Hi,

Thank you for your query.

1. I am assuming that:
a. You have true pulsatile tinnitus synchronous with your heartbeat and that there are no additional sounds.
b. You ear drums are normal and your PTA (Pure Tone Audiogram) and Impedance Audiogram (Tympanometry) is normal (no middle ear problems or ear infection). Get a Tympanogram done to check middle ear pressures and Eustachian Tube function. If this Impedance Audiogram is abnormal, then a trial of medication should be taken for three to four weeks. If this does not work, a myringotomy with a grommet insertion may help. Steroid drops can be given through this ventilation tube.
c. Your blood pressure is within normal limits.
d. There is no vertigo or dizziness.

2. Hyperthyroidism is a cause for pulsatile tinnitus. Other common conditions which increase blood flow are anemia (low hemoglobin) and strenuous exercise. Get your Thyroid function tests.

3. I would also rule out the following conditions:
a. Atherosclerosis (turbulent blood flow). Get a Neck Doppler and Lipid Profile done.
b. ECG and 2D Echo to check heart function.
c. A persistent Stapedial Artery.
d. Benign Intracranial Hypertension.
e. Sigmoid Sinus Dehiscence or diverticulum.
f. Cervical spondylosis.

4. Kindly let me know the results of your investigations. This will help in suggesting further treatment.

I must emphasize that in a vast majority of patients of tinnitus, the cause is never found. However there are further treatment options.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.

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