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If the sound in your ear pulses in time with your heartbeat, it’s not the same condition as classic ringing. It’s called pulsatile tinnitus, and it has a physical source.
Unlike phantom tinnitus generated by the brain, pulsatile tinnitus is real sound, usually turbulent blood flow in a vessel near the temporal bone of the ear.
Common sources include narrowed or atherosclerotic carotid arteries, glomus tumors of the middle ear, dural arteriovenous fistulas, and intracranial hypertension pressing on the venous sinuses.
Because the sound originates outside the auditory system, a clinician can sometimes hear it through a stethoscope placed behind the ear, which classic tinnitus cannot do.
It is one of the few ear symptoms that warrants imaging, and guidelines recommend an MRA or CTA workup to rule out vascular causes.
Source: Hofmann, E., Behr, R., Neumann-Haefelin, T., & Schwager, K., ‘Pulsatile tinnitus: imaging and differential diagnosis,’ Deutsches rzteblatt International, 2013
For educational purposes only. Not medical advice.
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