Pulsatile Tinnitus With Cold and Severe Sinus Congestion

[MisterMystery]

I have had "normal" subjective tinnitus for about a year now. I developed pulsatile tinnitus last night after several days of a weird cold and the worst sinus congestion I've ever had. The pulsatile tinnitus is rhythmic and in sync with my pulse. It sounds like a low-pitched "woo, woo, woo." It gets worse when I lie down or when I turn my head to the side. It seems to get better when I sit at a 45-degree angle.

I say the cold I had was weird because it started when I got out of bed in Tuesday morning and felt a sharp headache that almost felt like a muscle spasm. The headache would pulsate and increasingly hurt with each pulse. The headache lasted until I took ibuprofen later in the day. Later that Tuesday night, I developed a sore throat and began feeling dull, vice-like pressure in the center of my head. I probably felt sicker than I'd ever felt without feeling nauseous.

The sore throat is now gone, but the sinus congestion and cranial pressure have increased. I can't breathe at all through my nose, and I'm a little short of breath. This is really worrying me. I'm 36 years old and have always been a health nut. I'm 5'9" and 160 pounds. I have normal blood pressure, I go to the gym four times a week, and I watch what I eat, even though I don't look like I have to. I've always had sinusitis, but I use Claritin everyday, and I usually breathe just fine. Now the Claritin has zero effect.

What is going on with me? I greatly appreciate any advice.

 

[VaR]

Try taking steam and other measures for the blocked nose. I too experience this sound which seems like PT. I have the same sinus issues but the way I am dealing with them is taking steam regularly. Also, ETD + Sinus can sometimes lead to PT due to fluid in the ear. So, you should get that checked out. @Kaelon, what do you think?

 

[MisterMystery]

I have gone to the steam room at the gym and had endless cups of hot water or tea. That let me blow my nose, but in less than an hour, the congestion will come back. I just woke up, and I can't breathe through my nose. The PT is louder than ever and now doesn't go away if I sit at a 45-degree angle or what not. :-(

 

[Kaelon]

@VaR is right -- the thing to keep in mind, @MisterMystery, is whether or not your "pulsatile" Tinnitus is actually reflecting a vascular condition (like an arterial blockage or venous hum), or if it's indicative of neuromuscular strain. The latter is caused by inflammation and/or infection which you can treat and manage in a variety of ways, whereas the former is something that is extremely difficult to diagnose (unless if objectively observed by doctors).

Because you've had a cold, and are a chronic sinusitis sufferer -- and because you indicated that ibuprofen helped your headache and some of your symptoms -- this really strikes me as inflammation that is compressing the muscles around your ear, potentially your Eustachian tubes (which cross through your nasal sinuses). Also, because moving your head now that you're all congested doesn't seem to have an effect and your breathing (or inability thereof) directly corresponds with your Tinnitus, I suspect that your congestion is directly fueling this Tinnitus.

I recommend you go to a doctor and request Amoxicillin (500 mg x 3 times a day for 7 days) and Prednisone (50 mg daily, tapering down to 10 mg daily, for 10 days). Additionally, consider trying some anti-inflammatory techniques with your sinuses -- like using sterile/distilled luke warm saline solution in a neti pot -- to help flush out your sinuses, to see if this improves your symptoms.

Full disclosure: in my case, I spent a couple of months trying unsuccessfully to diagnose what was causing my high pitched Tinnitus that had some "oscillating" sounds -- growing louder and softer with each heart beat, in perfect sync -- and the above approaches helped reduce my symptoms considerably, and at the very least confirmed in my mind that inflammation is playing a role here. Note, however, that doctors will dismiss otitis media as a likely cause in your case unless if it occurs in the outer ear or immediately behind the ear drum. Lower middle ear infections and inner ear infections cannot really be detected by doctors, so you need to insist / beg / plead that they give you this medicine to see if it improves your symptoms, and if it does, you know inflammation is playing a role here.

Best of luck here, MisterMystery -- please keep us in the loop. I hope you feel better!

 

[VaR]

Yeah, and I believe since your congestion keeps coming back, it definitely might be what's causing that whooshing sound in your ears. I believe you should try some nasal decongestants and something like neti pot to reduce your symptom of congestion. And get yourself checked by a doctor for your PT. Ask him to check for any fluid buildup in ears. Also, when you go to a steam room, or use a steamer at home, be sure to not go out in the cold or expose yourself to any cold temperature as that makes you more prone to congestion.

 

[MisterMystery]

OK. So my congestion finally "broke," and I blew out several big globs of yellowish mucous. My breathing has returned to normal, though I have a deviated septum, and that interferes with my breathing sometimes. The PT appears to have stopped, except when I bend over. Is that significant?

I bought a Neti pot, but I'm scared to use it. My septum is deviated enough that I can't blow my nose out my left nostril, and I'm worried the water would go down the wrong tube and cause an infection!

