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Over the past few years I have taken care of hundreds of patients with pulsatile tinnitus. Many of them had serious, and potentially life-threatening, conditions (such as dural arteriovenous fistulas), and others had more benign problems, like a venous aneurysm or venous sinus stenosis. Some patients were suffering from catastrophic pulsatile tinnitus, while others could tolerate its symptoms.

What many of those patients have in common, though, is that almost every one of them was told at some point that there was nothing to be done to treat pulsatile tinnitus. They were advised to learn to “live with it.” That’s terrible advice, reflecting the lack of proper education many physicians have received on this topic.

The symptoms of pulsatile tinnitus should never be dismissed, since a diagnostic workup can lead to the discovery of one of those serious underlying health problems. If a workup fails to find the cause of the pulsatile tinnitus, at least we can reassure the patient that we have ruled out those life-threatening conditions. This information can be very comforting, and often allows a patient to cope better with pulsatile tinnitus.

In the best-case scenario, we find a cause – such as venous sinus stenosis – that is treatable. We offer a minimally invasive stenting procedure that in many patients can relieve the symptoms of pulsatile tinnitus.

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