Long-Term Outcomes of Sigmoid Sinus Wall Reconstruction for Pulsatile Tinnitus Due to Sigmoid Sinus Wall Anomalies.

Objective: To assess the long-term outcomes of sigmoid sinus wall reconstruction (SSWR) in patients with pulsatile tinnitus (PT) with sigmoid sinus wall anomalies (SSWAs).

Study design: Single-center retrospective review.

Setting: Tertiary referral center.

Patients: Patients who underwent SSWR for PT with SSWAs more than 5 years prior to study initiation.

Interventions: Therapeutic-all patients underwent sinus wall reconstruction for pulsatile tinnitus with sigmoid sinus anomalies.

Main outcome measures: The primary outcomes were complete or partial resolution of PT lasting at least 5 years postoperatively and short-term relief from PT after surgery with long-term recurrence as determined by a self-assessment questionnaire and corroborated by the medical record.

Results: Thirty-five patients (37 ears) out of 58 eligible patients 5 years postoperatively from SSWR completed the survey. Short-term and long-term success rates of SSWR are 97.3% (36/37 ears) and 83.8% (31/37 ears), respectively. Of the patients, 13.5% (5/37 ears) experienced recurrence of PT on the same side following initial resolution. Of our patients, 8.6% had a confirmed diagnosis of idiopathic intracranial hypertension (IIH) after a follow-up period of more than 5 years.

Conclusions: Sinus wall reconstruction is an effective procedure for long-term control of PT in patients with SSWAs, with an acceptable safety profile and very low additional risk of exacerbating or provoking complications associated with IIH.