Stent Placement for Disabling Pulsatile Tinnitus Caused by a Lateral Sinus Stenosis: A Retrospective Study

Oper Neurosurg (Hagerstown). 2017 Oct 1;13(5):560-565. doi: 10.1093/ons/opx026.

Abstract

Background: Lateral sinus stenosis is a little-known cause for pulsatile tinnitus (PT). In several small series, stenting has been described as an effective treatment for disabling PT linked with this type of stenosis.

Objectives: To describe the clinical, radiological, and manometric characteristics of patients treated for disabling PT by lateral sinus stenosis. Assessment of the efficacy of stenting for this indication.

Methods: Retrospective study of patients treated for isolated PT by stenting of a lateral sinus stenosis in our institution, between 2009 and 2015.

Results: Fourteen patients were included in our study. All of them were women. The median age at the onset of symptoms was 39.0 (21.0) years. The median body mass index was 28.5 (7.0) kg/m 2 . Stenting of the lateral sinus led to the disappearance of PT without recurrence in 13 patients. In one patient, stenting did not modify the noise. In this case, another cause of PT was diagnosed after stent placement.

Conclusion: Lateral sinus stenosis is a curable cause of venous PT. Other causes of PT must be ruled out before an endovascular treatment is undertaken, due to the frequent asymptomatic nature of Pacchioni granulations in the lateral sinus. Treatment by stenting is effective in all cases, provided that stenosis underlies the PT.

Keywords: Pulsatile tinnitus; Stent.

MeSH terms

  • Adult
  • Aged
  • Constriction, Pathologic / complications*
  • Constriction, Pathologic / diagnostic imaging
  • Cranial Sinuses / diagnostic imaging
  • Cranial Sinuses / pathology*
  • Endovascular Procedures / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Image Processing, Computer-Assisted
  • Magnetic Resonance Angiography
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stents*
  • Tinnitus / diagnostic imaging
  • Tinnitus / etiology*
  • Tinnitus / surgery*