A poofing sound in the ear is one of the many symptoms of tinnitus and can be caused by a variety of factors. If the ringing sound is associated with head movement and occurs during head movement but not in a quiet state, it is considered to be caused by a foreign body in the external auditory canal, which can be caused by fine hair, small particles or small pieces of cerumen that can hit the eardrum with head movement. If this tinnitus sounds like running water and is accompanied by hearing loss and stuffy feeling in the ear, and the symptoms are relieved when lying down and aggravated when sitting or standing, it is considered to be caused by secretory otitis media; if the puffing sound in the ear is consistent with the rhythm of heartbeat and pulse, it is considered to be pulsatile tinnitus, which is often related to cardiovascular diseases, such as hypertension and jugular venous bullae.