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Treatment of Pulsatile Tinnitus
By Dr. Prof. Vishal Pathania – ENT Specialist in Gurgaon
Pulsatile tinnitus is a distinct type of tinnitus where patients perceive a rhythmic sound in their ear, often in sync with their heartbeat. Unlike the common ringing or buzzing of tinnitus, pulsatile tinnitus usually indicates an underlying vascular or anatomical cause. While it can be distressing, timely evaluation and proper treatment can significantly improve quality of life.
Causes of Pulsatile Tinnitus
Before starting treatment, identifying the root cause is essential. Some common causes include:
Vascular abnormalities such as arterial stenosis, aneurysm, or venous hum.
Middle ear conditions like glomus tumors or middle ear effusion.
Increased intracranial pressure (idiopathic intracranial hypertension).
Atherosclerosis and hypertension.
Arteriovenous malformations (AVMs).
Diagnosis
Treatment begins with a thorough evaluation, which may include:
ENT examination with otoscopy.
Audiological tests to assess hearing function.
Imaging studies (CT scan, MRI, MR angiography, or venography) to rule out vascular or structural causes.
Blood pressure and cardiac assessment if systemic factors are suspected.
Treatment Options for Pulsatile Tinnitus
1. Treating the Underlying Cause
Ear infections or effusion → antibiotics or drainage procedures.
Glomus tumor or vascular malformations → surgery, embolization, or radiosurgery.
Idiopathic intracranial hypertension → weight reduction, acetazolamide, or CSF shunting.
Hypertension and atherosclerosis → lifestyle changes, antihypertensive drugs, or cholesterol control.
2. Medical Management
Medications to control blood pressure, reduce intracranial pressure, or manage vascular disease.
Lifestyle modifications: low-salt diet, exercise, weight management, avoiding caffeine and smoking.
3. Interventional and Surgical Options
Endovascular procedures for arterial stenosis or AV malformations.
Surgical removal of tumors or vascular lesions if indicated.
4. Symptomatic Relief
If the cause is not immediately treatable:
Sound therapy and masking devices to reduce awareness of the pulsating sound.
Cognitive Behavioral Therapy (CBT) to manage anxiety linked with tinnitus.
Relaxation techniques and stress management.
When to See a Doctor
Seek urgent ENT consultation if:
Pulsatile tinnitus is sudden in onset.
It is only on one side.
It is associated with hearing loss, dizziness, headaches, or neurological symptoms.
Conclusion
Pulsatile tinnitus is not just an annoyance – it can be a sign of significant vascular or neurological problems. With proper diagnosis and targeted treatment, many patients experience complete relief. At Pathania ENT Clinic, Gurgaon, we use advanced diagnostic tools and multidisciplinary care to provide the best treatment for tinnitus, tailored to each patient’s cause and condition.
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