Sinus wall reconstruction for sigmoid sinus diverticulum and dehiscence: a standardized surgical procedure for a range of radiographic findings

Otol Neurotol. 2011 Sep;32(7):1116-9. doi: 10.1097/MAO.0b013e31822a1c7d.


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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cranial Sinuses / diagnostic imaging
  • Cranial Sinuses / surgery*
  • Diverticulum / diagnostic imaging
  • Diverticulum / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Plastic Surgery Procedures / methods*
  • Radiography
  • Retrospective Studies
  • Vascular Diseases / diagnostic imaging
  • Vascular Diseases / surgery*