 

[VaR]

Now, you are at the stage I am. We have to try the anti-inflammatory route.

 

[MisterMystery]

So the PT went away a few weeks ago but returned today. I had the flu earlier this week, and after I thought I had recovered, I had bad indigestion. I felt normal in all respects until tonight, when I suddenly developed PT again. Like earlier last month, I get it when I lie down or move my head to the side, and it goes away when I touch my jugular vein. Does the return of my PT indicate a serious underlying condition?

 

[Karen]

Hi, Mr. Mystery,

No, I don't believe it necessarily means you have a serious underlying condition, but if it doesn't go away again, it might be worth going to a doctor. What type of doctor? It's hard to say, because ENT's often don't know much about PT, or often don't have the time to run tests and try to diagnose this condition. If there is a neurologist or neurotologist in your area, you could start with one of them. If the doctor feels you have an underlying problem, he may order some tests for you, such as a CT scan or MRI.

 

[marqualler]

@MisterMystery For what it's worth--I had a cold that lasted for about a week that also gave me the feeling of PT--whether it truly was or not I am not quite sure, but I do know that the "whooshing" type sound was louder than the ringing. It also meant my ears were plugged and so it felt like everything was "spiking". Over the course of a week, those symptoms really died down and now I really have little to no "whooshing" and am left with just the ringing. My ringing started with similar symptoms but with a very extreme sinus infection. Since then, and especially over the last month and a half, the ringing has settled down quite a bit to the point where it isn't really too bothersome anymore. I still protect my ears in loud places (I'm in a band and played too long without any hearing protection at all and now use heavy-duty earmuffs) but do all the same things that I did before T came along. And I feel a lot better knowing that the PT symptoms really were just due to the cold. I suspect yours will die down too once all of that mucus passes. It seems like this has been a really bad winter for lots of people in terms of viruses like this one!

 

[MisterMystery]

@MisterMystery I suspect yours will die down too once all of that mucus passes.

That's what happened last time. This time, I have no mucus.

 

[Karen]

Mister Mystery,

I'd give it a couple weeks, and if it doesn't go away, or if it gets worse, you might consider going to a doctor. Again, I would suggest a neurologist or neurotologist if you suspect it is pulsatile tinnitus (in time with your heartbeat). Have you checked it, to be sure it is exactly in sync with your heartbeat?

 

[MisterMystery]

Mister Mystery,

I'd give it a couple weeks, and if it doesn't go away, or if it gets worse, you might consider going to a doctor. Again, I would suggest a neurologist or neurotologist if you suspect it is pulsatile tinnitus (in time with your heartbeat). Have you checked it, to be sure it is exactly in sync with your heartbeat?

Yes, it is in sync with my heartbeat. By the way, the PT went away on Tuesday, but it's back now. I noticed it came back after I walked up the stairs and leaned over to put down a bag. Blood rushing to my head seems to trigger it.

 

[Karen]

It does sound like it could be PT, but the fact that it went away and came back may mean it is transient. I've heard of others who have PT that comes and goes. As for me, mine is constant. Have you been able to change the pulsating in any way by pressing on your neck? Some people can, but mine doesn't change when I do that.

For more information about PT, you might wish to check out the Whooshers.com website. There, you'll find information about the various causes of PT, and people who have been cured. Don't let it scare you, however. There are people, like you, who have transient pulsating, for whom it goes away on its own.

 

[MisterMystery]

It does sound like it could be PT, but the fact that it went away and came back may mean it is transient. I've heard of others who have PT that comes and goes. As for me, mine is constant. Have you been able to change the pulsating in any way by pressing on your neck? Some people can, but mine doesn't change when I do that.

Yes, it goes away if I press on my jugular vein, and it comes back if I lie down or rotate my head to the side.

For more information about PT, you might wish to check out the Whooshers.com website. There, you'll find information about the various causes of PT, and people who have been cured. Don't let it scare you, however. There are people, like you, who have transient pulsating, for whom it goes away on its own.

Thanks. I do scare easily because my anxiety is bad enough as it is!

 

[Karen]

I can certainly relate to that, about the anxiety! Having this condition causes anxiety because you're not exactly sure what's going on in your head and body. Please try to distract yourself as best you can, and don't let it get you down.

I've had the pulsating for nearly five years now, and mine has gotten a little better than it was when it started. I think it's because I have calmed down and am not worrying about it any more.

Since mine is constant, I've had some tests, and nothing specific was found. The tests I had were a CT scan of the temporal bone area, and an MRI and MRA of the head, as well as a Doppler of the carotid arteries. These are tests you could consider --- only if you find that it doesn't go away, or begins to get worse.

Please keep me posted on how you're doing.

 

[MisterMystery]

Please keep me posted on how you're doing.

Thanks, Karen. It's good to be able to talk to people who understand. My parents don't understand subjective tinnitus, let alone pulsatile tinnitus, and they refuse to educate themselves about it.

