@morninglory

Did you have head and neck angiogram with CT scan done with contrast to rule out blood vessel malformations? Looks like you may benefit from a second opinion with ENT and Cardiologist focusing on blood vessel disorders.
Here is from Harvard on pulsatile tinnitus:
A. What you describe sounds like pulsatile tinnitus is a type of rhythmic thumping, pulsing, throbbing, or whooshing only you can hear that is often in time with the heartbeat. Most people with pulsatile tinnitus hear the sound in one ear, though some hear it in both. The sound is the result of turbulent flow in blood vessels in the neck or head. The most common causes of pulsatile tinnitus include the following:
Conductive hearing loss (ENT). This is usually caused by an infection or inflammation of the middle ear or the accumulation of fluid there. Carotid artery disease. The accumulation of fatty plaque inside the carotid arteries can create the kind of turbulent blood flow that resounds as pulsatile tinnitus.

High blood pressure (Cardiology). When blood pressure is high, blood flow through the carotid artery is more likely to be turbulent and thus cause a pulsating sound.

Blood vessel disorders (Cardiology). A variety of malformations and disorders are occasionally the source of pulsatile tinnitus. These include a blood vessel with a weakened, bulging patch (aneurysm), an abnormal connection between an artery and vein (arteriovenous malformation), twisted arteries, or a benign blood vessel tumor (glomus tumor) behind the eardrum.

By David M. Vernick, MD, Contributor: "If you were my patient, I would take a careful history (a patient's story often holds important clues), and then examine your ears. I would also use a stethoscope to listen to the blood flow through the arteries in your neck. If I did not find any obvious cause for your symptoms, I would likely recommend some additional testing, including a hearing test. If I heard a bruit (BROO-ee) — the unusual sound that blood makes when it rushes past an obstruction — in one or both carotid arteries, I would suggest you have a test to look for a narrowing in the carotid arteries or other malformations.

Most of the time, pulsatile tinnitus is nothing to worry about. If it doesn't go away on its own after a few weeks or becomes really bothersome, talk with your doctor about it."
https://www.health.harvard.edu/diseases-and-conditions/is-it-worrisome-to-hear-a-pulse-in-my-ear