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Pulsatile tinnitus in left ear for years
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Questions in the Ear Disorders forum are answered by Dr. Eric Wilkinson. Topics include acoustic neuroma, skull base tumors, hearing loss, cochlear implants, stapes surgery, eardrum repair, chronic ear infection, facial nerve problems, childhood deafness, vertigo, balance disorders, and tinnitus.

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Pulsatile tinnitus in left ear for years

For at least 12 years I believe I have been suffering from this symptom. I have never had a thorough examination due this this specific symptom however. In fact no one has ever diagnosed me with this even though I have seen a few ENT in the past, and only one of them asked me to get a hearing test done, which I choose not to do because my hearing was in my opinion not a serious issue nor have I seen any noticeable hearing loss. I have however just recently done research on the internet and have come to this conclusion mainly because the symptoms are almost identical to those who suffer from this symptom.
To be a little more specific on this though, it only effects my left ear and it very rarely is noticeable when I am standing up or sitting down in a normal position. But when I bend over to pick something up or when I lower the top of my head to the ground that is when the tinnitus becomes awful, the whooshing roaring sound becomes much louder.  On top of all this I also have terrible balance which I have been experiencing for years. As to whether or not this is because of Pulsatile tinnitus I am not positive.

My question is this. What is most likely causing this to happen and what can be done about it?

I do plan on seeing a ENT on this issue later in the month but it is really bothering me and would like a response or possible diagnosis sooner than that. Thanks.
Related Discussions
Avatar_dr_m_tn
Pulsatile tinnitus requires an ENT evaluation, audiometry, and possible imaging (CT and MRI/MRA/MRV) to determine the etiology.  Sometimes the pulsatile tinntitus that you are describing, that is worse with bending over, is from a venous hum due to a large jugular vein on one side.  If compressing the jugular vein on that side of the neck makes it go away, that is also suggestive.

See your ENT for a full evaluation.

This answer is not intended as and does not substitute for medical
advice - the information presented is for patients education only.
Please see your personal physician for further evaluation of your
individual case.
6 Comments
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Avatar_n_tn
This is my guess

http://www.vestibular.org/vestibular-disorders/specific-disorders/canal-dehiscence.php

It is pretty rare and few people talk about it.
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152264_tn?1280358257
I'm amazed that you've been having position-related tinnitus and terrible balance for many years without having consulted a doctor about it!!

I wouldn't agree with W/a/J that it sounds like superior canal dehiscence. I wonder if you have a vascular problem causing it, which is intensified by the increased intracranial pressure of bending over?

But I don't know.. I'm not a professional of any sort.

Get it checked out by your doctor!! You should definitely have a hearing test, because small hearing losses can be unnoticeable to the patient but still be present and signify something. My sister-in-law has a vascular loop and some hearing loss on that side that she never knew about until tested.

Best of luck to you.

Nancy T.
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Avatar_m_tn
In answer to what can be done about it - The tinnitus and the balance problem will go away gradually with these exercises.
The Yoga Pranayam (breathing exercises) will  help with ear problem.
Build up your timing gradually. If you feel tired or dizzy, stop and resume after 1 minute.

Bhastrika - Take a long deep breath into the lungs(chest not tummy) via the nose and then completely breathe out through the nose. Duration upto 5 minutes.

Anulom Vilom –
Close your right nostril with thumb and deep breath-in through left nostril  
then – close left nostril with two fingers and breath-out through right nostril  
then -keeping the left nostril closed  deep breath-in through right nostril
then - close your right nostril with thumb and breath-out through left nostril.
This is one cycle of anulom vilom.
Repeat this cycle for 20 to 30  minutes twice a day(maximum 60 minutes in one day).
You can do this before breakfast/lunch/dinner or before bedtime or in bed.Remember to take deep long breaths into the lungs.You can do this while sitting on floor or chair or lying in bed.


Bhramri Pranayam -Close eyes. Close ears with thumb, index finger on forehead, and rest three fingers on base of nose touching eyes. Breathe in through nose. And now breathe out through nose while humming like a bee.
Duration : 5 to 12  times

Kapalbhati -(Do it before eating) Push air forcefully out through the nose about once per second. Stomach will itself go in(contract in). The breathing in(through the nose) will happen automatically. Establish a rhythm and do for 20 to 30 minutes twice a day.(Max 60 min/day) Not for pregnant women. Seriously ill people do it gently.

Once you are better, continue the pranayam once a day.
Be patient, as the benefits will show over a period of months.Only by doing you will benefit
and feel good because you are helping your body.Those who say I have tried everything....
will be amazed at the result of doing pranayam.
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Avatar_n_tn
Nancy, could be correct too...

No doubt but my hunch should be investigated, and easily ruled out through case history and a VEMP. If your ENT does not know what a VEMP is, you need to skip right on out of the office, and find someone that is more current.

I have to agree, don't forget to breathe, without it, you could die. I have been breathing every day of my life...  so far, it has worked wonders. I save time though, I do it through both nostrils at the same time. It takes practice!  Who Knew?
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Avatar_n_tn
Thanks to everyone for all your concern and comments. I just recently saw an ENT and am now scheduled for a MRA soon as my insurance approves of it. At the doctor office however the ENT noticed no cause of symptoms after examining my ear. I also got a audiometry test, and I was told my hearing was fine.

Dr. Wilkinson coincidentally I found a small lump on the left side closer to the back of my neck, that is not noticeable at all by sight. However, this lump can be pretty easily found by rubbing my neck. I actually recall finding this same lump a few years ago but thought that it wasn't anything serious and didn't have to do with my ear problem.  Also I checked the right side of my neck in the same location and no lump was present. I'm taking a guess that this could be causing my pulsatile tinnitus. Also I tried applying pressure to the left side  of my neck while bending over and I didn't notice any change in my symptom. Do you still feel this could be a venous hum from a large jugular vein? or could it be a vascular malformation or something else?

Also the ENT I saw told me to get a MRA of my temporal bone. I just left him a message explaining that there is a small lump on my neck. When I get in contact with him I will probably ask to get a MRA of my neck as well. Any other suggestions? Thanks again.
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