As cicadas emerge across the United States, their loud, high-pitched noises signal the arrival of summer. These sounds, however, are temporary, lasting approximately four weeks. In contrast, millions of Americans experience a persistent noise long after summer ends—tinnitus.
Tinnitus is characterized by a buzzing, ringing, hissing, whistling or clicking sound in one or both ears without external noise. Nearly 20 million Americans suffer from this condition. Among them, five million have pulsatile tinnitus—a rhythmic pulsing noise that synchronizes with their heartbeat. Described as a "whooshing" sound similar to a baby's heartbeat on an ultrasound machine, this condition can be debilitating.
Dr. Ali Shaibani, an interventional neuroradiologist at Northwestern Medicine's Pulsatile Tinnitus Clinic, explains the impact: “While cicadas bring loud noises for a short period of time, it’s nothing compared to what patients with pulsatile tinnitus are hearing every single day.” He adds that some patients experience such severe interference in daily life that they have suicidal thoughts or attempt extreme measures to stop the noise.
Pulsatile tinnitus arises from blood vessel issues in the head and neck and ranges from harmless to dangerous conditions. Diagnosis involves hearing tests, physical examinations and imaging tests to understand the patient's internal state.
One common cause is idiopathic intracranial hypertension (IIHTN), where elevated pressure inside the head results from narrowed veins responsible for relieving cranial pressure. Dr. Shaibani compares this narrowing to how a whistle works: "When the two large veins that bring blood out of the brain are narrowed, it can cause the ‘whooshing’ sound." Treatment may involve medication or minimally invasive endovascular surgery in severe cases.
Aside from pulsatile tinnitus symptoms like "whooshing," IIHTN can cause daily headaches and vision issues that fluctuate with body position changes or jugular vein pressure adjustments. Treating the underlying cause often cures pulsatile tinnitus.
A less common but more dangerous cause is an arteriovenous shunt near the skull base. The Pulsatile Tinnitus Clinic staff conducts extensive testing to identify this condition, which is treatable using minimally invasive techniques.
Treatment options for pulsatile tinnitus include:
- Medications for underlying conditions such as hyperthyroidism, anemia or high blood pressure.
- Endovascular surgeries like stenting.
- Self-management techniques such as sound therapy and cognitive behavioral therapy if no underlying cause is found.
The Northwestern Medicine Pulsatile Tinnitus Clinic features a multidisciplinary team specializing in neurointerventional surgery, otolaryngology (ear, nose and throat), neurology and neuroradiology.
For appointments or more information, call 312-926-3185 or visit nm.org.
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