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Dr. Andrew Rynne

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Why am I able to hear and feel pulse above soft palate?

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Dr. Sumit Bhatti

ENT Specialist

Practicing since :1991

Answered : 2563 Questions

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Posted on Wed, 19 Dec 2012 in Ear, Nose and Throat Problems
Question: Hi! For about 2 years now,I can hear and feel my pulse just above my soft palate. It occasionally causes a brief ringing in my ears. I also have a sort of full feeling in my left ear. I don't have the normal symptoms for patulous eustachian tube, and my ENT says that I don't have eustachian tube dysfunction. The problem is in both ears, but my left ear is worse than my right. Started around the same time as a globus sensation. Will occasionally remit for a few days. Head and neck massage helps for a few days as well. Normal MRI and carotid sonogram. TMJ - 2 mm too far to the right, but no pain or popping. Any idea what this could be? It is VERY annoying, to the point of depression.

Sincerely,

XXXXXXX
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Answered by Dr. Sumit Bhatti 1 hour later
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 additional sounds which comprise objective tinnitus. Both these types may co-exist.
b. You ear drums are normal and your PTA (Pure Tone Audiogram) and Impedance Audiogram (Tympanometry) is normal (no middle ear problems).
c. You have any sinus disease or thyroid disorder.
d. Your blood pressure is within normal limits.
e. You are not anemic (low hemoglobin)

2. Since the tinnitus is in both ears and the MRI Scan and Carotid Sonography is normal, an MRI Angiogram may be done.

3. I would rule out the following conditions:
a. Atherosclerosis (turbulent blood flow). Get a Lipid Profile done.
b. A persistent Stapedial Artery.
c. Benign Intracranial Hypertension.
d. Cervical spondylosis.

4. If MR-Angiogram is normal, this pulsatile tinnitus may be a palatal myoclonus, since you have been diagnosed with Benign Fasciculation Syndrome.

5. 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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