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Pulsatile Tinnitus & Ear Clicking
Tone Matching & Generation


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Pulsatile Tinnitus & Ear Clicking Matching

In order to most closely mimic the sounds a person may hear inside their ear (or head), this sound generator is best used with headphones with the volume set away from the maximum. If you hear a continous tinnitus tone, use our tinnitus matching tool here instead.

** PLEASE NOTE! If you have any problems getting this webpage to work, please try using the Chrome browser instead and make sure javascript is enabled!




Loudness Fluctuation

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First, click PLAY and find the sound quality that most closely matches what you hear from the bottom row of buttons. This section is divided into regular and irregular sounds. Regular denotes a tempo that is rhythmic (like a heartbeat) whereas irregular denotes sounds that have no rhythm, occuring completely at random moments, like a geiger counter.

Next, you can adjust the pitch and speed using the first 2 sliders. You can also specify whether there is any variability or fluctuations in the loudness of the sounds you hear using the 3rd slider.

Finally, all your custom tinnitus settings can be saved as a link via the SAVE SETTINGS button. The settings will be copied to the clipboard. By pasting, you can share this custom unique link as a bookmark or share with others what you experience.

In order to bring greater awareness to this problem, use the hashtag #ihavetinnitus, #tinnitusshare when sharing on social media.

Watch video instruction on using this webpage.

For more information about pulsatile tinnitus as well as irregular ear clicking.

Please note that there are NO digital volume settings other than manipulating your device's/computer's volume buttons. Click here for an explanation why.

Check out generic tinnitus treatment options in our online store or generate your very own personalized white noise sound or notched audio.



Background Information

Pulsatile tinnitus is generally described as a rhythmic whooshing noise which occurs in time with one's heartbeat (feel your pulse on your neck or wrist and see if it occurs in sync with the noise in the ear). This type of tinnitus mandates a medical work-up with radiological tests (cartoid ultrasound, CTA, MRA/MRV) as well as bloodwork (CBC, TSH). This particular form of tinnitus may be treatable depending on what is ultimately found to be abnormal. Such abnormalities include TMJ, carotid stenosis/dissection, high-riding jugular bulb, vascular hyperdynamic states (hyperthyroid or anemia), intracranial hypertension, etc.

This symptom may also occur if there is a temporary conductive hearing loss due to eustachian tube dysfunction, ear infection, or serous otitis media. In these circumstances, the pulsatile tinnitus should resolve once the ear issue improves and the conductive hearing loss disappears.

Of note, at least in caucasian white females, intracranial hypertension is one of the most common causes of pulsatile tinnitus once middle ear conditions have been ruled out.

Arrhythmic tinnitus has a few causes, some which are easily treatable, and another that may even require surgery. The easily treatable kind is removal of any object that is resting against the eardrum such as a piece of hair or foreign body. The more frustrating kind is when one of the 2 muscles (tensor tympani or stapedius) found in the ear starts twitching, much like the more common eye-twitching. Otherwise collectively known as middle ear myoclonus... these muscle are not able to be visualized as they are located within the middle ear. The tensor tympani attaches to the malleus ossicle (the "hammer" of the 3 middle ear bones) and the stapedius muscle attaches to the stapes ossicle (the "stirrup").

The stapedius muscle is the smallest skeletal muscle in the human body. At just over one millimeter in length, its purpose is to stabilize the smallest bone in the body, the stapes. The tensor tympani is a muscle located in a bony canal above the eustachian tube and connects to the malleus bone. Its main role is to dampen loud sounds, such as those produced from chewing, shouting, or thunder. Because its reaction time is not fast enough, the muscle cannot protect against hearing damage caused by sudden loud sounds, like explosions or gunshots.

Just like any muscle in the body, these muscles can also "twitch" rapidly causing the clicking noise in the ear. Tensor tympani muscle spasms typically produce a clicking/fluttering sound whereas stapedius muscle spasms produce more of a buzz/click sound. About 80% of patients suffering from middle ear myoclonus recall either a triggering stressful event or sudden loud noise exposure.

Middle ear myoclonus (MEM) produced noises occur completely at random without any associated correlation with external triggers. Tonic tensor tympani syndrome (TTTS) produced noises also occur randomly, BUT is associated with external triggers typically occurring with certain sounds/pitches (for example, occurs only with talking, hearing a child cry, swallowing, etc).

Unfortunately, there is no "test" one can obtain to definitively diagnose this problem with absolute certainty. One can infer there may be an issue by observing twitching of the eardrum under endoscopic magnification. Abnormalities may be seen on stapedial reflex and acoustic reflex decay. However, really the best way to diagnose is based purely on history and excluding palatal myoclonus as a diagnosis (no soft palate twitching seen even though the patient is able to hear it).

One can try to treat this condition with TriMagnesium 500mg total per day and if that fails, consider even trying muscle relaxants and anticonvulsants (ie, flexeril, neurontin, dilantin). One study found that tegretol (anti-convulsant) with baclofen (muscle relaxant) worked best.

However, ultimately the only way this problem can be definitively treated is surgical... the muscle gets cut. Botox can NOT be utilized as one needs to be able to "see" or "feel" the muscle in order to inject botox. This surgery is performed by a neuro-otologic surgeon.