Patient's Query
Hi doctor,
I have a wooshing sound in my right ear that I have been paying attention to since about nine months (might have been here longer, maybe I just never paid attention to it). I asked my ENT about it, and I just want to double-check, because her statement kind of contradicts my research. She said my MRI was enough for this.
I have made the following observations:
It is not completely clear whether the sound is pulse-synchronous. Sometimes it seems clearly pulse-synchronous, but most of the time it feels more like a continuous wooshing noise.
It becomes louder when bending forward and when straining/bearing down with abdominal pressure. However, it does not become louder during a Valsalva maneuver.
It is only on the right side. -It is not muscle-related. Clenching the jaw or pressing the forehead/back of the head against the hand does not change it.
The intensity varies. It is not always present, but it is almost always audible with pressure or when bending forward.
I already did an MRI of the brain due to lightheadedness and dizziness, which I have had for about nine months.
MRI report findings:
The internal and external CSF spaces are of normal size.
No diffusion restriction. On SWI, there are no susceptibility artifacts suspicious for hemorrhage.
No focal parenchymal lesions.
No pathological intraparenchymal, leptomeningeal, or pachymeningeal contrast enhancement.
No mass lesion.
The major venous sinuses show patent contrast opacification and preserved flow voids.
On TOF angiography, there is a normal flow signal in the arteries at the skull base.
No evidence of intrasellar or intraorbital pathology.
Mild mucosal thickening of the paranasal sinuses. A few opacified mastoid air cells are present bilaterally.
I also did a Doppler ultrasound of the carotid and vertebral arteries. I am just worried about a correlation between my dizziness (which started after a focal tingling attack on my left upper forehead and face), my light visual symptoms, and this (possibly pulsatile) tinnitus.
I really appreciate any help you can provide.
Please guide.
Hi,
Welcome to icliniq.com.
I understand your concerns.
Regarding the whooshing sound in your right ear, the MRI (magnetic resonance imaging) results are comprehensive and reassuring. The scan included a standard brain examination, time-of-flight (TOF) angiography, and an evaluation of the venous sinuses, effectively ruling out critical vascular issues such as arteriovenous fistulas, stenosis, or aneurysms.
The fact that the sound intensifies when you bend forward or exert yourself, combined with your diagnosis of inappropriate sinus tachycardia, suggests that this tinnitus is likely benign. It seems to be related to hyperdynamic blood flow or individual variations in venous drainage rather than a dangerous structural issue.
Since the imaging confirmed open vessels and no intracranial pathology, your ENT (ear, nose, and throat) specialist's conclusion that the MRI results are sufficient is medically sound.
Additionally, your symptoms of dizziness and light visual disturbances may warrant a follow-up with a neurologist. This could help explore possibilities such as vestibular migraine or evaluate potential side effects from your current heart rate medications.
I hope this information is helpful to you. Please follow up with more details.
Thank you.
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