Abstract
ObjectiveTo evaluate clinical characteristics and present surgical outcomes of PT caused by sigmoid sinus wall dehiscence (SSWD)MethodsThis study retrospectively reviewed 34 patients with PT who were diagnosed with SSWD in our institution between December 2008 and July 2013. Among them, 27 patients underwent sigmoid sinus wall reconstruction (surgery group) and 7 patients refused surgery (non-surgery group). Preoperative data were obtained from the patients’ medical records. All patients were followed up regularly for at least 25 months. Preoperative and postoperative computed tomography angiography (CTA) images were compared. Student’s t-tests were used to compare age, body mass index (BMI) and preoperative Tinnitus Handicap Inventory (THI) scores between the surgery and the non-surgery groups and to compare pre- and follow-up THI scores.ResultsThere was no significant difference in age, body mass index, or preoperative THI scores between groups. Following surgery, 14 patients had complete resolution, 5 had partial resolution, 7 experienced no change and PT was aggravated in 1 patient. The difference between preoperative and postoperative THI scores was significant. No severe complications were found postoperatively. Comparison of the preoperative and postoperative CTA images revealed that remnant unrepaired dehiscences were the cause of unsatisfactory outcomes following surgery. In the non-surgery group, PT remained largely unchanged.ConclusionsSigmoid sinus wall reconstruction is an effective and safe treatment for PT caused by SSWD. It is imperative that all regions of the dehiscence are sufficiently exposed and resurfaced during surgery.
Highlights
Pulsatile tinnitus (PT) is characterised by a rhythmic pulsing often in time with the heartbeat and is caused primarily by vascular anomalies [1, 2]
There was no significant difference in age, body mass index, or preoperative Tinnitus Handicap Inventory (THI) scores between groups
Sigmoid sinus wall reconstruction is an effective and safe treatment for PT caused by sinus wall dehiscence (SSWD)
Summary
Pulsatile tinnitus (PT) is characterised by a rhythmic pulsing often in time with the heartbeat and is caused primarily by vascular anomalies [1, 2]. The prevalence of sigmoid sinus anomalies in PT patients is about 20% [4,5,6] These sinus abnormalities have received increasing attention because PT caused by SSD and SSWD is curable with a high rate of success [7,8,9]. SSD and SSWD are closely related and often occur concurrently in patients with PT; each may be the sole cause of PT [14]. Both SSD and SSWD occur in nonPT patients [5, 6], the prevalence of SSD is lower than that of SSWD [5].
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