Dehiscence of the sigmoid sinus and disabling pulsatile tinnitus: review of the different surgical options and proposition of a new surgical technique using a bone bank

In this report, we describe the case of a patient presenting with right pulsatile tinnitus secondary to dehiscence of the sigmoid sinus. This abnormality of the sigmoid sinus is considered to be a rare cause of pulsating tinnitus. Different surgical approaches are described in this article. We opted for a conservative technique without skeletonization or compression of the sigmoid sinus. The isolation of the sinus was achieved with shaped cortical femur bone from our bone bank and with autologous bone pate. This treatment significantly and durably relieved the patient. Thus, we believe it is possible, despite the importance of the anatomical abnormality, to treat this pathology surgically via a transmastoid approach. We describe a new conservative and less invasive surgical technique significantly limiting the risk of complications.