RNID: For deaf and hard of hearing people.

This factsheet is part of our tinnitus range. It is written for people who have tinnitus, their families, friends and the professionals who work with them.

Tinnitus is a medical term to describe noise(s) that people can hear in one ear, both ears or in the head – such as ringing, buzzing or whistling. The sounds heard can vary from person to person, but the common link is that they do not have an external source.

If you would like this factsheet on audio tape, in Braille or in large print, please contact our Information Line.

Read this factsheet to find out:

At the end of this factsheet, we give you details of organisations you can contact for further information.

Medical disclaimer

The information given in this factsheet is not medical advice and by providing it neither RNID nor our tinnitus and medical advisors undertake any responsibility for your medical care, nor accept you as a patient. Before acting on any of the information contained in this factsheet, or deciding on a course of treatment, you should discuss the matter with your GP (family doctor) or other medical professional who is treating you.

What is pulsatile tinnitus?

Pulsatile tinnitus is a type of tinnitus where you hear rhythmical noises that beat at the same rate as your heart. If you check your pulse while listening to the pulsatile tinnitus, you will notice that they beat at the same rate.

What causes pulsatile tinnitus?

Pulsatile tinnitus has two main causes:

  • changes in blood flow in the blood vessels near your ear
  • an increase in your awareness of the blood flow near your ears.

Only in exceptional cases is pulsatile tinnitus a sign of a more serious condition.

Changes in blood flow

  • You might develop a general increase in the blood flow throughout your body, for example if you exercise strenuously.
  • You might develop a localised increase in blood flow, which can happen if a blood vessel is narrower than usual. To compensate for this, neighbouring blood vessels have to carry extra blood and this extra flow generates noise.
  • You might develop a turbulent blood flow. This happens when your arteries harden - atherosclerosis - and this causes the blood vessel to narrow and prevents blood from flowing smoothly. This flow then becomes noisy in the same way that a smoothly-running river becomes noisier at a set of rapids or a waterfall. 
  •  You might develop an increased awareness of blood flow.
  • If you have a perforated eardrum or glue ear, you may become more aware of sounds inside your body as they are no longer masked by external sounds. Glue ear is a condition where a sticky glue-like fluid builds up in the ear.

What is the relation between blood flow and pulsatile tinnitus?

  • If you have a localised increase in blood flow, which can happen if a blood vessel is narrower than usual, neighbouring blood vessels have to carry extra blood – this extra flow generates noise.
  • Turbulent blood flow can occur when your arteries harden (atherosclerosis). Atherosclerosis causes blood vessels to narrow and prevents blood from flowing smoothly. Blood flow then becomes noisy – in the same way that a smoothly running river becomes noisy when it reaches rocks or a waterfall.

What is the relation between increased awareness and pulsatile tinnitus?

  • An increased sensitivity in your hearing pathway can make your brain more aware of normal noises in your blood vessels. This is similar to becoming aware of non-pulsatile tinnitus.
  • If you have a hearing loss or a hearing condition, such as a perforated eardrum or glue ear, you may become more aware of the sounds inside your body because they are no longer ‘masked’ by external sounds.

How is pulsatile tinnitus diagnosed?

You need to see your GP first. They will refer you to a hospital consultant, who will take a detailed medical history and examine you. In particular, they will look at your eardrums and the blood vessels in your neck and skull. They will use a stethoscope to see if they can hear a pulsatile noise in your neck and skull – if so, this is called ‘objective tinnitus’ (because it can be heard by other people).

You will also have a series of hearing tests, which is usual for any type of tinnitus. Your consultant may use imaging techniques, such as ultrasound or magnetic resonance imaging (MRI), to look at how blood is flowing through your body. Such scans are routine and do not indicate that the consultant believes that something is seriously wrong with you.

How is pulsatile tinnitus treated?

If a specific cause for pulsatile tinnitus can be found – such as high blood pressure or glue ear – then it may be possible to treat. If no underlying cause is found, you will be shown how to manage your tinnitus. You may be offered counselling, sound therapy, relaxation therapy and tinnitus retraining therapy (TRT). You can find out more about these by contacting RNID Tinnitus Helpline.

Where can I buy products that may help?

RNID Products sells a range of equipment for people with hearing loss and tinnitus. Visit the RNID Shop at www.rnid.org.uk/tinnitusproducts (external link) to buy items of equipment online. Alternatively, you can request a copy of the Solutions catalogue by contacting RNID Products directly or by contacting RNID Tinnitus Helpline.

RNID Products, 1 Haddonbrook Business Centre, Orton Southgate, Peterborough PE2 6YX
Telephone: 01733 361199
Textphone: 01733 238020
Fax: 0870 789 8822
Email: solutions@rnid.org.uk
RNID Shop website (external link, opens new browser window)

Where can I get further information?

British Tinnitus Association (BTA)

The BTA campaigns for better services for people with tinnitus. It supports a network of local tinnitus groups around the country, has a range of publications and produces a quarterly magazine, Quiet.

British Tinnitus Association (BTA), Ground Floor, Unit 5, Acorn Business Park, Woodseats Close, Sheffield S8 0TB
Telephone: 0800 018 0527
Textphone: 0114 258 5694
Fax: 0114 258 2279
Email: info@tinnitus.org.uk
BTA website (external link, opens new browser window)

Hush

Hush is the name of the Hull tinnitus self-help group. They run a helpline and produce information and tapes for people with tinnitus.

Hush, 109 Southella Way, Kirkella, Hull HU10 7LZ
Telephone: 01482 656033
Email: hush@btinternet.com
Hush website (external link, opens new browser window)

Contact a local group

If you feel you need more help with tinnitus directly from other people who also have it, you could contact a local tinnitus support group. They are set up and run by people with the condition or by professionals who work with tinnitus patients. The type of support and help they are able to offer varies between groups. Contact RNID Tinnitus Helpline for details of your nearest group.

Further information from RNID Tinnitus Helpline

RNID Tinnitus Helpline offers information and advice to people with tinnitus, their families and friends, and the professionals who work with them. You can contact us for further copies of this factsheet and the full range of our products for people with tinnitus. We also sell a book, "Understanding tinnitus – managing the noises in your ears or in your head", and a range of relaxation CDs and cassettes.

RNID Tinnitus Helpline

19-23 Featherstone Street, London EC1Y 8SL
Telephone: 0808 808 6666
Textphone: 0808 808 0007
Fax: 020 7296 8199
SMS: 0780 0000 360 (supported by Lloyds TSB)
tinnitushelpline@rnid.org.uk  
Tune out tinnitus website (external link, opens new browser window)
Available Monday-Friday, 9am-5pm

Acknowledgement

For valuable help and advice, we thank Don McFerran FRCS, Consultant Otolaryngologist, Essex County Hospital, Colchester.

This factsheet was produced in collaboration with the British Tinnitus Association.