Pulsatile tinnitus sounds are tinnitus sounds that are synchronous with your heartbeat. Thus, pulsatile tinnitus is generally related somehow to the blood flowing in the blood vessels in your neck and head—close enough to your ears that you can hear them.
Although pulsatile tinnitus sounds are rhythmic pulsing sounds in time with your heart beat, they have a number of variations. For example, they may be drumming, beating, pounding, throbbing, pulsating or fluttering sounds. They may have single beats, or they may have biphasic beats (like the clip-clop of a horse). They may even make swishing, swooshing or whooshing sounds (to name some of them).

Here are some of the more common causes of pulsatile tinnitus. You may have what is called a glomus tumor. Glomus tumors occur in about 12% of diagnosed cases of pulsatile tinnitus. A glomus tumor is a non-cancerous mass of intertwined blood vessels growing near your ear. The blood pulsating through them could be causing your pulsatile tinnitus.
If you had a glomus tumor, perhaps it could also be pressing on something causing your pain. I don’t have a clue, of course—but a good ENT doctor (not all are good as you have found out) or a good vascular surgeon should be able to figure out what is going on, and whether it needs further investigation or treatment or not.

Another common cause of pulsatile tinnitus is “Benign Intracranial Hypertension” syndrome or BIH. BIH accounts for about 39% of all diagnosed cases of pulsatile tinnitus. BIH is increased pressure of the fluid that bathes your brain. This syndrome includes headaches and blurred vision among other things.

Pulsatile tinnitus could also be the result of Carotid Artery Disease (CAD) which accounts for 17% of all diagnosed cases of pulsatile tinnitus. With CAD, the “gunk” in your arteries (to use a fancy medical term—which is sure easier to spell than “atherosclerotic build-up of cholesterol”) reduces the space inside the arteries in your neck leading to turbulent blood flow which you hear as pulsatile tinnitus.