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Pulsatile tinnitus is the one ear that can be caused by several different conditions. Here are some causes and solutions for pulsatile tinnitus in one ear. If your pulsatile tinnitus is accompanied by ringing in the ear, you should see a doctor right away. If you suspect it may be related to an underlying medical condition, your doctor may refer you to an ophthalmologist or a vascular specialist to rule out possible vein or eye problems.
Sigmoid sinus diverticulum
Sigmoid sinus diverticulum is a rare etiology of pulsatile tinnituses of the one ear. It is a blood-carrying channel on the side of the brain that exits via the internal jugular vein. During the process of a person’s life, it may become infected or enlarge. This condition is diagnosed by the physician’s examination, and if there is a diagnosis, surgery may be necessary.
A 31-year-old woman had a three-year history of pulsatile tinnituses in her right ear. She had a low-pitched audible bruit around the right mastoid, and her hearing was reduced or increased with compressing the right upper neck and left the jugular region. Her otoscopic examination was normal. She was given an intravenous contrast injection to enhance the images. A conventional cerebral angiogram revealed a small sigmoid sinus diverticulum (7×6 mm).
While there is little evidence to support a causal relationship between Sigmoid sinus diverticula and PT, it may contribute to elevated intracranial pressure in patients with PT. In addition, Sigmoid sinus diverticula are associated with venous stenosis, which has been hypothesized to play a role in sound generation. In some cases, treatment for the diverticulum and venous PT should be done concurrently.
Sigmoid sinus dehiscence is also a potential cause of pulsatile tinnituses in one ear. The dehiscence is most common in SSWA patients and may be a complication of idiopathic intracranial hypertension. It may also be associated with an undiagnosed SSWA.
Glomus tumors
In cases of pulsatile tinnituses in one ear, it is possible that a mass in the glomus tympanicum is causing the problem. Such a tumor usually involves erythema and occupies the middle ear cavity. The mass may also invade nearby structures and secrete vasoactive and catecholamine substances. Although a glomus tumor causes pulsatile tinnitus in only one ear, it can sometimes transform into a malignant tumor. The site of origin is determined by the cellular composition of the tumor.
Diagnostic imaging is critical in the diagnosis of glomus tumors. They are typically reddish-purple vascular masses that resemble normal paraganglia. A glomus tumor has characteristic clusters of chief cells (called zellballen, literal translation of cell balls) that are enhanced by silver staining. Although this pattern may not be appreciated in smaller tumors, it is important to consider this tumor in the context of other causes of pulsatile tinnitus in one ear.
Another cause of pulsatile tinnituses in one ear is a tumor of the glomus jugulare. Although rare, this type of tumor can be mistaken for a dural fistula, and a doctor should rule out a dural fistula. As a result, it is important to seek medical treatment as soon as possible.
Surgical resection is the mainstay for the treatment of glomus tumors. This condition is the most common cause of pulsatile tinnitus in one ear, and surgical resection is the primary method of treatment. As with other causes of pulsatile tinnitus, treatment involves the removal of the tumor or a combination of surgical approaches…
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