I Think I Have Somatosensory Pulsatile Tinnitus

Hi everyone.

I have had tinnitus for 7 years. The first things that I noticed was the fact that my tinnitus seemed to be pulsatile. It became very obvious when I was playing sports, when my heart started to beat faster.

My tinnitus is not just pulsatile: it's a high pitch sound. I do have hearing loss in the range between 8 kHz and 12 kHz. I can modulate it with jaw and neck movements, but I can also stop it by a strong compression of my jaw muscles.

I came across this article last week which helped me understanding my symptoms:

https://www.researchgate.net/public...type_That_Implicates_the_Somatosensory_System

I've never heard about somatosensory pulsatile tinnitus before. I just believed that my tinnitus was just somatic.

I would like to know what treatment/therapy I can try? I read that electrical acupuncture and physical therapy may work for this type of tinnitus.

I'm also curious to know if bimodal stimulation may work, such as Lenire, or Dr. Shore's device.

Thank you for your help and answers.

 

Are you saying your tinnitus is high pitched to the pace of your pulse. So pulse and hitch pitch come at the same time.

My tinnitus started like this. Now it has reduced to tinnitus and intermittent PT.

What other symptoms do you notice. Can you hear your neck movements, bone creaking, when you tap your neck below your ear, any microphone booming sounds?

I always thought this type of PT is due to the artery pulsing against the auditory nerve due to either arterial inflammation or nerve inflammation due to tinnitus.

 

Yes, sometimes my tinnitus is pulse and high pitch, it can alse be constant.
It is not a pulsatile tinnitus, It is a tinnitus caused by hearing loss and which has a somatosensory aspect.

 

I see, my case is as above.

So you never hear your pulse / blood flow in your ear?

 

No, I don't hear my blood flow.

 

I believe my tin. is pulsatory as well. It is a high pitched hiss (8500 Hz). But if I have the guts to really listen to it, I notice there is a slow beat to it, like a slow heart beat.
It must be somatosensory. I have other muscle and nerve issues too, from 'toxic overload' and I just found out that the TRPV's and TRPA1 , that i believe to play a role in my tinnitus, also play a role in my dysesthesia (burning pain of the skin; also from neck injury, like my tinn a year before that. )

Does your tin. spike after eating cinnamon or maybe even omega 3/ ~6 ?

 

I don't know, I don't think so.
Somatosensory pulsatile tinnitus is a subjective tinnitus, It will be hard for me to give more details about this particular subtype of tinnitus but everything is explained in the study.
If your tinnitus is high pitched and pulsatile and if you can make it quieter by compressing your jaw, it's very likely somatosensory pulsatile tinnitus.

 

When I stand up suddenly , My tinnitus gets louder and I hear it pulsing in my head. It just lasts a few seconds.

 

Per somatosensory tinnitus, after reading hundreds of medical journal articles where thousands of case studies are discussed, I have recorded about 50 different possible combinations. There's a big difference to cause between lateral and non-lateral.

C2 to C4 and even lower can activate the jaw, but other issues are far more common within the neck. The thyroid is sometimes seen activated with ST by ultrasound, but sometimes false readings are given. In most studies, it's the neck and cardiac, but cardiac sound can be compressed. For older men, the abdominal aortic may have involvement.

Some study theory is based on stress and hypertension while also twisting neck, head and shoulders where blood pressure rises suddenly and briefly as cause. Partials stuck to artery walls become loose due to fast pumping of blood and then they collect all together somewhere else in a vein or artery. After this happens, blood will pump with slow and fast actions causing sound. Michael who give a link to a well known article that dismisses that the vertebral artery as cause. Other studies say that if nothing is found by radiological testing, then it may very well be the vertebral artery. The vertebral artery could be cause from severe hypertension of neck such as with whiplash.

Spinal nerves and cranial nerves - V,VII, IX and X may have involvement. Jugular and Carotid from neck twisting - along with wrongful movement of the sternocleidomastoid (non lateral) while under great stress. If one can remember when they first noticed PT, then cause can be often determined. Testing pulses throughout the body with being in different positions has value. I have a link somewhere that has pages of pulse and position tests. It may takes a few nights, but sooner or later it's often possible to track flow while laying down. Different positions are needed.

Auditory systems as single cause is dismissed by most researchers. Healthcare and insurance only wants to do limited investigation - and it nothing shows, they will say it's the auditory system. They will say it's the occipital nerves and one needs to stretch them. I talked to a vascular doctor today, and he said that PT is never from blood flow, veins and arteries. He said it's hearing loss and the auditory system.

