clipped from: en.wikipedia.org In a minority of cases, a clinician can perceive an actual sound (e.g., a bruit) emanating from the patient's ears. This is called objective tinnitus. Objective tinnitus can arise from muscle spasms that cause clicks or crackling around the middle ear.[8] Some people experience a sound that beats in time with the pulse (pulsatile tinnitus[9]). Pulsatile tinnitus is usually objective in nature, resulting from altered blood flow or increased blood turbulence near the ear (such as from atherosclerosis or venous hum[10]), but it can also arise as a subjective phenomenon from an increased awareness of blood flow in the ear.[9] Rarely, pulsatile tinnitus may be a symptom of potentially life-threatening conditions such as carotid artery aneurysm[11] or carotid artery dissection.[12]