Pulsing (throbbing) tinnitus

If this is caused by anaemia or hypertension drug treatment of these may be effective. If it is caused by intracranial vascular malformation or occlusive cranial vascular disease the treatment approach would be surgical.

It is reported that tinnitus caused by somatosounds are amenable to habituation and this may be assisted by retraining therapy (Jastreboff and Hazell, 1993).
MEDICAL MANAGEMENT OF ASSOCIATED OR CONSEQUENTIAL PROBLEMS WITH TINNITUS
In a considerable proportion of patients the actual perception of the tinnitus sound is probably less troublesome than the accompanying emotional and autonomic consequences and the functional effects on day to day life such as sleeplessness, fatigue, difficulties with concentration and memory lapses. These can be more deleterious to the individual than the noxious experience of tinnitus. These effects may occur whether or not the individual makes negative attributes to tinnitus, but negative attributions impede habituation to tinnitus. Drug treatments for tinnitus need, in order to be effective, to take into consideration these problems which people experience with tinnitus.
Before being seen in the tinnitus clinic many patients are put on sedative/hypnotic drugs for their insomnia. It is important to be circumspect in prescribing these drugs, and they should only be given for reasonably short periods. It is advisable to provide reasonable counselling for methods of combatting insomnia without drugs.
Association of anxiety and/or depression with tinnitus may be a two-way relationship, the causal direction is usually difficult to discern. If the condition is so severe as to be unable to benefit from counselling or professional psychological support, tranquilisers or antidepressants may be given careful consideration. It is best to cooperate/consult with psychologist and psychiatrist.
STIMULATORY OR PHYSICAL METHODS IN THE TREATMENT OF TINNITUS
These are treatment methods which aim to influence or affect the auditory system in ways which can rectify or modify its dysfunctional state in order to abolish or alleviate tinnitus. The following is a list of these methods of treatment:
Magnetic stimulation
Ultrasonic stimulation
Low intensity laser application
Transcutaneous electrical nerve stimulation (TENS)
Acupuncture
Hyperbaric oxygen therapy
Treatment of temporo-mandibular joint and myo-facial disorders
The above methods are beneficial in some patients but they are all open to further research and development.