Q. My MRI and CT reports are normal, yet I have pulsatile tinnitus 24 hours a day. Why?

Answered by
Dr. Chirag Solanki
and medically reviewed by Dr. Sushrutha Muralidharan
This is a premium question & answer published on Jul 13, 2021 and last reviewed on: Aug 13, 2021

Hi doctor,

I have had pulsatile tinnitus for the past three months 24 hours a day. It is loud, except when lying down, I am so upset. It is not my BP, although it has risen since the beginning of this. They upped my Benicar from 5 mg to 25 mg. so now it is fine. I have had every test like MRI brain and neck, MRA brain and neck, MRV and angiogram, CT of brain and neck. All were negative. My jaws hurt intermittently, and I do have bad TMJ. I have seen two ENT doctors and one neurologist. One ENT doctor said it could be from TMJ. The other two doctors said no. So I just got a mouth guard at night. It has helped with the pain in my jaws. I am so upset. Do you think it could be from TMJ? If not, any suggestions on what to do next? Kindly guide me.



Welcome to

As all the tests, including MR (magnetic resonance), CT (computed tomography), etc., have turned out to be normal, there is no secondary reason causing tinnitus. So the problem lies inside the inner ear, only nothing else.

TMJ disease process, especially if inflammatory or infective, may affect the ear, causing tinnitus but not very common. It is your inner ear only that is causing the problem. And which might be difficult to objectively test for.

The thing you have not mentioned is if the tinnitus is continuous or episodic and if you have deafness in any ear or not. If the testing for deafness was done or not? Is there any change in tinnitus over the last three months if it is improving or worsening? Kindly answer the questions so that I can guide you accordingly.

Hi doctor,

Thank you.

The pulse tinnitus is 24/7 continuous. I did have a CT of the temporal bone, and nothing showed. There has been no change in pulsing since it began. I did have a hearing test and had some hearing loss. My jaws occasionally ache around the ear area. It is in both ears. What do you think could be in my inner ear causing this? Why would it not show up on MRI or CT of temporal bone? Are there other tests I should have? Kindly give your opinion.



Welcome back to

If you have hearing loss in both ears, then it is more likely the problem with the ear or the ear's nerve only as MRI (magnetic resonance imaging) is not showing any positive finding. An MRI will not show anything when there are such issues. Please ask your ENT about the possibility of Meniere's disease also. I hope this was helpful.

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