Pulsatile tinnitus typically presents as a rhythmic thumping or whooshing sound, which appears to be in synchronization with the heartbeat. Studies do not indicate a clear link between earwax buildup and pulsatile tinnitus.

Tinnitus describes when a person can hear a sound in one or both ears that does not come from an external source.

The condition may present as a ringing sound or other sounds such as roaring, buzzing, humming, or crackling. Pulsatile tinnitus is a rarer form of the condition.

This article discusses whether a buildup of earwax, or cerumen impaction, may lead to pulsatile tinnitus. It also explores the causes of pulsatile tinnitus, treatment, and when someone needs to consider consulting a healthcare professional.

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The body produces cerumen, or earwax, to protect the ears from infection. Earwax typically exits the ear canal naturally due to jaw movement. However, sometimes this process does not work correctly, which can result in a buildup of earwax. Doctors may refer to this as cerumen impaction.

According to a 2020 article, cerumen impaction is a common cause of nonpulsatile tinnitus. However, the research in the article does not suggest that earwax buildup may cause pulsatile tinnitus.

Further research suggests that subjective tinnitus, which is a subtype of tinnitus that may include pulsatile tinnitus, may stem from certain ear conditions that can also lead to hearing loss. One of these ear conditions is cerumen impaction. Therefore, there may be a link between the two conditions. However, further research into the topic may be necessary.

There are two categories of pulsatile tinnitus causes: vascular and nonvascular.

Vascular causes of pulsatile tinnitus can include:

  • Arteriovenous malformation: This is when a tangle of blood vessels in the brain diverts blood from the arteries directly into the veins, instead of passing the blood through the brain tissue, which is their typical function.
  • Dural arteriovenous fistula: This is when there are atypical connections between an artery supplying blood to the brain and the veins that drain it.
  • Internal carotid artery stenosis: This describes a narrowing of the artery that delivers blood from the heart to the brain.
  • Brain aneurysm: This describes bulging in a blood vessel in the brain due to a weakness in the blood vessel wall.
  • Internal carotid artery dissection: This describes a tear in the wall of theartery that delivers blood from the heart to the brain.
  • Congenital vascular variants: This describes various abnormalities in blood vessels present from birth.

Nonvascular causes of pulsatile tinnitus can include:

  • Tumors in areas of the head and neck: This may include paraganglioma, which are rare tumors that form close to some blood vessels and in nerve tissue outside of the adrenal glands.
  • Idiopathic intracranial hypertension: This describes high levels of pressure in the brain.
  • Systemic conditions: These are health conditions that affect the entire body instead of a single organ or body part, such as anemia.
  • Palatal myoclonus: This is a rare condition that involves rhythmic, involuntary, jerking movements of the soft palate. The soft palate is the muscular part at the back of the roof of the mouth.

Treatment for pulsatile tinnitus will depend on the underlying cause behind the condition. A person may require multiple treatments from different doctors if their condition has several causes.

A doctor may recommend general treatments for tinnitus, such as reducing caffeine intake, sound therapy, cognitive behavioral therapy, or tinnitus retraining therapy. However, there is no evidence to suggest that these will help treat pulsatile tinnitus specifically.

If a person requires treatment for cerumen impaction, there are several options available, including:

  • Cerumenolytic agents: These are liquids that help soften or dissolve the ear wax. They may contain ingredients such as almond, peanut, or olive oils.
  • Irrigation: This involves a healthcare professional syringing warm water or a mixture of warm water and hydrogen peroxide into the ear to help remove earwax.
  • Manual removal: If the other methods are ineffective, a doctor may use a special tool to remove the excess earwax from a person’s ear manually. The most common technique for manually removing earwax is microsuction, which involves a doctor using a small instrument to suck earwax out of the ear.

If a person can hear sounds with no apparent source, such as buzzing, ringing, or whistling in their ears that appear to be in synchronization with their heartbeat, they need to speak with a doctor.

A healthcare professional may review someone’s medical history and perform a physical examination to determine whether they have pulsatile tinnitus and its underlying cause.

After an initial appointment, a doctor may then order other diagnostic tests, such as imaging tests, and recommend suitable treatment.

People also need to speak with a healthcare professional if they have concerns about cerumen impaction.

Pulsatile tinnitus is a relatively rare form of tinnitus that typically presents as a rhythmic thumping or whooshing sound that appears to be in synchronization with the heartbeat.

Cerumen impaction may lead to nonpulsatile tinnitus. However, there is not enough evidence to suggest earwax is a direct cause of pulsatile tinnitus. Causes of the condition may include issues with blood vessels or other health conditions, such as tumors and pressure in the brain.

Treatment for pulsatile tinnitus will vary depending on the underlying cause of the condition. A person can consult a doctor for diagnosis if they think they may be experiencing pulsatile tinnitus.