cause of pulsating sound in ears with hearing loss
In some instances of noise exposure, tinnitus can be noticed even before hearing loss develops, so it should be considered a warning sign and an indication of the need for hearing protection in noisy environments. Medications can also damage inner ear hair cells and cause tinnitus.
These include common entities such as middle ear infection and uncommon ones such as otosclerosis, which hardens the tiny ear bones or ossicles. Another, rare, cause of tinnitus from the middle ear that does not result in hearing loss is muscle spasms of one of the two tiny muscles in the ear.