Vascular or Pulsatile Tinnitus

[Carolyn Triebold]

I had some severe ear wax and my internist used water to "blast it out". About 3-4 months after this I awoke to severe vertigo. I was in bed for two days as I continued to walk to my left. For two days I was nauseous when I was walking, I had vertigo for two weeks. Soon thereafter I developed vascular or Pulsative tinnitus. I have had that for over two years. It is exaggerated at night and I must use a earplug to mute the tinnitus to sleep. I have found that when I travel out of the Western United States the tinnitus does not bother me, however I struggle with it in the western states and in the Los Angeles area where I live. I would like to find some options to lesson the tinnitus which is present only part-time, most often at night. Thank you

 

[Dr. Nagler]

I had some severe ear wax and my internist used water to "blast it out". About 3-4 months after this I awoke to severe vertigo. I was in bed for two days as I continued to walk to my left. For two days I was nauseous when I was walking, I had vertigo for two weeks. Soon thereafter I developed vascular or Pulsative tinnitus. I have had that for over two years. It is exaggerated at night and I must use a earplug to mute the tinnitus to sleep. I have found that when I travel out of the Western United States the tinnitus does not bother me, however I struggle with it in the western states and in the Los Angeles area where I live. I would like to find some options to lesson the tinnitus which is present only part-time, most often at night. Thank you

Thank you for your inquiry.

I have a few thoughts about your history, and then I'll offer you a suggestion in response to your question.

In terms of your history, I doubt very much if the vertigo and tinnitus had anything to do with forceful ear syringing three or four months prior. Three or four hours, three or four days, maybe. But three or four months? Seems to me like too much time had elapsed to conclude some sort of causal relationship. More likely the two weeks of vertigo was due to some sort of virus that affected your vestibular system. And as far as your pulsatile tinnitus goes, "soon thereafter" is a bit too nebulous a term for me to draw a conclusion one way or another.

So basically, you have pulsatile tinnitus - and I presume you have had an appropriate work-up for pulsatile tinnitus, including an MRA that showed no evidence of a correctable lesion. You are seeking some relief at night because using an earplug to mute the tinnitus is not sufficient. My suggestion would be not to use an earplug (or earplugs) at night, but rather use a tabletop device (like a Brookstone Tranquil Moments unit) to add sound to your environment, perhaps on the white noise, brook, or rain setting. Do not try to cover your tinnitus with the sound; rather just play it softly in the background to take the edge off. We detect sensory signals in terms of contrast rather than absolute magnitude, and adding some background sound to your environment at night will serve to decrease that contrast and hopefully afford you some appreciable relief.

Hope this helps.

Dr. Stephen Nagler