People with pulsatile tinnitus may hear rhythmic sounds from inside their head. Pulsatile tinnitus in only one ear can have many causes, including high blood pressure and certain types of tumors.

Healthcare professionals define tinnitus as a condition in which a person hears sounds that do not come from an outside source. Other people cannot typically hear these sounds. People with tinnitus may hear sounds such as ringing, roaring, or buzzing that come and go.

Pulsatile tinnitus (PT) is a rare form of the condition.

This article discusses PT in more detail, including its causes, diagnosis, treatments, and when to speak with a healthcare professional.

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According to the National Institute on Deafness and Other Communication Disorders (NIDCD), roughly 10–25% of adults have tinnitus. There is no cure for the condition. However, doctors can often provide treatment to help reduce a person’s tinnitus symptoms.

People with PT, a rare type of tinnitus, typically hear noises that beat in time with their pulse. Most people with PT only have it in one ear. Doctors call this unilateral PT. If someone has it in both ears, doctors call it bilateral PT.

Changes to blood flow in a person’s blood vessels can cause PT. This includes the large arteries and veins at the base of a person’s skull, as well as the smaller arteries and veins in a person’s ear.

However, changes to blood flow do not always cause PT. Instead, a person may be more aware of blood flow or other sounds in their body due to causes such as:

A person’s blood flow may change and lead to PT for several reasons, such as:

  • unmanaged high blood pressure
  • increased or faster blood flow in a person’s blood vessels due to:
    • exercise
    • anemia, which is when a person does not have enough healthy red blood cells
    • pregnancy
    • thyrotoxicosis, which is when a person has too much thyroid hormone in their body
  • turbulent or noisy blood flow, which may be caused by atherosclerosis
  • increased or faster blood flow in only one or a few blood vessels, which may be caused by tumors in a person’s neck or head


Certain types of tumors may cause people to have PT in one ear. Paragangliomas are rare tumors that can develop near a person’s carotid artery, which carries blood to a person’s brain, neck, and face. Doctors may also refer to them as glomus tumors.

People with some types of paragangliomas may have PT. They may also have conductive hearing loss (CHL), in which sounds cannot pass from a person’s outer ear to inner ear. People with CHL may hear sounds as faint or muffled.

Paragangliomas that can cause PT include some tumors that form in bones at the base of a person’s skull. Jugular paragangliomas form near a person’s jugular foramen bone, and tympanic paragangliomas form near a person’s temporal bone.

If a person has a paraganglioma, doctors may be able to hear the PT noise during a physical exam.

Tumors that cause PT are normally benign, which means they are abnormal growths in a person’s body that do not spread to other parts of the body and are not cancerous.

However, some benign tumors that cause PT may cause other symptoms and conditions, such as:

Healthcare professionals can identify the underlying cause of a person’s PT in most cases. To diagnose PT, doctors may:

  • check a person’s medical history, including any history of tinnitus
  • conduct a physical exam of a person’s neck, skull, and eardrums, using a tool to look inside a person’s ears
  • conduct hearing tests to check how well a person can hear certain sounds in background noise, which may include speech and tone tests
  • order blood tests
  • use a tympanometer to test how well a person’s eardrum moves in response to air and sound

They may also use different scans to narrow down the cause of a person’s PT, such as:

  • CT and MRI scans to investigate blood vessels in a person’s head and ear
  • angiography to look at the inside of a person’s blood vessels using X-rays
  • magnetic resonance angiography to investigate any narrowing or irregularities in a person’s blood vessels
  • computed tomographic angiography to create detailed pictures of blood flow in a person’s neck and head
  • ultrasound scans to look at the blood flow inside a person’s neck

Additionally, doctors may use these scans to determine if a person has paraganglioma.

Which PT treatment doctors prescribe depends on the causes and progression of a person’s PT. Identifying the cause of a person’s PT is important for appropriate treatment.

PT treatments include:

  • surgery
  • observation, or watching and waiting to see if the condition improves
  • medical management, which may involve a doctor prescribing certain medications depending on the underlying cause

Doctors may offer tinnitus treatments to people with PT to help reduce or manage symptoms, such as:

However, no studies have investigated how well these treatments help people with PT.

The main treatment for paraganglioma is surgery to remove the tumor. Doctors may also use other types of treatment to reduce symptoms caused by the tumor.

If a person has PT symptoms, they should seek professional medical attention. Doctors can accurately diagnose the cause of a person’s PT and recommend appropriate treatment.

Correctly identifying the cause of PT is important for successful treatment. Some causes of PT, such as cardiovascular disease, may have serious complications. Diagnosing and treating these conditions early can help improve a person’s outlook.

People with PT often hear rhythmic noises from inside their body. Most people with PT hear these sounds in one ear. Changes to a person’s blood flow causes PT. A range of conditions can cause these changes, including high blood pressure, atherosclerosis, and tumors such as paragangliomas.

Doctors use several methods, such as hearing tests, imaging scans, and physical examinations, to diagnose the cause of a person’s PT. Accurate diagnosis is important for successful PT treatment. Therefore, a person should speak with a doctor if they believe they are experiencing PT in one ear.