Surgical treatment of pulsatile tinnitus related to the sigmoid sinus

Xing, Yuxuan; Gao, Song; Zhou, Yuchen; Song, Shenghua; Lü, Ling; Chen, Jie; Dai, Yifei

doi:10.1016/j.joto.2022.10.001

Cited by 4 publications

(2 citation statements)

References 20 publications

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“…Several studies reported that the conventional transmastoid approach has disadvantages such as prolonged surgical and recovery time, attributed to a sizable incision and excessive drilling 13 . Additionally, these studies demonstrated a relatively high risk of sigmoid sinus injury, venous thrombosis, and aesthetic problems 14 . Eisenman 8 reported that two out of 14 patients experienced major complications: one presented with visual loss and intracranial hypertension, while the other presented with progressive headache and ipsilateral sinus thrombosis.…”

Section: Discussionmentioning

confidence: 99%

“…13 Additionally, these studies demonstrated a relatively high risk of sigmoid sinus injury, venous thrombosis, and aesthetic problems. 14 Eisenman 8 reported that two out of 14 patients experienced major complications: one presented with visual loss and intracranial hypertension, while the other presented with progressive headache and ipsilateral sinus thrombosis. Song 15 underscored the importance of considering potential issues such as sinus violation during dissection, formation of dural sinus to mastoid air cell fistula, or delayed dural arteriovenous fistula formation when employing the conventional surgical approach.…”

Section: Discussionmentioning

confidence: 99%

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Tailored re‐roofing technique for pulsatile tinnitus caused by sigmoid sinus dehiscence or diverticulum

Lee,

Na,

Hur

et al. 2024

Laryngoscope Investig Oto

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BackgroundSigmoid sinus diverticulum/dehiscence (SSD) is one of the treatable causes of venous pulsatile tinnitus. It can be diagnosed using temporal bone computed tomography (CT) or magnetic resonance angiography/venography (MRA). In cases where patients find their symptoms intolerable, surgical treatment is typically preferred. Here, we have presented a novel surgical technique involving sigmoid sinus re‐roofing and have analyzed its feasibility.MethodsBetween January 2020 and July 2023, approximately 150 patients with pulsatile tinnitus were evaluated at two different tertiary hospitals. Of these, 12 patients were diagnosed with SSD, and seven underwent surgical treatment. Five patients were treated with tailored reroofing (TRR) of the sigmoid sinus and two with transmastoid resurfacing (MRS) of the sigmoid sinus. We compared the Korean tinnitus handicap inventory (K‐THI) score, pure tone audiogram (PTA) threshold, and CT findings before and a month after surgeries for these two techniques. The operation time was also analyzed.ResultsIn TRR cases, the K‐THI score reduced from 55.0 ± 31.4 preoperatively to 4.0 ± 3.0 postoperatively, and the SSD was well‐repositioned and covered by a bone chip postoperatively. In MRS cases, the K‐THI score reduced from 41.0 ± 9.9 preoperatively to 15.0 ± 21.2 postoperatively, and the SSD was well‐covered with bone cement postoperatively. The average surgical time of five TRR and two MRS cases were 77.5 ± 32.5 and 174.0 ± 75.0 min, respectively. No complications were noted.ConclusionsDespite the insufficient number of cases, we noted that TRR requires a reasonable amount of time, involves a smaller incision, and may provide favorable outcomes compared to conventional MRS in cases of pulsatile tinnitus associated with SSD.Level of evidenceIV.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Tailored re‐roofing technique for pulsatile tinnitus caused by sigmoid sinus dehiscence or diverticulum

Lee,

Na,

Hur

et al. 2024

Laryngoscope Investig Oto

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What should otolaryngologists know about dural venous sinus stenting?

Mamikoglu,

Cooper,

Stidham

et al. 2024

Eur Arch Otorhinolaryngol

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Endovascular vs surgical treatment of sigmoid sinus diverticulum causing pulsatile tinnitus: A systematic review

Sathya,

Nguyen,

Klein

et al. 2024

Interv Neuroradiol

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Introduction Sigmoid sinus diverticulum (SSD) has been increasingly reported as a cause of pulsatile tinnitus (PT). While both endovascular and surgical treatments have been used, there is a lack of consensus on the treatment modality to treat SSD. We conducted a systematic review of the available literature to compare the clinical outcomes and safety of endovascular versus surgical approaches for treating SSD. Methods A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses to identify studies encompassing the management of SSD. Studies reporting the clinical outcomes and safety of endovascular or surgical treatments for SSD between January 2000 and January 2023 were included. Results were characterized using descriptive statistics. Results Endovascular treatment (EVT) was reported by 17 articles, yielding 26 patients with 27 diverticula. Surgical treatment was reported by 20 articles, yielding 105 patients with 107 diverticula. EVT led to complete or near-complete resolution in all patients with SSD and PT. Complications occurred in 3.7% (1/27) with a return to baseline after 2 months. There were no permanent complications from EVT. Surgical treatment resulted in complete resolution in 77.6% (83/107) of cases, incomplete resolution in 11.2% (12/107), and no resolution in 11.2% (12/107). Significant complications occurred in 9.3% (10/107) of the surgical-treated patients. Conclusion EVT in patients with PT and venous diverticulum appears more effective and safer than surgical treatment, but large studies are lacking. Studies directly comparing endovascular and surgical treatment are needed.

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Surgical treatment of pulsatile tinnitus related to the sigmoid sinus

Cited by 4 publications

References 20 publications

Tailored re‐roofing technique for pulsatile tinnitus caused by sigmoid sinus dehiscence or diverticulum

Tailored re‐roofing technique for pulsatile tinnitus caused by sigmoid sinus dehiscence or diverticulum

What should otolaryngologists know about dural venous sinus stenting?

Endovascular vs surgical treatment of sigmoid sinus diverticulum causing pulsatile tinnitus: A systematic review

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