Endovascular treatment of pulsatile tinnitus due to superior petrous sinus stenosis and superior semicircular canal dehiscence.

Abstract

Pulsatile tinnitus is a debilitating symptom that can have many different origins.1 2 In most cases, an underlying cause can be identified and venous stenting is an effective treatment for vascular causes such as dural sinus stenosis.3 Superior semicircular canal dehiscence4 5 by the superior petrosal sinus (SPS) is a rare cause of pulsatile tinnitus.6 Surgery is effective for improving symptoms but it is invasive and has a higher rate of complications.7 Endovascular treatment should be considered as an alternative to surgery for these cases. ⁸ We describe a case of pulsatile tinnitus secondary to an SPS stenosis and dehiscence of the superior semicircular canal (video 1). neurintsurg;17/8/794/V1F1V1Video 1 Superior petrous sinus stenting. Stenting of the SPS was performed under conscious sedation after a clear reduction of pulsatile tinnitus following the temporary partial deployment of the stent. Follow-ups demonstrated patency of the stent with the persistent complete resolution of tinnitus. This case illustrates the utility of temporary stent deployment under conscious sedation to establish causality between SPS stenosis and pulsatile tinnitus.