How to check for pulsatile tinnitus in the left ear

Pulsatile tinnitus in the left ear is a rhythmic tinnitus. The main cause is the blood vessels or muscles in the patient's head and neck. At this time, it is transmitted through the bones or blood vessels to reach the cochlea, making the patient feel it. At this time, timely examination should be carried out and the corresponding medical history should be understood. There are many causes of this tinnitus, the most common of which are vascular diseases, abnormal skull base veins, etc.

How to check for pulsatile tinnitus in the left ear

1. Medical history: Detailed inquiries about the patient's previous medical history of the ear and body systems, such as the history of use of ototoxic drugs, injury history, otitis media history, etc., are all of great value for the diagnosis of tinnitus. Also note the following points. (1) Age and gender: The incidence rate is lower in children and higher in the elderly, which is related to arteriosclerosis and nerve degeneration. (2) Acute onset: In the conduction system, Eustachian tube obstruction and acute otitis media are common, while in the sensory system, trauma, poisoning, blast, and Memeniere's disease are common. Those with a slow onset are often related to systemic diseases.

Common causes of pulsatile tinnitus are mostly caused by vascular abnormalities: one type is vascular lesions and malformations, such as abnormalities of the skull base venous system, arterial or venous malformations of the head and neck, etc. The most common clinical causes are high jugular glomus tumors and mastoid emissary vein malformations. The other type is hemodynamic abnormalities, such as severe anemia, hyperthyroidism, hypertension, and arteriosclerosis.

In addition to the above-mentioned high jugular glomus tumor and mastoid emissary vein malformation, vascular diseases that can cause pulsatile tinnitus include carotid artery aneurysm, carotid artery stenosis, arteriovenous fistula, and compression of the internal jugular vein by the hyperplastic transverse process of the atlas during cervical spondylosis. Anemia, hyperthyroidism, hypertension and arteriosclerosis may cause abnormal blood viscosity, increased cardiac output or changes in blood vessels, which may change the hemodynamics of blood supply to the skull and cochlea, thereby producing vascular murmurs, which in turn cause pulsatile tinnitus when transmitted to the cochlea.