, after awhile. Your body has undergone a lot of changes during and after pregnancy, and it has also affected the volume of blood circulating in your body; that could have something to do with it.

There are many possible causes for pulsatile tinnitus, but in your case, it could be related either to your TMJ, or possibly to fluid buildup in your body during/after pregnancy. Have you ever heard of benign intracranial hypertension? That is caused by fluid buildup in the head, and it could be related to pregnancy and weight gain. You could see a specialist to rule that out as a cause. Also, if you're still concerned after that, you could try a dentist or TMJ specialist to see if it is related to your jaw.

There are other tests you can undergo to see if the PT is caused by some obstruction, such as a fistula. You could have an MRI along with MRA and MRV, with contrast. You could also consider having a CTA scan (with contrast), although that test does involve radiation.

I'm also going to refer you to Whooshers.com, a website for those of us with pulsatile tinnitus. There, you'll find information about what to say to your doctor, and success stories of cured whooshers. There is also a closed Facebook group of Whooshers that you can join.

If there is any way I can help or provide moral support, please let me know.

Hugs and best wishes,
Karen

 

[Lindagb]

Wow, yours is nearly identical to mine!!!! Mine began during pregnancy, in my right ear, a low w/o woo, w/o woo sound almost like blowing. Very low in the morning if auditable at all, increasing in pitch and volume throughout the day. Exercise makes it go away though for a short time. I only hear it if my head is facing left and tilted down at the neck. All my testing found was a d ialated mastoid emissary vein whichb I read could become enlarged during pregnancy. Not sure if thats the cause of it or not however.

 

[LaurieR]

I have the PT but I have not been pregnant. I work a very physical job. I think that it is a pressure thing. But I notice it later in my day while I am work. Do you or have you considered masking the noise?
I notice this pulsating t while doing yoga and there is a part of me that thinks that my PT starting when I started doing yoga. I tried some poses that I was not yet strong enough to do. I notice the pT intensity increases depending on my neck angle.

 

[Sillypanda]

Personally have the same thing and seriously it's caused by medication or getting off medication you guys.....

 

[SunflowerPT]

@Lous22 This is EXACTLY how mine is, too! Please, let's keep each other updated. So far I've had an MRA done which came back clean. I saw an audiologist for a hearing test which was normal, and she said I had no fluid in my ears. My doctors all told me I had fluid in my middle ear causing this, but the audiologist says there wasn't any. I had a tympanometry done which also so no fluid. So now I feel back at square one and super anxious again. Waiting for my ENT appointment now. Hoping they will order more imaging for me.

Interestingly enough, I had horrible TMJ as a child/teenager, but not so much as an adult. Or, maybe I've just gotten used to it? Wondering if I should see my dentist. Can TMJ cause positional PT? And why/how?

 

[Greg Sacramento]

Interestingly enough, I had horrible TMJ as a child/teenager, but not so much as an adult. Or, maybe I've just gotten used to it? Wondering if I should see my dentist.

With Pulsatile tinnitus and no hearing loss and a clean MRA, but had TMJ as a child, then it could be a longtime tooth infection and now maybe under teeth. Possible a top back wisdom or molar tooth.

If you can hear PT with neck bent at certain angles, then the internal carotid artery and or internal jugular vein may be cause. This may not show on a MRA, but a MRV is better for PT issues including intercranial hypertension and thrombosis. Sometimes blood flow (veins and arteries) including veins and arteries within mouth can have involvement. Cranial branches to the oral cavity could also have involvement.

It would be very doubtful that you have intercranial hypertension or related 3 types of thrombosis, but what @Karen discusses above can have relationship. It's look like you don't have papilledema (vision loss), so a neuro eye exam would not be needed. A CBC and blood work is always needed with PT. Also a check for vitamin levels, including too much vitamin A and too low Vitamin D.

 

[SunflowerPT]

@Greg Sacramento I had an ultrasound of my carotid arteries done and that came out normal as well. Will probably call my dentist on Monday to look into the infection route. I have zero tooth pain, mouth pain, gum pain, though.

 

[kaboom08]

Comforted yet concerned that I can also identify exactly with this! About 1.5 years ago I experienced positional vertigo which was treated by a PT. Around the same time I felt some fluttering in my ears, with a sound like when you hear wind or breathe into a microphone. This went away after a couple of months for several weeks but it seems to be related to stress/being tense. I had an audiologist check my hearing/ears and she said it was probably jaw tension. My dentist said I don't have true TMJ but some minor evidence of grinding. Now, my ear fluttering and noises have bad again and I've noticed this pulsatile tinnitus in my right ear occasionally when I bend forward, especially if I slightly lean my head to the left (facing down or right). It is a classic whooshing and for the first time it has been in time with my pulse. I should also add that this all started during a time of notable stress in my life, and also after I started stimulants for attention deficit disorder. I have also given birth but a couple of years before the ear issues.

 

[Ian Mc]

I too have positional pulsatile tinnitus, it increases if I turn my neck to the left, decreases if I turn to the right, really kicks in if I look down to the ground (and I mean really increases). If I lie flat on my back without a pillow supporting my neck it totally disappears.., I've had blood tests, an ENT check me over, carotid ultrasounds, MRI, and CT scan of the temporal bones all normal. I honestly believe that it is coming from my neck / upper spine are, but who knows...!

 

[tiniturtle]

This is typical behavior for vascular pulsatile tinnitus. It will not stay consistent. It will change with position, and it will change without changing position. Your bloodflow is a very dynamic thing, and your blood vessels move.

 

[jdixon]

I too have positional pulsatile tinnitus, it increases if I turn my neck to the left, decreases if I turn to the right, really kicks in if I look down to the ground (and I mean really increases). If I lie flat on my back without a pillow supporting my neck it totally disappears.., I've had blood tests, an ENT check me over, carotid ultrasounds, MRI, and CT scan of the temporal bones all normal. I honestly believe that it is coming from my neck / upper spine are, but who knows...!

Mine is very similar to yours. I hear it in the left ear. If I bend my head forward then it almost becomes a constant hissing sound. If I rotate my head to the right, the pulsing is amplified and sounds like someone is squeezing an inflatable toy.

All I've had so for is an ENT check me over and then an MRI to rule out a tumor. I wish my doctor had sent for me an MRA at the same time. I had a CT scan last year when I had a migraine and it came back ok (suspect they were looking for a stroke) but I'm not sure if they had the machine tuned to look for other things at that time.

I have a bit of heightened awareness around this as last year my wife had pulsatile tinnitus that was diagnosed as a fistula in her brain. She had surgery for it and is fine now.

 

[Lilah]

I too have positional pulsatile tinnitus, it increases if I turn my neck to the left, decreases if I turn to the right, really kicks in if I look down to the ground (and I mean really increases). If I lie flat on my back without a pillow supporting my neck it totally disappears.., I've had blood tests, an ENT check me over, carotid ultrasounds, MRI, and CT scan of the temporal bones all normal. I honestly believe that it is coming from my neck / upper spine are, but who knows...!

I have the whooshing pulsatile tinnitus as well in my left ear sometimes which increases when I turn right. I can stop it or decrease it by pressing an area on my neck (left side). I've had all the tests done as well.