For those with severe tinnitus of any form beyond hearing loss due to sound , ears problems and medication causes, it's takes many hours of examinations. For floaters and vision associations, A pre 2 hour appointment is needed with a neuro eye center. Then that is soon followed by an eight hour session. For somatosensory tinnitus testing of pulses and physical exam can take days. Most studies where links are given, patient examination takes time.

 

I have both Pulsatile and Somatic type, however the high pitch somatic bothers a lot 24x7 I can still manage pulsatile as its on and off during the day. For the past two weeks the pitch in the right ear has gone up a notch and is affecting my daily life.

 

It isn't pulsatile tinnitus, then.

 

Hi @ThomasC

What did you mean by "compressing your jaw"? Did you mean "compressing your jaw muscle"?

I think the distinguishing points are as follows:

1. If you can make it quiet by on a muscle strongly contracting your jaw or neck muscle, AND pressing on the side of your neck (to suppress the carotid or jugular) does nothing to quiet the tinnitus, then it is somatosensory pulsatile tinnitus.

2. If you can quiet your tinnitus by pressing on the side of your neck AND strongly contracting your jaw or neck muscle provokes a spike in the pulsatile tinnitus, then it is traditional pulsatile tinnitus of vascular origin.

Levine's article on the "pulsatile somatosensory tinnitus" talks about "compression of the jaw and neck muscle" but I don't know what this means really.

 

I have very high pitched Tinitus that is pulsatile. I also have other symptoms which include a loud cracking noises when I turn my head. Was due to see an ENT a couple of days ago but Corona Virus cancelled it.

 

Somatosensory pulsatile tinnitus
Many studies on this that lead into many directions.

Summary thoughts from different studies that I think has importance:

The effect of spinal neurons that may also include trigeminal spinal neurons - granule cells.
They project or provide structural substrate for somatosensory information that influences auditory processing within central auditory pathways.

Often discussed is that spine body structure has changed from a head or neck injury. Some studies discuss the effect of vibrations either in upper neck or lower neck. So the physical somatic problems quickly can bring on the pulsing aspect, but often these sounds are not heard for years. Many in research state that this has nothing to do with the internal jugular vein.
It may be from all of this, failure of somatosensory auditory - CNS interactions to suppress cardiac somatosensory sounds and causes activation of the central auditory pathway.
Some medical articles provide physical aspect treatment, such as certain kinds of acupuncture and dry needling, but I'm still exploring this.

 

I have these same symptoms and it is indeed Pulsatile Tinnitus.

 

Did a doctor diagnose you, or are you diagnosing yourself then?

 

Today I noticed when I tap my neck below my ear it sounds exactly like a microphone booming. What does that mean is going on? Should I see a NUCCA chiro?

 

Sound reaches the inner ear through two modes of conduction - air conduction and bone conduction.
Has wax in the external auditory canal or fluid on the middle ear been ruled out?

Do a visual supine leg length check by looking into a wall mirror to see if one shoulder is lower that the other. Notice if there's less curve on one side where the neck meets the shoulders. If one side is lower may indicate that one sternocleidomastoid is off balance and this might cause a microphone sound when touching this noted area. The sternocleidomastoid is innervated by the accessory nerve. It also may be that this muscle is not off balance, but the accessory nerve is reacting to a cushion effect from this muscle. I doubt that microphone booming has anything to do with this muscle or neck, since for you - there's other possible associations.

Your accessory nerve may be reacting to your external auditory canal - middle ear. It could also be your jaw bones or TMJ muscles - reaction to accessory nerve.

I would get what I mentioned checked out and consider radiological testing before letting a
NUCCA chiro touch your neck for just this reason.

 

Thank you!

 

After 9 years of screaming, high pitched pulsatile tinnitus in my left ear, the only thing that helped at all was being fitted for a "Bite Splint". Basically a plastic appliance that I wear over my lower teeth 24 hours per day. The appliance allowed my TMJ to regain some spacing between the upper and lower portions of the joint. The joint was very narrowed and was worse on the left side due to bruxism (Deep channels in teeth). The Screaming high pitched Pulsatile Tinnitus level was reduced by about 30 to 50%.
The pulsatile tinnitus went from Completely Unbearable to barely tolerable. It is still present 24/7, as it has been for 9 years. But, at least, I was able to get off of the xanax. Since the PT is worse when I lie down on my back, I take Bi-Layer Melatonin, and gabapenten to aid in sleeping.

