How Venous Sinus Stenting Treats Pulsatile Tinnitus

The house goes quiet, you rest your head on the pillow, and the sound starts again. You hear a rhythmic whooshing in one ear that keeps perfect time with your heartbeat. For many people, pulsatile tinnitus makes sleep, focus, and conversation harder every day.

Pulsatile tinnitus usually comes from blood flow near the ear. When the cause is a narrowed vein inside the skull, a minimally invasive procedure called venous sinus stenting can correct it. The good news is that studies show 95% of patients treated with endovascular procedures for venous-related tinnitus said the sound went away completely. Read on to learn how stenting works, who qualifies, and what to look for when searching for the best doctor for venous sinus stenting in Thousand Oaks.

What Causes the Whooshing Sound in Your Ear?

Large veins called venous sinuses drain blood from the brain and pass close to the inner ear. If one of these veins narrows, blood speeds up and swirls as it squeezes through, causing you to hear that turbulent flow as a pulsing whoosh. Venous sinus stenosis is one of the most common treatable causes. Other possible sources include:

• Idiopathic intracranial hypertension, or a buildup of spinal fluid pressure around the brain
• A dural arteriovenous fistula, an abnormal link between an artery and a vein
• Thinning of the bone over a vein near the ear
• Narrowing of the carotid artery
• A blood vessel tumor near the ear
• High blood pressure, anemia, or an overactive thyroid

Signs Your Tinnitus May Have a Vascular Cause

Pulsatile tinnitus deserves a medical evaluation, especially if it starts suddenly or affects only one side. Clues that point to a blood vessel problem include:

• A sound that matches your pulse
• Noise in one ear more than the other
• A sound that softens when you press gently on the side of your neck
• Noise that gets louder when you lie down or turn your head
• Headaches or blurry vision along with the sound

Some people confuse pulsatile tinnitus with hearing problems. If you think you may be experiencing pulsatile tinnitus, keep a short log of when the sound starts, how long it lasts, and what makes it louder or softer. Bring the log and a list of your medications to your appointment with an endovascular specialist. These details help your specialist narrow down the cause.

How Vascular Specialists Confirm Venous Sinus Stenosis

Finding the exact cause guides the right treatment. A neurological evaluation for pulsatile tinnitus may include these steps:

• A physical exam, including listening near the ear and neck with a stethoscope
• MR venography or CT venography to create detailed pictures of the veins in your head
• A cerebral angiogram, which uses a thin catheter and contrast dye to map blood flow in real time
• Venous manometry, which measures the pressure on each side of a narrowed vein

A large pressure difference across the narrowing tells your specialist that a stent will likely help.

Pulsatile Tinnitus Treatment Options

What to Expect During Venous Sinus Stenting

Venous sinus stenting is a procedure that takes place in an angiography suite. During this procedure, a specialist inserts a small catheter into a vein in the groin or wrist and uses live imaging to guide it to the narrowed sinus. They then place a flexible mesh stent that holds the vein open so blood can flow smoothly again. 

The stent stays in place permanently. Most people spend a night or two in the hospital for monitoring and take antiplatelet medicine for several months to keep the stent clear. Many patients notice the whooshing fade within days, and full improvement can continue over several weeks. You can usually return to light daily activities within a few days, and your specialist will schedule follow-up imaging to confirm the vein stays open.

Who Is a Good Candidate for Venous Sinus Stenting?

Your care team may recommend stenting if:

• Imaging confirms a narrowed venous sinus
• Testing shows a meaningful pressure difference across the narrowing
• Pulsatile tinnitus disrupts your sleep, work, or mood
• Medications have not controlled symptoms of high spinal fluid pressure
• Headaches or vision changes suggest pressure is building

Looking for the Best Pulsatile Tinnitus Treatment in Thousand Oaks?

Our wide network of neurointerventional specialists at the Vascular and Neuroscience Institute uses venous manometry, detailed vein imaging, and image-guided stent placement to treat pulsatile tinnitus at its source. Our Thousand Oaks team also includes Dr. Nikil Swamy, a neurointerventional surgeon who treats arteriovenous fistulas and performs angioplasty and stenting. He has served as an investigator in more than 10 clinical trials and takes time to explain each step in plain language.

Patients searching for the best doctor for venous sinus stenting in Thousand Oaks can visit our Thousand Oaks office on Lynn Road, near Los Robles Regional Medical Center, to get accurate answers and effective treatment.