 

[Karen]

You're welcome! I certainly understand what you're going through right now, and will be happy to help, or provide moral support. You're going to be all right, and things may get better with time.

 

[MisterMystery]

You're welcome! I certainly understand what you're going through right now, and will be happy to help, or provide moral support. You're going to be all right, and things may get better with time.

I had been going back and forth about this for a while. I originally scheduled an MRI and MRA, but then my PT went away. The cost was so high for me (I am unemployed) that I backed out. My dad said he would not help me pay for it. No matter how many times I tried to explain it, he couldn't understand the difference between the nonpulsatile tinnitus in my left ear and the pulsatile tinnitus in my right ear. He just kept saying that "millions of Americans" have tinnitus and that he just saw a commercial for lipoflavinoids for "ringing in the ear."

Of course, the PT returned the day after I canceled my MRI/MRA. This time, I wasn't sick at all and didn't have sinus congestion when it came back. I believe it came back when I walked up two flights of stairs with my bags. The PT then reached a peak one night and would not go away no matter what angle I slept at. I started to get scared and tried saying the rosaries (or what I can remember of them) as many times as I could until I fell asleep. The next morning, the PT was gone!

Fortunately, my PT still hasn't returned, but then I went to the my doctor yesterday because my throat and non-PT ear were hurting me. It turned out I had a large tonsil stone that was inflaming my tonsil and pinching a nerve in my ear. I happened to mention to the doctor that I had PT a few times this year but that I opted not to get an MRI/MRA because the PT went away. He looked at like me like I was nuts and told me twice that he "strongly advised" me to get the MRI/MRA. I told my dad what the doctor said, and he said to go ahead and get the scans.

Anyway, the point of all this is that I feel like an idiot for not going forward with the scans. I'm already an extremely anxious person. I woke up in the middle of the night last night with heart palpitations and thought I was going to die. I've thought about going to a shrink again, but when I went a year ago, he told me there was nothing wrong with me!

 

[Karen]

I'm so sorry you've been going through all this! Not many people truly understand what PT is, let alone having any suggestions for how to deal with it.

I hope you'll find a way to have those tests eventually, even if it's only to put your mind at ease that nothing serious is wrong. The heart palpitations could be a type of panic attack; I know, because I've had panic attacks like that in the past.

Try not to be anxious, and see if you can find a doctor who understands what PT is (such as a neurologist or neurotologist). PT is a very real condition; it's just hard to find answers, or knowledgeable doctors.

 

[MisterMystery]

I'm so sorry you've been going through all this! Not many people truly understand what PT is, let alone having any suggestions for how to deal with it.

I hope you'll find a way to have those tests eventually, even if it's only to put your mind at ease that nothing serious is wrong. The heart palpitations could be a type of panic attack; I know, because I've had panic attacks like that in the past.

Try not to be anxious, and see if you can find a doctor who understands what PT is (such as a neurologist or neurotologist). PT is a very real condition; it's just hard to find answers, or knowledgeable doctors.

So I finally went through with the MRI/MRA. I feel relieved that I went through with it, but I had NO idea it would be so noisy. Nobody told me anything about noise. Even with foam earplugs, my ears are very sore right now, my T has spiked somewhat, and I'm hearing static and a weird, indescribable noise when I cover my ears. Someone please tell me this is temporary.

 

[Lucy2922]

I'll be very interested to see what the results reveal. Having just very recently just developed PT, I'm looking ahead at how to proceed. I can't speculate on the noise you're hearing now, but sounds like it was due to the MRI and would be temporary after the noise exposure. But I have never had that procedure, so hopefully someone who has will chime in. Good luck on all fronts!

 

[Karen]

I've had the MRI and MRA, and yes, it was kind of loud, but I had an open MRI, so that might have made a difference. For me, any problems proved to be temporary. I would think yours will settle down soon, too.

 

[KayBay89]

I'm anxious to know what your results are, because I have the exact same symptoms.

The only difference is that mine began when I had iron deficiency anemia (from lady issues that went on for a few months), and I started hearing the pulsing in my right ear. Sometimes it's here for a whole day, sometimes I can only hear it if I turn my head to the left. Pressing on my jugular vein makes it stop, or pressing just under my ear.

I also got a terrible sinus infection/upper respiratory infection a few weeks ago, so I thought that worsened it. But now I am well and the PT is still present. I've noticed that it gets worse when I'm tense as well.

I don't know if this is of importance, but I can easily pop my ears (mostly my right one) by moving my jaw or yawning. Is this normal?

Anyway, I should probably start my own thread with my own symptoms and not hog yours I am awaiting hearing your results, hoping to allay my fears about my own condition.

I wish you all the very best and pray that the results come back with nothing wrong!

 

[Kpot]

So kaybay what was the result with your ear? Mine started today with a cold. Driving me crazy.