Pulsatile tinnitus is the type of tinnitus that can be heard by other people aside from the person experiencing the tinnitus.  It is pulsatile because the noise is rhythmic and it beats along with your heartbeat.  There is only approximately 3% who have pulsatile tinnitus from those who experience tinnitus.  Another term used to call pulsatile tinnitus is objective tinnitus. 

Pulsatile tinnitus may be heard with a number of characteristic sounds like a low pitched booming or thumping, also a rough blowing sound which coincides with respiration, or a clicking high pitch rhythmic sound.  The beating can be single, rhythmic or multiple biphasic beats.  Contractions in the middle ear may cause a rapid clicking sensation.  Low volume ear hums which are inaudible to the examiner can be due to blood flow in the veins or associated with Meniere’s disease.

The causes of pulsatile tinnitus are because of one of two things.  It may happen due to some changes in the blood flow of the blood vessels near the ears or it may happen when a person becomes more aware of the flow of blood near the ears.  There are only a few cases when pulsatile tinnitus is a sign of a life threatening condition.

Since the causes of pulsatile tinnitus are the increased blood flow in the vein near the neck, base of the skull and the ears we must know what could possibly be the reasons for these changes.  Strenuous exercise generally increases the flow of blood all over the body.  A localized increase in blood flow happens when there is a blood vessel that is narrow.  To counteract this, the nearby blood vessels will need to carry more blood and the extra flow of blood will create noises.  A turbulent blood flow happens in atherosclerosis.  The arteries harden and the blood vessels are narrowed thus the flow of blood is not smooth and causing noises.  A punctured ear drum can also make you more aware of the sounds in your body since the brain is no longer able to pick up external sounds.

Patients who have pulsatile tinnitus need to undergo proper medical examination to possibly locate the causes of the pulsatile tinnitus.  There are many ways to address pulsatile tinnitus if the cause is determined.  There are some cases however where the causes are unknown and they fall to those that belong to the idiopathic category.  Further examination must be done for those whose initial medical examinations would reveal no abnormalities.  An ultrasound, CT scan, MRI, MRA and angiography may help in determining the causes of pulsatile tinnitus.