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The condition you describe is known as pulsatile tinnitus
This is commonly present on one side and usualy has an underlying cause which can be identified
A common cause in elderly patients is vascular stenosis that is blood vessels in head or neck area getting constricted.The disorderly blood flow produced due to this can cause the sound produced to be transmitted to the ear causing throbbing to be heard in the ear.
Stenosis in blood vessels can occur due to formation of plaque in the blood vessels or it can less commonly be caused by condition called fibromuscular dysplasia
Formation of aneurysms in the arteries of head and neck and especially dissecting aneurysms is another possible cause
Anatomical variations in the anatomy of blood vessels may also be responsible
Arterio-venous fistulas or intra cranial hypertension are other possible causes
Investigations including DSA ( digital subtraction angiography), MRI, CT scan and doppler tests may be needed to diagnose the underlying cause.You need to see an ENT surgeon and a neurosurgeon to get the underlying cause diagnosed and treated.
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