Pulsatile Tinnitus and Antibiotics

Hi, I'm new on this board and have what will probably be a very unusual first post.

I started suffering from pulsatile tinnitus in my left ear in February of this year while I was in my last month of pregnancy. I figured it had something to do with the increased blood volume and/or constant congestion and that it would go away after the baby was delivered. Unfortunately, it only got worse as the months drew on. It was affecting my sleep as the sound was very loud -- like a screech-y machine.

I finally saw an ENT specialist in November, and he said he could also hear the noise with a stethoscope placed next to my ear. I had an MRI/MRA done, and the doctor said that the scans were completely normal. When he pressed on the artery below my ear, the sound would stop. As soon as he would let go it would start again. He suggested that I see a vascular surgeon for possible ligature of the artery.

Last night, I laid down, expecting the same clanging machinery I had been hearing for the past 10 months. There was only a very light, muffled scratching. And then it stopped. Just like that. Today, it's still gone.

I'm completely mystified. The only thing that changed was that in the midst of these doctor appointments and tests I developed bronchitis. The doctor who diagnosed that started me on a course of azithromycin. My last dose was on Sunday night. I've consistently read that antibiotics can cause or exacerbate tinnitus, but I'm wondering if somehow it helped me? Like perhaps the congestion I've been suffering from somehow caused this problem, and now that the congestion is clearing up, so is the tinnitus?

I'm unwilling to say it's "gone", since it hasn't even been 24 hours, but I'm optimistic. Any and all thoughts and comments on this are welcome. And to all of you suffering from this, I'm very sorry. I know how incredibly irritating and even debilitating it can be.

 

What you describe is so-called "objective" tinnitus (as opposed to subjective tinnitus). Objective tinnitus is rare, but unlike subjective tinnitus, there is at least some chance that it can be treated.

If the exams come back normal, then it can be difficult to proceed (obviously). I cannot really comment on what to do - except that visiting a specialist is not a bad idea (even if no immediate cause is found).

The following diagram shows an exhaustive list of all possible avenues that could/should be explored in relation to the various types of tinnitus (your type is found on the left side of the diagram...):

Any antibiotic with a medication name ending in -mycin is ototoxic; some more than others, however.

I would not have an opinion on that. I am aware that some people may benefit from antibiotics under certain circumstances eg. people with Lyme's disease (and who develop tinnitus because of that) may benefit from a course of antibiotics.

 

That is a fantastic chart, @attheedgeofscience. Thanks!

Also, fantastic news, @bikinibottom! I have been reading a lot on Whooshers about how pulsatile tinnitus can resolve on its own if the condition is a neurovascular complication -- and at least the circulatory component of that neuromuscular complication part seems to have been verified by the ENT. Were I you, I would still undergo consultation with a vascular surgeon to determine the cause -- as PT that spontaneously vanishes as a fair recurrence rate later in life, I have read.

Keeping you in my thoughts!

 

Thanks to both of you for your thoughtful posts. I appreciate the recommendation to move forward with seeing the vascular surgeon, despite the PT being "gone" (for now).

 

@bikinibottom did your PT ever come back after taking the antibiotics?