pulsatile tinnitus that comes and goes


Do you have tinnitus and it worries you?

Do you want to know what causes tinnitus or the occasional ringing in the ear?

If you want to know what causes occasional throbbing tinnitus, why it occurs, and what are some ways to treat it, we recommend that you read on.

In this article, we want to answer your questions about tinnitus and occasional throbbing tinnitus.



What is tinnitus?

Types of tinnitus

What are the causes of tinnitus?

What are the factors that cause tinnitus?

What is throbbing tinnitus?

What are the causes of occasional throbbing tinnitus?



How can tinnitus be prevented?




Tinnitus or ringing in the ears can be unilateral or bilateral and can also be caused by middle ear injuries, inner ear injuries, high blood pressure or vascular problems such as atherosclerosis of the peripheral arteries, In fact, after hearing tests and examinations, hearing tests will determine the cause of your infection.


What is tinnitus?

Doctors use the term tinnitus to describe ringing in the ears that they have. There are many people with tinnitus who, when they want to complain to their doctor, say they hear a ringing in their ears unilaterally or bilaterally, but despite hearing a ringing in the ear, it is the most common description that patients have of their discomfort. Other sounds can be heard in the ear, including the description of the sounds that are heard in the ears of these people can be referred to the following:

Rumble  /  Whistle  /  Buzz  /  Hiss

The sufferer hears sounds in his ear for which there is no external source, meaning that there is nothing around the person that has produced the sounds that are heard.

Unfortunately, tinnitus can be very distressing if it occurs for a long time, and sometimes the sound you hear can interfere with hearing the real sound of the environment and the real sound of your relatives and those around you. Long-term tinnitus has been shown to be associated with depression, anxiety and stress, as well as an increased risk of suicide.


Types of tinnitus

Tinnitus can be unilateral or bilateral. Tinnitus may be objective or subjective. Tinnitus, if it is objective, means that both you and other people can hear sounds. This is usually due to disorders in the blood vessels in and around our ears. This means that when your heart is pounding, you and others can hear the sound of your heart beating. Tinnitus is a throbbing tinnitus that is sometimes felt following an increase in heart rate, increased blood pressure or increased blood flow to the arteries around the ear, and atherosclerosis or hardening of the peripheral arteries.

Subjective tinnitus is rare, but objective tinnitus is much more common. Only you can hear sounds such as ringing, roaring, wind, dripping water, etc in your ear.

Mental tinnitus or objective tinnitus

Physical tinnitus or subjective tinnitus


What are the causes of tinnitus?

Injuries to your middle or inner ear are one of the reasons that can manifest as tinnitus.

You know that the human middle ear receives sound waves and directs these waves to the inner ear, and in fact it is the inner ear that, with its organized structures, converts these sound waves into electrical impulses and converts them. They are sent to the brain through the nerve, and the brain receives and interprets this finding and data in the auditory center, so that you can hear and understand the sound of the environment.

Humans are only able to hear the sounds of their surroundings when the brain interprets these electrical signals and translates them into sound. When the inner ear is damaged, it changes the path of data transmission as well as (in brain damage) the path of sound processing by the brain.


What are the factors that cause tinnitus?

Damage to the eardrum and damage to the middle ear bones can impair sound conduction.

Tumors that are inside the ear or tumors that develop benignly or malignantly near the auditory nerve can also cause ringing in the ear by applying pressure, inflammation, and changes to the auditory nerve.

Another factor that can cause tinnitus is exposure to loud noises or noise pollution.

 Research shows that people who have used chainsaws and heavy tools that make a lot of noise are much more likely to develop tinnitus or tinnitus. Also, if a person frequently listens to loud music through headphones, he is more likely to develop tinnitus and headaches.

Other causes include the toxicity of some drugs. These drugs include:


  • People taking high doses of aspirin, for example, take high-dose aspirin for a long time
  • The second category is diuretics such as boomtanide
  • Antibiotics such as gentamicin and erythromycin
  • Antimalarial drugs such as chloroquine
  • Certain drugs used in chemotherapy courses such as vincristine, cisplatin


Other factors that can cause tinnitus include:

  • People with hypercholesterolemia or high blood cholesterol
  • People with head and neck trauma
  • People with hypertension
  • People with TMJ (temporomandibular joint) disorders may also have tinnitus. In addition to tinnitus, they may also have jaw pain and headaches.
  • Muscle spasm in the middle ear (such as the tympanic tensor muscle)
  • Accumulation of earwax, which in addition to ringing in the ears can also cause changes in hearing
  • And finally, aging, which can be associated with hearing loss.


What is throbbing tinnitus?

When the sound is heard in the ear or the tinnitus is rhythmic, it is called pulsating tinnitus.

This rhythm generally follows the heartbeat as well as the sound of blood flowing through the arteries

Many people with pulsating tinnitus experience it occasionally.

When their heart beats, they say that their ears are buzzing at the same time.

Unlike other forms of tinnitus, which are caused by ear problems, head and neck trauma, structural problems in the ear structure, and disorders of the auditory pathway to the brain and sound processing center in the brain, pulsating tinnitus does not follow these conditions. Rather, pulsating tinnitus is caused physically.


What are the causes of occasional throbbing tinnitus?

Pulmonary tinnitus occurs when the ear becomes aware of a change in blood flow to nearby arteries. These factors include:

Changes in the walls of blood vessels inside or around the ear

Base scalp vascular problems

And increased blood flow to the arteries of the head and neck

In the following, we will explain some of the common causes of throbbing tinnitus.


  • Generalized increase in blood flow or increased blood circulation

These occasional, throbbing sounds are more likely to be heard in the ear when the blood is moving faster than before in the arteries, such as when a person is doing very strenuous exercise or when a woman is pregnant.


