Hi,
Noted your rare history of feeling of pulsation in ear, on and off, feels like pressure build up, not constant, not in time with heart beat.
The commonest causes I can think about are as follows:
Fluid build up in middle ear and mastoid due to infection getting from nose via Eustachian tube, resolving on its own and you getting asymptomatic.
A condition called glomus jugulare can cause such symoms.
Vascular malformation around the
inner ear or inside.
This can be diagnosed by the following ways:
Consult an ENT Surgeon for proper clinical evaluation, ENT
Endoscopy and investigations.
MRI and MRA of the affected area.
Audiometry.
Relevant blood tests.
All these will give proper diagnosis when done when in symptoms phase.
Take care. Hope I have answered your question. Let me know if I can assist you further.
Regards,
Dr. T. Chandrakant, ENT & General Surgeon