Pulsatile tinnitus...

[Melina]

Hi Dr. Nagler, thank you for taking the time to read my question.

I have had ringing in both ears (predominantly right) since childhood, as well as lots of ear infections, but two years ago after a long plane flight (with a minor cold) I developed pulsatile tinnitus in my right ear. It began very loudly when lying down, as thudding and rumbling, and gradually got quieter, but is still there. Through experimentation I have discovered that when I consume a lot of dairy, it gets significantly worse, so I am avoiding it as much as I can. I also feel congested on the right side, with headaches, and a tender ear (such as when I push on the cartilage or bone behind it) when the tinnitus is especially bad. Sometimes I hear my heartbeat or whooshing. The sound seems to change a lot. I have seen 2 ENTs (not within the last year), who don't think anything is wrong. Yesterday during a general health check a GP commented that I had excessive ear wax in my right ear, but other than that it looks fine, but I feel that that obviously is pointing to an answer...

Can you offer any advice?

 

[Dr. Nagler]

Can you offer any advice?

Well, since you have already undergone two ENT evaluations since the onset of your pulsatile tinnitus, I am going to assume that the proper work-up has been completed, which means that whatever the cause of your pulsatile tinnitus is, it is not one of the (rare) causes that can be readily corrected, nor is it one of the (even rarer) causes that represent a threat to your health or life.

That said, what you are left with is for all intents and purposes a nuisance. It can be a HUGE nuisance ... or it can be a little nuisance ... or it can be anything in between. And what you do about it - as with non-pulsatile tinnitus - depends on just how much of a nuisance it is. Your options? Since your work-up is complete and unremarkable, your options are exactly the same as those on this board with non-pulsatile tinnitus.

Hope this helps.

Dr. Stephen Nagler