  • Severe anemia

Another factor that causes a person to develop pulmonary tinnitus is severe anemia.


  • Hyperthyroidism

Another factor that can cause pulsating tinnitus is an overactive thyroid gland (hyperthyroidism).

When a person has hyperthyroidism, changes in the body actually occur following an increase in hormone produced by the thyroid gland, one of which is an increase in blood flowing through the arteries throughout the body.


  • Increased localized blood flow

When it happens that blood flow is increased in only one or more groups of blood vessels, tumors in the head and neck can also cause abnormal blood vessels to grow in these areas, causing blood flow to occur in Abnormally formed blood vessels cause the person to feel a throbbing tinnitus in the affected ear.

When we talk about tumors that can cause pulsating tinnitus, these tumors are mostly benign and not cancerous.


  • Turbulent blood flow

which is a change in the walls of arteries with age and is Often referred to as hardening and thickening of the inner wall of the arteries, it causes bumps and bumps in the arteries and in the flow of blood through the arteries. The presence of these bumps, and in fact the lack of a smooth path, causes a turbulent flow, and in fact, the sound of this flow can be heard in the arteries near the ear.


  • highest awareness

Some people are very sensitive in their auditory pathways, which means that their brains are more alert and sensitive to the natural sound that is due to blood flow in the arteries near the ear, and in fact these people will hear these sounds more.


  • Intracranial hypertension

Conditions that can cause increased intracranial pressure may, in addition to throbbing tinnitus, cause headaches as well as visual disturbances.

Young and middle-aged people, especially women who are overweight, are at higher risk for the disorder

This disorder is sometimes referred to as idiopathic or benign intracranial hypertension, which occurs with pulsating tinnitus, headaches, and vision problems. Confusion or hearing problems may also occur.



When you see a doctor with tinnitus, the doctor will first take a detailed history of you and ask you about the symptoms and manifestations that are bothering you now. It also asks about your medication history, your medical history, trauma, and head and neck injuries. And asks you about recent surgeries and family history.

It then examines you for the differential diagnoses it has in mind, and usually uses a hearing test to pinpoint the exact causes of your tinnitus.

Hearing tests are usually performed by hearing test specialists. Sounds are transmitted to each person's ear individually via a headphone. The person should then announce when they hear a sound in each ear by pressing a button or raising their hand.

They may also determine the possible causes of your tinnitus by comparing what you hear to what your peers should hear.

Sometimes, depending on the situation, a CT scan or MRI may be used to help the doctor find out if there is any damage or anatomical defect in the ear.

One point is that most standard radiographs may not show all vascular disease, tumors, and other abnormalities.

When it comes to throbbing tinnitus, you may need to have a more complete vascular examination. For example, your blood pressure should be measured and if you have cardiovascular problems and blood pressure problems, you should be referred to a specialist to regulate blood pressure or disorders in the cardiovascular system.



Treatment for tinnitus depends entirely on the underlying cause. Your doctor will check for any vascular abnormalities and blood pressure disorders, as well as tumors. If there is extra ear wax or wax, remove it. If your tinnitus is related to medication, your doctor may modify or replace your medication to restore ear health.


  • medicines

Your doctor may choose medication to eliminate the extra noise in your ear or to reduce the noise you hear in your ear. Among the drugs used to treat and reduce tinnitus, we will name the following common drugs:

Amitriptyline and nortriptyline are tricyclic antidepressants and can sometimes be used with a doctor's prescription.

Regarding the above drug treatments, I must say that they can reduce the noise in some cases and in a group of people, but not all people respond to these drugs properly, and sometimes their side effects can be annoying and dangerous. Side effects of these drugs include fatigue, constipation, blurred vision and nausea.

Also, in rare cases in people with good background conditions, these drugs can cause heart problems.


If you have tinnitus and are looking for a home remedy for it, pay attention to the following


  • Tinnitus and home remedies

There are devices called "tinnitus masks" that can produce soothing sounds, thus eliminating the annoying ringing, roaring and buzzing of the ear and overlapping the sounds that are bothering your ear.

These devices may look like hearing aids. Sometimes the internal mask of the hearing aid itself is used in people who also have hearing loss.


  • Lifestyle changes to control and reduce tinnitus

Reducing stress can control tinnitus. It is said that stress alone does not cause tinnitus, but because of the effects it can have on blood pressure, it can increase the likelihood of developing pulsating tinnitus and make it more severe.

We recommend that you avoid exposure to loud noises and avoid listening to loud music with headphones to reduce the severity of tinnitus.

Sometimes in some people with tinnitus, amplifying the voice can help reduce the sound of ringing in the ears. In this way, these people can easily get rid of annoying tinnitus by amplifying the sounds in the environment with hearing aids.


  • Cochlear implantation

Cochlear implants are sometimes needed. ‌ The purpose of implanting cochlear implants is to repair hearing loss, and this implant allows the damaged part of the ear to be strengthened and help with effective hearing. It is actually a microphone implanted just above the ear that connects to the set of electrodes in the inner ear


The implant transmits the signal you need to hear to the auditory nerve for processing. These implants use electrical stimulation and will help the brain to properly understand sounds.


How can tinnitus be prevented?

Protect your ears from loud noises as much as possible to reduce the risk of developing tinnitus.

Be sure to pay close attention to the sound quality of your TV, radio and music players. Be sure to use ear protection when exposed to sounds higher than 85 decibels. Noise higher than 85 decibels equals the average noise of heavy traffic.

If you are faced with loud construction noises

Or if you are in an environment where loud music is playing

You should use appropriate and protective ear protection, such as earplugs.

If you do not have this tool, be sure to cover your ears completely by hand.

You should also avoid medications that are toxic to the ear and damage the ear.

Finally, if you encounter any annoying manifestations, you should see a doctor for an examination.

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