I have suffered with Pulsatile Tinnitus for over ten years. My PS is a rhythmic hissing sound that is in sync with my heat beat. The sound is mostly on the left side. I have had most ever test, exam, scan/image done to try to determine what the cause of my PS is from. Most recently I went to see Michael J, A, Robb, MD Robb Oto-Neurology Clinic in Phoenix, AZ. He specializes in disease and disorders of the ear and the brain including vertigo, dizziness, imbalance, tinnitus, ringing and sensitive ears. They performed a CT scan of the temporal bones w/out contrast. This was a much more sensitive CT exam then was conducted before. What they found was "There is a severe focal thinning or dehiscence involving the floor of the left middle cranial fossa at the level of the left temporomandibular joint. The clinical significance of this finding in this patent is not certain." I guess what this means is the bone in the scull that separates the left side of the ear is very thin. The doctor believes that this is what may be causing my PS tinnitus. I am hearing the blood rushing through the veins and arteries on the left side of my head. The doctor feels this is correctable by relining the left side of the base of the skull at the left middle cranial fossa at the level of the left temporomandibular joint. I would love to get rid of my PS but this procedure sounds like brain surgery. The surgery according to the doctor, involves lefting the brain while the base of the skull is relined. I will be getting a second opinion. I will most likely live with this problem unless someone can convince me that this will correct my PS and the risk of the surgery is low. My PS effects my hearing and makes it very difficult to sleep at night. My question to the doctor is how did the bone in the base of the skull become thin to cause the PS. My PS suddenly showed up one morning when there was nothing there before. The doctor has me on a regiment of vitamins base on recent blood work that showed low levels of various constituents. I will be getting my blood retested in 3-months. Any comments from anyone that has a similar problem or diagnosis would be appreciated .