Pulsatile Tinnitus and Sinuses

[aflorida79]

Hello I am 28 years old and this is what is going on.
I have been sick on and off for the past 2 months, on March 5th my body gave up and my husband took me to the ER where they diagnosed me with pneumonia. Was put on antibiotics for 5 days and cough medication.  Four days later I realized I could hear an "ultrasound noise", how I can best describe it, and it was so loud it was scary, I had terrible headaches and started vomiting, so again to the ER where they did a CT scan without contrast and they found ild moucus on the left frontal sinuses, then they put me on antibiotics for another 10 days and oxycoden por pain.  The headaches have been worst, I feel pressure on the inside of my ear too and the noise is driving me insane, when I push down on my jugular vein, it stops.  I went back a wk later because I felt the pain down my neck to my shoulder and chest, they did and EKG was normal, then a carotid ultra sound and the doctor told me that what they found wasn't something to admitt me immediately but to go to a Neuro.  So I did, she didnt even touched me, but based on what I told her, she diagnosed me with Pulsatile Tinnitus, then they ordered a MRI/MRA with and without contrast, the nurse called me and said the doctor had asked to call me to let me know its negative....whats negative?? So frustrating!! So last nite was one of the worst the pains are killing me, I went to ENT today, they did audiogram and I passed nicely and all. He then says I sound like I have a "major sinus infection", doeas not even mention the tinnitus, and puts me on steroids and antibiotics for another week.
Am I on the right track here?  Can someone help me?
I appreciate it!

Arlene

[Quixotic1]

Hi, Sorry you're going through this.  You were absolutely right about the pulsatile ("in time with and caused by the pulse of the heart) tinnitus (a sound heard only by the patient and not from the outside).  You likely have some dilated vessels on the eardrum, in the middle or inner ear. The blood flow in that area is increased and you are hearing this.  The inflammation from a sinus infection or from an ear infection is the most common cause of sudden, usually temporary, pulsatile tinnitus.  It "should" subside as the infection/inflammation subsides.

They checked out the brain and the carotid artery to make sure there was no pressure (like a narrowing or tumor) on the artery.  That was negative, so that is good.  The sound goes away when you press on the carotid artery because that reduces the blood flow to the ear (and brain).  I am also presuming that when they examined you they listened over the carotid arteries with the stethoscope?  That needs to be done to make sure they really can't hear the sound with their own ears.  If it can be heard by the examiner, then the sound is called a "bruit" and can be serious.

Tinnitus itself is very difficult to treat.  It can occur from neurologic insults also like neuro disease (eg. MS), trauma, whiplash, med side effect (most notably aspirin - though that is usually constant)  The best thing you can do is distraction, have music on in the background and listen to it.  Tinnitus is worsened by focusing on it (like a sore in your mouth and trying to keep you tongue away from it).  Steer clear of any stimulants (in terms of the tinnitus)  This includes caffeine and would also include decongestants.  (With decongestants like pseudoephedrine or phenylpropanolamine you have to weigh the benefit of the decongest in helping the pain of the infection versus the annoyance of the tinnitus)

Tinnitus itself is not harmful - to the body - it is a great aggravation to the sanity.  I have had tinnitus while awake 24/7 for 25 years.  It became severe in 2000 and I have had to slowly train myself to ignore it.  Mine, though, was caused by a head injury.

I commiserate with you.  But, it should resolve as the inflammation does.  Good luck,

Quix, MD (not here officially, not a neurologist and not an ENT specialist, but a tinnitus sufferer also.)

[aflorida79]

Thank you very much for all the info.  I am sorry you have had this for sooo long.  Yes, the doctors can hear it with the stetoscope and call it a bruit, that is why they have done all those tests.  The noise is bad, but whats worst are the pains...I feell like my left side of head its being pulled out of ear...I start feeling nauseated too.  Hopefully the steroids and new antibiotics will take care of it.
Thank you again Quix