Sinus Wall Reconstruction for Sigmoid Sinus Diverticulum and Dehiscence

OBJECTIVE: To describe the radiographic presentation, surgical treatment, and complications of pulse-synchronous tinnitus (PST) due to sigmoid sinus diverticulum and dehiscence. STUDY DESIGN: Retrospective case series. SETTING: Tertiary care, academic medical center. PATIENTS: Thirteen patients (14 ears) surgically treated for PST due to sigmoid sinus diverticulum and dehiscence. INTERVENTION: Transmastoid reconstruction of the sinus wall with a standardized technique. MAIN OUTCOME MEASURE: Resolution of PST and complications of surgery. RESULTS: All patients had complete resolution of their PST after surgery. There were 2 major postoperative complications, neither of which resulted in permanent morbidity. CONCLUSION: Sigmoid sinus diverticulum and dehiscence is a surgically treatable cause of PST, with a high rate of success. The radiographic diagnosis may be subtle and easily overlooked. Complications of surgery can be serious, and vigilance must be maintained to ensure prompt diagnosis and treatment.