Editing Tinnitus (section)

=== Pulsatile tinnitus ===
Some people experience a sound that beats in time with their pulse, known as ''pulsatile tinnitus'' or ''vascular tinnitus''.<ref name="Pulsatile tinnitus August 2017">{{cite web |last1=McFerran |first1=Don |last2=Magdalena |first2=Sereda |title=Pulsatile tinnitus |url=https://www.actiononhearingloss.org.uk/-/media/ahl/documents/publications/factsheets-and-leaflets/factsheets/tinnitus/factsheet-pulsatile-tinnitus.pdf |website=Action on Hearing Loss |publisher=Royal National Institute for Deaf People (RNID) |access-date=22 July 2018 |archive-date=22 July 2018 |archive-url=https://web.archive.org/web/20180722095632/https://www.actiononhearingloss.org.uk/-/media/ahl/documents/publications/factsheets-and-leaflets/factsheets/tinnitus/factsheet-pulsatile-tinnitus.pdf |url-status=dead }}</ref> Pulsatile tinnitus is usually objective in nature, resulting from altered blood flow or increased blood turbulence near the ear, such as from [[atherosclerosis]] or venous hum,<ref>{{Cite journal |author=Chandler JR |title=Diagnosis and cure of venous hum tinnitus |journal=The Laryngoscope |volume=93 |issue=7 |pages=892–895 |year=1983 |pmid=6865626 |doi=10.1288/00005537-198307000-00009|s2cid=33725476 }}</ref> but it can also arise as a subjective phenomenon from an increased awareness of blood flow in the ear.<ref name="Pulsatile tinnitus August 2017"/>

The differential diagnosis for pulsatile tinnitus is wide and includes vascular etiologies, tumors, disorders of the [[middle ear]] or [[inner ear]], and other intracranial pathologies.<ref>{{Cite journal |last1=Pegge |first1=Sjoert A. H. |last2=Steens |first2=Stefan C. A. |last3=Kunst |first3=Henricus P. M. |last4=Meijer |first4=Frederick J. A. |date=2017 |title=Pulsatile Tinnitus: Differential Diagnosis and Radiological Work-Up |journal=Current Radiology Reports |volume=5 |issue=1 |pages=5 |doi=10.1007/s40134-017-0199-7 |issn=2167-4825 |pmc=5263210 |pmid=28203490}}</ref> Vascular causes of pulsatile tinnitus include venous causes (e.g., high riding or dehiscent [[jugular bulb]], [[sigmoid sinus]] diverticulum), arterial causes (e.g., cervical [[atherosclerosis]], potentially life-threatening conditions such as [[carotid artery]] [[aneurysm]]<ref>{{Cite journal |vauthors=Moonis G, Hwang CJ, Ahmed T, Weigele JB, Hurst RW |title=Otologic manifestations of petrous carotid aneurysms |journal=American Journal of Neuroradiology |volume=26 |issue=6 |pages=1324–1327 |year=2005 |pmid=15956490 |pmc=8149044 }}</ref> or [[carotid artery dissection]]), or dural [[arteriovenous fistula]] or [[arteriovenous malformation]]s.<ref name="Carotid Artery Dissection">{{cite journal |last1=Selim |first1=Magdy |last2=Caplan |first2=Louis R. |title=Carotid artery dissection |journal=Current Treatment Options in Cardiovascular Medicine |date=June 2004 |volume=6 |issue=3 |pages=249–253 |doi=10.1007/s11936-996-0020-z |pmid=15096317 |s2cid=7503852 }}</ref> 

Pulsatile tinnitus may also indicate [[vasculitis]], or more specifically, [[giant cell arteritis]]. Pulsatile tinnitus may also be caused by tumors such as [[paraganglioma]]s (e.g., [[glomus tympanicum]], [[glomus jugulare]]) or [[hemangioma]]s (e.g., [[facial nerve]] or [[Cavernous hemangioma|cavernous]]). [[Middle ear]] causes of pulsatile tinnitus include [[Patulous Eustachian tube|patulous eustachian tube]], [[otosclerosis]], or [[middle ear myoclonus]] (e.g., [[Stapedius muscle|stapedial]] or [[Tensor tympani muscle|tensor tympani]] myoclonus). The most common [[inner ear]] cause of pulsatile tinnitus is [[Superior canal dehiscence syndrome|superior semicircular canal dehiscence]].<ref>{{Cite journal |last1=Ward |first1=Bryan K. |last2=Carey |first2=John P. |last3=Minor |first3=Lloyd B. |date=2017-04-28 |title=Superior Canal Dehiscence Syndrome: Lessons from the First 20 Years |journal=Frontiers in Neurology |volume=8 |pages=177 |doi=10.3389/fneur.2017.00177 |issn=1664-2295 |pmc=5408023 |pmid=28503164 |doi-access=free }}</ref> Pulsatile tinnitus may also indicate [[idiopathic intracranial hypertension]].<ref>{{cite journal |last1=Sismanis |first1=Aristides |last2=Butts |first2=Frank M. |last3=Hughes |first3=Gordon B. |title=Objective Tinnitus in Benign Intracranial Hypertension: An Update |journal=The Laryngoscope |date=January 1990 |volume=100 |issue=1 |pages=33–36 |doi=10.1288/00005537-199001000-00008 |pmid=2293699 |s2cid=20886638 }}</ref> Pulsatile tinnitus can be a symptom of intracranial vascular abnormalities and should be evaluated for ''irregular noises of blood flow'' ([[bruit]]s).<ref>{{cite encyclopedia | vauthors = Diamond BJ, Mosley JE | title = Arteriovenous Malformation (AVM) | year = 2011 | encyclopedia = Encyclopedia of Clinical Neuropsychology | veditors = Kreutzer JS, DeLuca J, Caplan B | publisher = Springer | isbn = 978-0-387-79947-6 | doi = 10.1007/978-0-387-79948-3 | pages = 249–252  | doi-access = free }}</ref>