Neck position still has a large influence on the amplitude of the PT, but the jaw has less effect than before the appliance.

I was fitted for the appliance by The Atlanta Center for TMJ. It was very expensive and wasn't covered by insurance. My dentist says he could have done the same thing for me, but I wanted a specialist to get it right.

Over the last 9 years, I saw multiple Neurologists, Otologists, ENT, neck specialists, had acupuncture for months, had Physical Therapy, had 4D MRI Brain scans, Neck Scans, Ear Scans, MRI's, CAT scans, etc. Only slight neck disk issues were diagnosed. I don't have any neck pain, but I have vibrations (micro-spasms?) internal to neck. I believe the neck is the source of my PT.

 

I too have this hissing or some days high pitched pulsatile tinnitus in my left ear along with general head tinnitus and it also is very somatic. Slight movements of my jaw amplify it hugely. It came on after a cut in Paroxetine from 70mg to 40mg.

My doctor reckons it could be SSRI discontinuation and might fade or go away but I am not so sure. It is 5 weeks now and only minor improvement.

I also have mild hearing loss about 4 kHz and declining up to 8 kHz on the audiogram.

My question is... will FX-322 help with this if it can regrow hair cells? Or bimodulation? Is there any hope on the horizon?

 

When I'm stretching I can hear my neck movement and creaking. It's like I'm listening to my head through a stethoscope.

What could this be an indication of?

 

Me too. I have noticed in the last 6 to 7 weeks that my 3 month old tinnitus in my left ear is now somatosensory and pulsatile. It wasn't always this way. It matched my right ear but was softer than my right ear. My left WAS my good ear.

Now it is noisy, pulsatile, and revs up really loud when I move my head, touch my face, walk or chew. When I stand suddenly, get out of bed etc it gets louder and revs up really fast matching my heart rate.

It is in my brain more than my ear per se. A high pitch hissing usually (sometimes ringing) and it is loud and intrusive.

It there any treatment for this?

I have been reading journal articles and don't really understand the mechanism. Again, my left ear has only recently transformed into this. I am unable to reduce the noise though with pressure or movement, only increase it.

 

@AliasM, as you know, when someone sits on a chair with weights on the ground and bends over to pick up the weights and lifts them above head, then places the weights back down, pressure is placed on head and top of neck. Not as much on arms and abs.

One main reason why people may develop or suddenly feel tinnitus in head when tilting the head down to lift weights, occurs from inflammation and edema. As a rule, this causes the subsequent distorting, especially through the application of pressure.

Also physically, certain parts of the auditory tube and the tympanic membrane that may also cause pulsatile sound. Perception of sound signal is disturbed, since the transmission of impulses to the nerve endings to the brain is distorted. This would most likely also cause headaches.

In association, within the occiput, occipital nerve fibers may be inflamed that may not be easily noted by radiology examination after injury for sometime, unless by CT angiogram. If occipital nerves are involved, tenderness of scalp, headaches or modulation of tinnitus by facial and jaw touching or movement might gradually start to set in.

Often these phenomena seen are associated with ordinary periodic fatigue and exhaustion. Frequent lack of sleep, periodic stress, anxiety, disorders suggests that the body stops functioning properly. Correcting this, along with improper posture of bending head and lifting, eliminating exercises where head is bought down or twisted to side against range of motion is the required treatment and hence the wrong perception of sounds, i.e., noise/tinnitus may substantially improve.

Consider spending some time visiting proper posture sites. Hugs.

 

Thanks Greg. Your insight and advice is second to none. I really hope you are right and this can be improved with time and some changes. I am working with a new physio who has me doing some neuro tapping. I am sceptical but hey, I'll try it. I am not sure though. I read that cardiac synchronous somatosensory activation of the central auditory pathway can't really be undone.

One thing is for sure though, I am never EVER returning to the gym. There will be no more lifting. Gentle walks around my neighbourhood will be it for me moving forward. I ruined my life going to the gym.

How is your somatic tinnitus going? Are you making any improvements?

 

I’ve had tinnitus about 7 weeks now and had improved a bit. It’s pulsatile tinnitus. Had stayed away from the gym since I suffered a head/neck injury. I think the injury also brought on TMJ. Anyway, was doing a leg exercise and maybe forced it and held my breath. I noticed that my ear had clogged up and felt full. It made my tinnitus worse again. Must have put some pressure on my ear. Anyone idea does working out make the tinnitus worse?

 

Bumping the somatosensory pulsatile tinnitus thread to see if any have had any successes in treatment...